How does change in depressive symptomatology influence weight change in patients with diabetes? Observational results from the Pathways longitudinal cohort.
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.
Ludman
Evette J
EJ
Group Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101, USA. ludman.e@ghc.org
Russo
Joan E
JE
Katon
Wayne J
WJ
Simon
Gregory E
GE
Williams
Lisa H
LH
Lin
Elizabeth H B
EH
Heckbert
Susan R
SR
Ciechanowski
Paul
P
Young
Bessie A
BA
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*