Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #113755

David M. Mosen, PhD, MPH¹, Renee Saris-Baglama², Carol Remmers, MPH¹, Bonnie Blaisdell, MA², and Christopher Jentz, MHSA¹. (1) Care Management Institute, Kaiser Permanente, 500 NE Multnomah St, Suite 240, Portland, OR 97232, 503-813-3827, david.m.mosen@kpchr.org, (2) QualityMetric, 640 George Washington Highway, Suite 201, Lincoln, RI 02865

Objective: Depression may impact the ability of adults with diabetes to manage their symptoms, possibly leading to poorer health outcomes. However, despite these possible health effects, little is known regarding the association of depression on health outcomes. The objectives of this study are to: 1) identify the prevalence of likely depression within the diabetic population and 2) examine the association of depression status with physical function status, role function and missed days of employment.

Study Design: We examined survey and administrative data for 1,075 adult diabetics. Diabetics were identified during 2003 using HEDIS inclusion criteria. The same patients were surveyed regarding functional health status using the SF-8™ Health Survey, which yields a physical component summary score (PCS), a mental component summary score (MCS), and two role functioning scale scores (role-physical and role-emotional), in addition to six other scale scores. Based on previously published research, patients with an MCS score of 42 or below are likely to have depression. Additionally, employed respondents were asked whether they missed any days of employment because of their diabetes within the past 30 days.

Appropriate multivariate statistics (e.g., Linear or Logistic Regression) were used to examine the independent association of depression status on physical functional status, role function, and missed days of employment adjusting for age, gender, race/ethnicity, educational attainment, and geographic location.

Principal Findings: Overall, 20.2% of those studied had MCS scores at or below 42, indicative of a high likelihood of depression. Those with a high likelihood of depression reported poorer physical functional status (Standardized Beta Coefficient = -0.20, t = -7.00, p< .0001), poorer role functioning due to emotional problems (Standardized Beta Coefficient = - 0.66, t = -28.8, p< .0001), poorer role functioning due to physical problems (Standardized Beta Coefficient = -0.30, t = -10.27, p< .0001), and a higher likelihood to miss 1 or more missed days of employment (OR = 2.59, 95% CI = 1.09-6.22); even after adjusting for study covariates.

Conclusions: Results of this study suggest that a large proportion of the adult diabetic population is likely to experience depression. Compared to diabetics with MCS scores above 42, diabetics who were likely to be depressed reported significantly lower physical functional status, role function, and a higher likelihood of missed days of employment. Because depression is associated with poorer health outcomes in the study population, further efforts are needed to better recognize and treat depression for adults with diabetes.

Learning Objectives: At the conclusion of the session, the participant in this session will be able to

• Identify the likely prevalence of depression for adults with diabetes
• Describe the impact of depression on functional status and missed days of employment
• Discuss policy implications of research
• Identify possible interventions better recognize and treat adults with diabetes

Keywords: Depression, Diabetes

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation