Research Article
Ethnic Minorities with Diabetes Differ in Depressive and
Anxiety Symptoms and Diabetes-Distress
Charlotte B. Schmidt,
1,2
Bert Jan Potter van Loon,
3
Bart Torensma,
4
Frank J. Snoek,
2,5,6
and Adriaan Honig
1,7
1
Department of Psychiatry, Onze Lieve Vrouwe Gasthuis (OLVG), Amsterdam, Netherlands
2
Amsterdam Public Health Research Institute, Amsterdam, Netherlands
3
Department of Internal Medicine, Onze Lieve Vrouwe Gasthuis (OLVG), Amsterdam, Netherlands
4
Department of Epidemiology and Biostatistics, Onze Lieve Vrouwe Gasthuis OLVG, Amsterdam, Netherlands
5
Department of Medical Psychology, Academic Medical Centre (AMC), Amsterdam, Netherlands
6
Department of Medical Psychology, VU University Medical Centre (VUMC), Amsterdam, Netherlands
7
Department of Psychiatry, VU Medical Centre (VUmc), Amsterdam, Netherlands
Correspondence should be addressed to Charlotte B. Schmidt; c.schmidt@olvg.nl
Received 17 October 2016; Revised 20 January 2017; Accepted 19 February 2017; Published 8 March 2017
Academic Editor: Dario Iafusco
Copyright © 2017 Charlotte B. Schmidt et al. Tis is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
Objective. To determine the association between ethnicity, diabetes-distress, and depressive and anxiety symptoms in adult
outpatients with diabetes. Research Design and Methods. Diabetes-distress (Problem Areas in Diabetes Scale, PAID5), depressive and
anxiety symptoms (Extended Kessler-10, EK10), and quality of life (Short-Form 12, SF12) were assessed in an ethnic diverse diabetes
outpatient population of a teaching hospital in Amsterdam. Descent of one’s parents and self-classifed ethnicity were obtained to
defne ethnicity. HbA1c, clinical data, and socioeconomic status were derived from the medical charts. Based on established cut-ofs
for PAID5- and EK10-scores, emotional distress was dichotomized for the purpose of logistic regression analyses. Results. Of 1007
consecutive patients approached, 575 participated. Forty-nine percent were of non-Dutch ethnicity and 24.7% had type 1 diabetes.
Diabetes-distress was reported by 12.5% of the native Dutch patients and by 22.0%, 34.5%, and 42.6% of the Surinamese, Turkish,
and Moroccan patients, respectively. Prevalence of depressive symptoms was 9.4% in native Dutch patients and 20.4%, 34.5%, and
27.3% in the other groups mentioned. Diabetes-distress and Moroccan origin were signifcantly associated (OR = 3.60, < .01) as
well as depressive symptoms and Turkish origin (OR = 4.23, = .04). Conclusions. Diferent ethnic minorities with diabetes vary
in their vulnerability for emotional distress, warranting clinical attention. Future research should elucidate explanatory factors and
opportunities for tailored interventions.
1. Introduction
Emotional distress is common in persons with diabetes [1]. It
is associated with poorer glycaemic control, reduced quality
of life, and higher mortality rates [2–4]. Emotional distress
can either be generic, defned as depressive and/or anxiety
symptoms not related to a specifc cause, or diabetes-specifc,
that is, directly related to the experience of living with
diabetes mellitus, such as fear of complications or worrying
about the disease and its direct consequences for daily life [1].
Both generic distress (depressive and anxiety symptoms) and
diabetes-distress are highly prevalent in persons with diabetes
[5], in particular in secondary and tertiary care [6]. Overall,
persons with diabetes report depressive symptoms twice as
ofen as the general population [7] and anxiety symptoms are
present in 27%–40% of persons with diabetes [8].
Predictors of depressive symptoms and diabetes-distress
were female sex, life events, and concomitant diseases in a
mixed sample of type 1 and type 2 outpatients with diabetes
across 8 countries [9]. Poor glycaemic control was a predictor
of diabetes-distress, but not of depressive symptoms [9].
Tese fndings are in line with earlier fndings in the US [10].
Hindawi
Journal of Diabetes Research
Volume 2017, Article ID 1204237, 11 pages
https://doi.org/10.1155/2017/1204237