Psychosocial factors and complications of IDDM. The Pittsburgh Epidemiology of Diabetes Complications Study. VIII.
OBJECTIVE
To investigate whether psychosocial factors are associated with diabetic complications.


METHODS
Questionnaires on quality of life, depressive symptomatology, and personality type were completed and a clinical assessment was performed. The study population was an incident cohort of childhood-onset insulin-dependent diabetic (IDDM) subjects whose duration of IDDM was greater than or equal to 25 yr (n = 175).


RESULTS
Patients with macrovascular disease (P less than 0.01) or nephropathy (P less than 0.05) reported significantly poorer quality of life compared with those who were free from all complications. Patients with macrovascular disease also reported greater depressive symptomatology (P less than 0.05). Quality of life significantly deteriorated according to the presence of multiple (greater than or equal to 4) complications (P less than 0.001). Higher depression symptom scores were also related to the presence of greater than or equal to 4 complications (P less than 0.001). Those with multiple complications reported less type A behavior than those without any complications (P less than 0.05).


CONCLUSIONS
This study shows that psychosocial differences exist according to both the number and the type of diabetic complications present. Because poorer quality of life and symptoms of depression may both result form complications, prospective follow-up is needed to clarify their temporal interrelationships, and to determine whether type A personality affords any protection against complications or is diminished as a result of developing complications.
Lloyd
C E
CE
Department of Community Medicine, University College and Middlesex School of Medicine, London, United Kingdom.
Matthews
K A
KA
Wing
R R
RR
Orchard
T J
TJ
D000328:Adult; D015331:Cohort Studies; D003863:Depression / Q000209:etiology; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology*; D003925:Diabetic Angiopathies / Q000523:psychology*; D003928:Diabetic Nephropathies / Q000523:psychology*; D003929:Diabetic Neuropathies / Q000523:psychology*; D003930:Diabetic Retinopathy / Q000523:psychology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D010551:Personality; D011788:Quality of Life; D012044:Regression Analysis
D006442:Glycated Hemoglobin