Assessing the association of depression and anxiety with symptom reporting among individuals with type 2 diabetes

J Behav Med. 2020 Feb;43(1):57-68. doi: 10.1007/s10865-019-00056-x. Epub 2019 May 20.

Abstract

Depression and anxiety have been linked to increased somatic symptoms among individuals with type 2 diabetes (T2D), but their independent effects and role in symptom attributions remain unclear. This study examined depression and anxiety in relation to total symptoms and symptom attributions in a diverse sample of 120 adults with T2D. Multiple linear regression tested associations after controlling for medical comorbidities and insulin use. Clinician-rated depression (β = .53, p < .001), self-reported depression (β = .59, p < .001) and self-reported anxiety (β = .62, p < .001) were positively associated with total somatic symptoms. Models adjusting for depression and anxiety revealed significant independent effects for each, regardless of measurement method. In attribution models, only self-reported depression (β = .27, p = .003) was significantly associated with greater attribution to diabetes, whereas clinician-rated depression (β = .19, p = .047), self-reported depression (β = .38, p < .001) and anxiety (β = .28, p = .004) were associated with increased attribution to medications. In models adjusting for depression and anxiety, self-reported depression was a significant independent predictor of diabetes (β = .29, p = .023) and medication (β = .38, p = .004) attribution; anxiety was a significant predictor of medication attribution (β = .25, p = .039). Findings suggest depression and anxiety are implicated in overall increases in somatic symptom complaints and an increased tendency to attribute these symptoms to diabetes and side-effects of diabetes medications among adults with T2D.

Keywords: Anxiety; Depression; Diabetes mellitus; Signs and symptoms; Type 2.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anxiety
  • Anxiety Disorders / epidemiology*
  • Comorbidity
  • Depression / complications
  • Depression / epidemiology*
  • Depressive Disorder, Major
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / psychology*
  • Female
  • Humans
  • Male
  • Middle Aged