title: Prevalence and determinants of depressive and anxiety symptoms in adults with type 2 diabetes in China: a cross-sectional study.
abstract: To evaluate the prevalence and determinants of anxiety and depression and to assess their impact on glycaemic control in participants with type 2 diabetes mellitus.
  
  
  
  A cross-sectional study.
  
  
  
  Community-based investigation in Xuzhou, China.
  
  
  
  893 Chinese men and women aged 18-84 years who fulfilled the inclusion criteria.
  
  
  
  People with type 2 diabetes completed the Pittsburgh Sleep Quality Index and the Zung Self-Rating Anxiety and Depression Scales. Demographic and physiological characteristics were recorded. Multiple logistic regression was used to evaluate the combined effect of factors associated with anxiety and depression and to assess the effects of anxiety and depression on glycaemic control.
  
  
  
  The prevalence of depressive symptoms and anxiety symptoms was 56.1% and 43.6%, respectively. Multivariate logistic regression analysis indicated that anxiety symptoms were associated with being woman, low income, chronic disease, depressive symptoms and poor sleep quality. Depressive symptoms were associated with being woman, older age, low education level, being single, diabetes complications, anxiety symptoms and poor sleep quality. Glycaemic control was not related to anxiety symptoms (OR=1.31, 95% CIs 0.94 to 1.67) or depressive symptoms (OR=1.23, 95% CI 0.85 to 1.63). A combination of depressive symptoms and anxiety symptoms was associated with poor glycaemic control (relative excess risk due to interaction: 4.93, 95% CI 2.09 to 7.87; attributable proportion due to interaction: 0.27, 95% CI 0.12 to 0.45).
  
  
  
  There was a high prevalence of depressive and anxiety symptoms in this Chinese sample of participants, although depression and anxiety were not singly associated with glycaemic control. However, a combination of depressive and anxiety symptoms was negatively correlated with glycaemic control in participants with type 2 diabetes.
authors.affiliation: Department of Endocrinology, Xuzhou Third People's Hospital, Xuzhou, China.
authors.forename: Nianquan
authors.initials: N
authors.lastname: Sun
authors.affiliation: Department of Non-communicable Disease Control, Xuzhou Center for Disease Control and Prevention, The School of Public Health, Xuzhou Medical University, Xuzhou, China.
authors.forename: Peian
authors.initials: P
authors.lastname: Lou
authors.affiliation: Department of Endocrinology, Xuzhou Third People's Hospital, Xuzhou, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Shang
authors.affiliation: Department of Non-communicable Disease Control, Xuzhou Center for Disease Control and Prevention, The School of Public Health, Xuzhou Medical University, Xuzhou, China.
authors.forename: Pan
authors.initials: P
authors.lastname: Zhang
authors.affiliation: Department of Endocrinology, Xuzhou Third People's Hospital, Xuzhou, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Non-communicable Disease Control, Xuzhou Center for Disease Control and Prevention, The School of Public Health, Xuzhou Medical University, Xuzhou, China.
authors.forename: Guiqiu
authors.initials: G
authors.lastname: Chang
authors.affiliation: Department of Non-communicable Disease Control, Xuzhou Center for Disease Control and Prevention, The School of Public Health, Xuzhou Medical University, Xuzhou, China.
authors.forename: Chunlei
authors.initials: C
authors.lastname: Shi
mesh_terms: D000368:Aged; D001007:Anxiety / Q000453:epidemiology* / Q000523:psychology; D002681:China / Q000453:epidemiology; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000378:metabolism / Q000523:psychology; D004522:Educational Status; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D017533:Marital Status / Q000706:statistics & numerical data; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D012890:Sleep; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000523:psychology; D011795:Surveys and Questionnaires
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: DIABETES & ENDOCRINOLOGY