OBJECTIVE:

To determine levels of depression and anxiety symptoms among adults with diabetes and identify factors associated with increased risk.

RESEARCH DESIGN AND METHODS:

This study administered self-report symptom inventories to patients at the beginning (n = 634) and end (n = 578) of an outpatient diabetes education program. Subjects (n = 246) contacted by mail 6 months later completed the same instruments.

RESULTS:

Rates of disturbance for depression (41.3%; 95% CI: 37.4-45.2%) and anxiety (49.2%; 95% CI: 45.3-53.1%) were higher than those typical in the general population (10-20%). Probability of disturbance ranged from 5-7% for those with the lowest risk profile to 82-92% for those with the highest risk profile. Diabetes-related complications were the only disease factor associated with significantly increased risk of disturbance. Women and those with less education were at much higher risk. Only 13% of those followed for 6 months were disturbed at all three time-points.

CONCLUSIONS:

Diabetes is associated with increased risk of psychological disturbance, especially for those with more diabetes-related complications. Sociodemographic factors account for much of the risk differential among people with diabetes.