title: Prevalence and influencing factors of co-morbid depression in patients with type 2 diabetes mellitus: a General Hospital based study.
abstract: BACKGROUND
  Depression and diabetes have been recognized as major public health issues in China, however, no studies to date examined the factors associated with the development of depression in patients with diabetes in China. This study aimed to estimate the prevalence of co-morbid depression among adults with type 2 diabetes mellitus (DM) and to examine the influence factors of co-morbid depression in a group of patients with type 2 DM.
  
  
  METHODS
  The study was conducted from March l to May 31, 2012, in the Department of Endocrinology of the First Affiliated Hospital of the General Hospital of the People's Liberation Army (PLA). A systematic random sample of 412 type 2 DM patients aged over 18 years was selected. A structured questionnaire was used for collecting the information about socio-demographic data, lifestyle factors and clinical characteristics. Depression and social support was evaluated by using the Chinese version of Beck Depression Inventory (BDI) and Social Support Rate Scale (SSRS), respectively. Weights and heights were measured. Hemoglobin A1c (HbA1c) was abstracted from each patient directly after the interview.
  
  
  RESULTS
  Of the total sample, 142 patients had depression according to the BDI scores (BDI scores ≥14), the prevalence of co-morbid depression in this study population was 5.7 % (142/2500). Of which, 56 had major depression (BDI ≥ 21), and 86 had moderate depression (BDI ≥ 14&BDI < 21). Logistic regression analysis indicated that a high HbA1c level, a high BMI, low quality health insurance, and being single, were significantly associated with the development of depression. However, a family history of diabetes and a high social support level are likely protective factors.
  
  
  CONCLUSIONS
  The prevalence of co-morbid depression was 5.7 % among Chinese subjects with type 2 DM in this study. High HbA1c level, high BMI score, being single, low social support level, and low quality health insurance were associated with the presence of depression. These findings support a recommendation for routine screening and management in China for depression in patients with diabetes, especially for those in primary care, to reduce the number of the depressed or the misrecognized depressed diabetic patients.
authors.affiliation: School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875 China.
authors.forename: Weijun
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Public Health Sciences, University of Rochester School of Medicine & Dentistry, Rochester, NY 14642 USA.
authors.forename: Huiwen
authors.initials: H
authors.lastname: Xu
authors.affiliation: School of Public Administration, Yunnan University of Finance and Economics, Kunming, 650221 China.
authors.forename: Shuliang
authors.initials: S
authors.lastname: Zhao
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of the General Hospital of the People's Liberation Army (PLA), Beijing, 100853 China.
authors.forename: Shinan
authors.initials: S
authors.lastname: Yin
authors.affiliation: School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875 China.
authors.forename: Xiaohua
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Sociology, Huazhong University of Science and Technology, 1037 Luoyu Road, Wuhan, 430074 China.
authors.forename: Jing
authors.initials: J
authors.lastname: Guo
authors.affiliation: School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875 China.
authors.forename: Shengfa
authors.initials: S
authors.lastname: Zhang
authors.affiliation: School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875 China.
authors.forename: Huixuan
authors.initials: H
authors.lastname: Zhou
authors.affiliation: School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875 China.
authors.forename: Fugang
authors.initials: F
authors.lastname: Wang
authors.affiliation: School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875 China.
authors.forename: Linni
authors.initials: L
authors.lastname: Gu
authors.affiliation: School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875 China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhu
authors.affiliation: School of Government, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875 China.
authors.forename: Haibo
authors.initials: H
authors.lastname: Yu
authors.affiliation: School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875 China.
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Qu
authors.affiliation: School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875 China.
authors.forename: Donghua
authors.initials: D
authors.lastname: Tian
keywords: Depression; Prevalence; Risk factors; Type 2 diabetes mellitus