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The interplay between diabetes, depression and affective temperaments: A structural equation model.

Martino Belvederi Murri1, Sara Mamberto2, Lucia Briatore3

  • 1Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

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Diabetes and depression are linked, with glycemic control influencing depressive symptoms. Affective temperaments and diabetes type shape this relationship, impacting distress and medication adherence for better patient care.

Keywords:
DepressionDiabetesDistressGlycemic controlPersonalityTemperament

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Area of Science:

  • Endocrinology and Metabolic Diseases
  • Psychiatry and Mental Health
  • Behavioral Medicine

Background:

  • Diabetes mellitus and depression exhibit a reciprocal relationship.
  • Limited research has modeled this interplay, considering affective temperaments and demographics.

Purpose of the Study:

  • To investigate the bidirectional association between glycemic control and depression in diabetes.
  • To examine the mediating roles of diabetes-related distress and adherence.
  • To explore the moderating effects of affective temperaments, diabetes type, age, and gender.

Main Methods:

  • Cross-sectional study of 279 participants with type 1 and type 2 diabetes.
  • Assessed depression (BDI), affective temperaments (TEMPS-A), adherence (MMAS), diabetes distress (DDS), comorbidities (CIRS), and glycemic control (HbA1c).
  • Utilized Structural Equation Modeling (SEM) with multigroup comparisons to analyze associations and moderation.

Main Results:

  • Diabetes distress mediated the association between HbA1c and depressive symptoms.
  • Affective temperaments influenced depression severity and distress, independent of glycemic control.
  • Physical comorbidities significantly impacted depression; diabetes type moderated the relationship.

Conclusions:

  • Glycemic control affects depressive symptom severity, but the reverse association is weak.
  • Affective temperaments and diabetes type are crucial moderators influencing distress and adherence.
  • Findings support targeted interventions to enhance diabetes care and patient quality of life.