title: Depression among diabetic women in urban centers in Mexico and the United States of America: a comparative study.
abstract: OBJECTIVE
  To compare the prevalence and patterns of depressive symptoms among women with type 2 diabetes in Puebla, Mexico, and Chicago, United States.
  
  
  METHODS
  Two cross-sectional studies were conducted independently, in Puebla (September 2010-March 2011) and in Chicago (January-July 2010). Depression symptomatology was evaluated in a random sample of 241 women self-reporting type 2 diabetes in Puebla and a convenience sample of 121 women of Mexican descent seeking care for type 2 diabetes in Chicago. Depressive symptomatology was measured by the Center for Epidemiologic Studies Depression Scale administered in either English or Spanish. Women were similarly socioeconomically disadvantaged with low education levels in both locations.
  
  
  RESULTS
  The Chicago sample of women reported higher levels of depression than the Puebla sample (38% versus 17%, P < 0.0001). Among those with comorbid depression and diabetes in both sites, minimal variations in symptoms were observed. Depressive symptoms, specifically the subjective element (feeling sad) and symptoms associated with diabetes (fatigue and sleep problems) were heightened in both groups. More frequent reporting of "feeling fearful" was statistically significant in Puebla.
  
  
  CONCLUSIONS
  Despite a higher prevalence of depression among Mexican immigrant women with diabetes in the United States compared to Mexico, there was little variation in their depressive symptoms, regardless of residence. However, women in Mexico did report a higher incidence of fear. Screening for depression in patients with diabetes should take into account symptoms of fatigue and sleep and the bi-directional relationship of depression and diabetes.
authors.affiliation: Facultad de Medicina, Benemérita Universidad Autónoma de Puebla México, Puebla, Mexico.
authors.forename: María del Carmen
authors.initials: Mdel C
authors.lastname: Lara Muñoz
authors.affiliation: Health Innovation and Population Studies, School of Medicin, University of Wisconsin-Madison.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Jacobs
authors.affiliation: Instituto Mexicano del Seguro Social, Puebla, Mexico.
authors.forename: Marco Antonio
authors.initials: MA
authors.lastname: Escamilla
authors.affiliation: Walsh School of Foreign Service, Georgetown University, Washington, United States of America, em1061@georgetown.edu.
authors.forename: Emily
authors.initials: E
authors.lastname: Mendenhall
mesh_terms: D000328:Adult; D000368:Aged; D002641:Chicago / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D003866:Depressive Disorder / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D005221:Fatigue / Q000453:epidemiology; D005239:Fear; D005260:Female; D006801:Humans; D017058:Mexican Americans / Q000523:psychology*; D008800:Mexico / Q000453:epidemiology / Q000208:ethnology; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D012494:Sampling Studies; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology; D012923:Social Class; D063189:Symptom Assessment; D014505:Urban Population