The 130th Annual Meeting of APHA

Abstract #44058

Robert S. Levine, MD¹, Baqar H. Husaini, PhD², Pamela C. Hull, MA², Darren E. Sherkat, PhD³, Janice Emerson, BS², and Van A. Cain, MA². (1) Deptartment of Family and Community Medicine, Meharry Medical College, 1005 D.B. Todd, Jr., Blvd, Nashville, TN 37208, (615)327-6782, rlevine@mail.mmc.edu, (2) Center for Health Research, Tennessee State University, P.O. Box 9580, 3500 John A. Merritt Boulevard, Nashville, TN 37209, (3) Department of Sociology, Southern Illinois University at Carbondale, 13 Hillcrest Drive, Carbondale, IL 62901

In this paper we examine the role of depression in diabetes with implications toward increasing compliance to medical regime and reducing diabetes complications. We assess the opportunity to integrate community-based support regarding the management of diabetes mellitus with concurrent depression in a predominantly African American, out-patient, Medicaid population. We analyzed data from 473 adult patients in internal and family medicine clinics who had enrolled in a preventive care study over a one-year period from a single practice plan at an Historically Black College and University (HBCU). Depression was assessed using the PRIME-MD tool for assessing depressive symptoms, and the CED-D scale for estimating psychological distress. Of these patients, 113 (23.9%) had a diagnosis of diabetes mellitus. Using the PRIME-MD tool, it was estimated that 33% of the diabetic patients (37/113) had evidence of depression, and that both levels of depression and psychological distress were higher among diabetics than non-diabetics when controlling for age (standardized Beta=0.09 for PRIME-MD, Beta=0.11 for CES-D, both p <0.05). Furthermore, depressed diabetics had a higher average number of associated medical problems (7.4 per patient) than non-depressed diabetics (4.1 per patient) (p < 0.01). Moreover, depressed diabetic patients reported twice as many in-patient hospitalization days in the previous year than non-depressed diabetic patients (p<0.01), and 2.7 times as likely to report an emergency room visit (p<0.01). Future investigations should investigate the possibility that community-based support for depressed diabetics might improve self-management capability while decreasing severity of illness and the need for more expensive forms of care.

Learning Objectives:

• Describe the prevalence of depressive symptoms among patients with diabetes in a low-income primary care clinic.
• Analyze the effect of depressive symptoms on medical comorbidity and utilization of acute care services among diabetic patients.
• Evaluate the potential to provide community-based support for diabetic patients with depression as a strategy for improving self-management and illness severity, while reducing the need for more expensive forms of care.

Keywords: Depression, Diabetes

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.