title: How does change in depressive symptomatology influence weight change in patients with diabetes? Observational results from the Pathways longitudinal cohort.
abstract: BACKGROUND
  Little is known about how change in depressive symptoms over time is associated with change in weight.
  
  
  METHODS
  Longitudinal associations between change in depression (Patient Health Questionnaire-9 [PHQ-9]) and weight (self-reported and chart abstracted) were examined in 2,600 patients with type 2 diabetes (mean age 62, SD = 11.6) who were surveyed by telephone in 2001-2002 and 5 years later as part of the Pathways study. Mixed effects regression analyses compared a) patients with persistently low depression symptoms with those whose depression worsened (increased at least 5 points on PHQ-9) over 5 years and b) patients with persistently high depression symptoms with those who improved (decreased at least 5 points on PHQ-9) over 5 years.
  
  
  RESULTS
  Those who worsened in comparison to those with persistently low depression symptoms did not differ in their pattern of weight change (z = 1.54, p = .12). Both groups weighed approximately 92 kg at baseline and lost approximately 2 kg. A significantly different pattern of change over time was observed for those with persistently high depression symptoms in comparison to those whose depression improved (z = 1.98, p = .04). Although the groups had almost identical weight at baseline (approximately 100 kg), at the 5-year assessment, those with persistently high depression symptoms had about half the weight loss (M = -1.71, SD = 9.08) in comparison to those whose depression improved (M = -3.62, SD = 19.93).
  
  
  CONCLUSIONS
  In persons with diabetes who have clinically significant levels of depressive symptoms, improvement in depression is accompanied by significantly greater, clinically significant weight loss.
authors.affiliation: Group Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101, USA. ludman.e@ghc.org
authors.forename: Evette J
authors.initials: EJ
authors.lastname: Ludman
authors.forename: Joan E
authors.initials: JE
authors.lastname: Russo
authors.forename: Wayne J
authors.initials: WJ
authors.lastname: Katon
authors.forename: Gregory E
authors.initials: GE
authors.lastname: Simon
authors.forename: Lisa H
authors.initials: LH
authors.lastname: Williams
authors.forename: Elizabeth H B
authors.initials: EH
authors.lastname: Lin
authors.forename: Susan R
authors.initials: SR
authors.lastname: Heckbert
authors.forename: Paul
authors.initials: P
authors.lastname: Ciechanowski
authors.forename: Bessie A
authors.initials: BA
authors.lastname: Young
mesh_terms: D001835:Body Weight / Q000502:physiology*; D003863:Depression / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology / Q000523:psychology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000503:physiopathology / Q000523:psychology; D011379:Prognosis; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D015431:Weight Loss / Q000502:physiology*