title: Impact of depression on health related quality of life in patients with diabetes.
abstract: BACKGROUND
  Diabetes mellitus (DM) is a serious chronic illness that has a major impact on the quality of life of the individuals. Our aim was to examine the determinants of health-related quality of life (HRQOL) in patients with DM.
  
  
  METHODS
  Adult outpatients attending a Diabetes Centre were recruited on consecutive basis between August 2006 and February 2007. Clinical data were collected from interviews with the subjects and from medical records. Assessment of depressive symptoms was done using the Center for Epidemiologic Studies Depression Scale (CES-D) and HRQOL using the Short Form 36 Health Survey (SF-36). A two-step regression analysis was conducted for identifying factors affecting patients' quality of life.
  
  
  RESULTS
  Five hundred and thirty-seven patients participated in the study. The mean (SD) age of the participants was 54.7 (13.3) years and 315 (58.7%) were males. The prevalence of depressive symptoms was 31.1% (n = 167). After adjusting for other variables, the effects of depressive symptoms persisted for all the 8 domains of SF-36 (P <0.001 for all). The medical factors that were negatively associated with HRQOL were a diagnosis of Type 1 DM, duration of the illness of more than 10 years, HbA1c levels of ≥7%, and comorbidity of stroke and retinopathy. Being male and a regular exerciser had a positive effect on HRQOL.
  
  
  CONCLUSIONS
  These findings highlight the importance of detecting and treating comorbid depression in DM.
authors.affiliation: Department of Early Psychosis Intervention, Institute of Mental Health, Singapore. Swapna_Verma@imh.com.sg
authors.forename: Swapna K
authors.initials: SK
authors.lastname: Verma
authors.forename: Nan
authors.initials: N
authors.lastname: Luo
authors.forename: Mythily
authors.initials: M
authors.lastname: Subramaniam
authors.forename: Chee Fang
authors.initials: CF
authors.lastname: Sum
authors.forename: Dorit
authors.initials: D
authors.lastname: Stahl
authors.forename: Pei Hsiang
authors.initials: PH
authors.lastname: Liow
authors.forename: Siow Ann
authors.initials: SA
authors.lastname: Chong
mesh_terms: D000328:Adult; D000368:Aged; D003863:Depression / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D011788:Quality of Life; D012846:Singapore / Q000453:epidemiology