Aims: The impact of depression on patients with chronic medical illnesses such as diabetes is well documented. Depression is relatively common in diabetes patients with diabetes-related complications and they are more likely to be referred to specialized outpatient facilities. Only a few studies have addressed the association between depression and multiple diabetes-related complications at these specialized outpatient facilities. The aim of this study was to determine the association between diabetes with multiple complications and depression in patients with Type 2 diabetes at a specialized outpatient clinic.
Methods: After giving informed consent, 1194 patients were screened for depression using the Patient Health Questionnaire (PHQ-9). Additional data on the type of diabetes and complications were taken from the medical records. Logistic regression analysis was conducted, with complications as the predictor variable and the probability of depression as the dependent variable.
Results: A total of 596 (63%) patients with Type 2 diabetes participated in the study. The presence of two or more complications (OR 2.23, 95% CI 1.02-2.94) was significantly associated with depression. Neuropathy (OR 1.7, 95% CI 1.10-2.77) and nephropathy (OR 1.68, 95% CI 1.00-2.48) were especially related to depression.
Conclusions: Patients with Type 2 diabetes with two or more complications, especially neuropathy or nephropathy, are at high risk of depression. Knowing this can help clinicians identify patients at risk for depression and facilitate timely and adequate treatment. © 2010 The Authors. Diabetic Medicine

Depressive disorder, Diabetes mellitus, Hospital care, Nephropathy, Neuropathy
This study was financed by the Dutch Innovation Fund of Health Care Insurers.
dx.doi.org/10.1111/j.1464-5491.2010.03125.x, hdl.handle.net/1765/33927
Diabetic Medicine: journal of diabetes UK
Erasmus MC: University Medical Center Rotterdam

van Steenbergen-Weijenburg, K.M, van Puffelen, A.L, Horn, E.K, Nuyen, J, Sytze van Dam, P, van Benthem, T.B, … van der Feltz-Cornelis, C.M. (2011). More co-morbid depression in patients with Type-2 diabetes with multiple complications. An observational study at a specialized outpatient clinic. Diabetic Medicine: journal of diabetes UK, 28(1), 86–89. doi:10.1111/j.1464-5491.2010.03125.x