title: The course of depressive symptoms in primary care patients with type 2 diabetes: results from the Diabetes, Depression, Type D Personality Zuidoost-Brabant (DiaDDZoB) Study.
abstract: OBJECTIVE
  The aim of the study was to examine the course (incidence, recurrence/persistence) of depressive symptoms in primary care patients with type 2 diabetes and to identify significant predictors of these different course patterns.
  
  
  METHODS
  A cohort of 2,460 primary care patients with type 2 diabetes was assessed for demographic, clinical and psychological factors in 2005 and followed-up in 2007 and 2008. Depression was defined as a score of ≥ 12 on the Edinburgh Depression Scale. Multivariate logistic regression analyses were used to determine whether several depression-course patterns could be predicted by means of demographics, medical co-morbidities and psychological factors.
  
  
  RESULTS
  A total of 630 patients (26%) met the criterion for depression at one or more assessments. In the subgroup with no baseline depression, incident depression at follow-up was present in 14% (n = 310), while recurrence/persistence in those with baseline depression was found in 66% (n = 212).The presence of any depression was associated with being female, low education, non-cardiovascular chronic diseases, stressful life events and a self-reported history of depression. Incident depression was predicted by female sex, low education and depression history, while patients with a history of depression had a 2.5-fold increased odds of recurrent/persistent depression.
  
  
  CONCLUSIONS
  Depression is common in primary care patients with type 2 diabetes, with one in seven patients reporting incident depression during a 2.5 year period. Once present, depression often becomes a chronic/recurrent condition in this group. In order to identify patients who are vulnerable to depression, clinicians can use questionnaire data and/or information about the history of depression.
authors.affiliation: Center of Research on Psychology in Somatic Diseases, Department of Medical Psychology and Neuropsychology, Tilburg University, PO Box 90153, 5000 LE Tilburg, the Netherlands.
authors.forename: G
authors.initials: G
authors.lastname: Nefs
authors.forename: F
authors.initials: F
authors.lastname: Pouwer
authors.forename: J
authors.initials: J
authors.lastname: Denollet
authors.forename: V
authors.initials: V
authors.lastname: Pop
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D011320:Primary Health Care / Q000379:methods*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012008:Recurrence; D012307:Risk Factors; D057566:Self Report; D012737:Sex Factors