Correlates and Outcomes of Depression in Adult Diabetics

Community Health Center Association/ Ct, Newington CT

Investigators

Abstract

[unreadable] DESCRIPTION (Provided by the Applicant): The incidence of Type II diabetes in the primary care population is growing at a rapid rate and there is evidence that minority populations such as Latinos and African Americans may be at higher risk. Depression is more prevalent in patient populations with diabetes but the reasons for the association of depression and diabetes remain little understood. The goal of this research project is to: 1) investigate the prevalence and correlates of major depressive disorder (MDD) and depressive symptoms in adult type II diabetics who receive their health care in 3 community health centers in the New England Clinicians Forum Practice-Based Research Network; 2) to assess the interaction of MDD with diabetes control indicators and self-reported diabetes self-management activities; and 3) initiate a pilot intervention-outcome study to provide guideline [unreadable] concordant depression treatment for Type II diabetics identified with MDD, and longitudinally assess at three and six months both depression and diabetes outcomes and self-reported adherence to diabetes control activities. Patients will be randomly selected from the diabetic patient registries currently maintained by each study site and invited to participate in depression screening using the PHQ-9. Baseline health status data recorded in the registries, demographics, and self-report data about diabetes adherence, social support, health behaviors, and level of functional disability will be collected. Of the approximately 300-360 patients expected to enroll and complete baseline data collection in the allocated time period, approximately 100 are expected to screen in for MDD. The patients with MDD will be offered depression care and followed at 3 and 6 months. This study will provide important information about identifying and managing the comorbidity of diabetes and depression in a highly vulnerable group of patients. It will add to the literature by examining correlates of depression in a racially and ethnically diverse population of diabetic patients managed in community health centers, and will strengthen knowledge about the covariation of depression and diabetes self-care and control by following patients longer than the 8-12 weeks utilized in many prior studies. [unreadable] [unreadable]