title: The effect of depression on self-care behaviors and quality of care in a national sample of adults with diabetes.
abstract: OBJECTIVE
  To examine the effect of minor and major depression on self-care behaviors and quality of care among adults with diabetes.
  
  
  METHODS
  Data from 16,754 participants with diabetes in the 2006 Behavioral Risk Factor Surveillance Survey were examined. Multiple logistic regression was used to assess the independent association between depression status and indices of (1) self-care behaviors and (2) quality of diabetes care received, after accounting for confounders.
  
  
  RESULTS
  Individuals with minor (OR 0.69, 95% CI 0.57-0.84) and major (OR 0.50, 95% CI 0.39-0.64) depression were less likely to engage in leisure-time physical activity. Individuals with minor (OR 1.51, 95% CI 1.18-1.94) and major (OR 1.66, 95% CI 1.28-2.15) depression were more likely to be current smokers. With regard to quality of care, individuals with minor (OR 0.81, 95% CI 0.66-0.99) and major (OR 0.70, 95% CI 0.54-0.89) depression were less likely to receive an annual dilated eye exam. Additionally, individuals with minor (OR 0.79, 95% CI 0.65-0.95), but not major (OR 0.85, 95% CI 0.67-1.09) depression, were less likely to receive a flu shot in the past 12 months.
  
  
  CONCLUSIONS
  In adults with diabetes, both minor and major depression are associated with decreased self-care behavior and quality of care.
authors.affiliation: Department of Medicine, Center for Health Disparities Research, Medical University of South Carolina, Charleston, SC 29425, USA. egedel@musc.edu
authors.forename: Leonard E
authors.initials: LE
authors.lastname: Egede
authors.forename: Charles
authors.initials: C
authors.lastname: Ellis
authors.forename: Anouk L
authors.initials: AL
authors.lastname: Grubaugh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D040343:Behavioral Risk Factor Surveillance System; D003863:Depression; D003920:Diabetes Mellitus / Q000628:therapy*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011787:Quality of Health Care; D012648:Self Care; D055815:Young Adult