ORIGINAL ARTICLE Depressive symptoms and clustering of cardiovascular disease risk factors in diabetes patients Reema A. Karasneh 1 & Sayer I. Al-Azzam 2 & Karem H. Alzoubi 2 & Jaafar A. Abu Abeeleh 3 & Yousef S. Khader 1 Received: 3 August 2013 /Accepted: 28 March 2015 # Research Society for Study of Diabetes in India 2015 Abstract Depressive symptoms may be related to the devel- opment of coronary heart disease (CHD) in patients with dia- betes mellitus. The objective of the present study was to in- vestigate the relationship between cardiovascular disease risk factors and depressive symptoms in patients with type 2 dia- betes. A total of 179 patients with type 2 diabetes completed a questionnaire and gave a blood sample. The questionnaire consisted of demographics, the medication adherence ques- tionnaire, the summary of diabetes self-care activities ques- tionnaire, and the Beck Depression Inventory II questionnaire. Blood samples were analyzed for glucose and lipid profile. Elevated depression Beck score had a significant relation with female gender, numbness or pain in peripheries, younger age group ≤50 years, and elevated triglycerides (TG). Diabetes complications also had a significant relation with depression and more specifically with performance impairment and depression-nonspecific items. A significant relation was found between uncontrolled diabetes and somatic disturbance. Under-adherence to medications was significantly related to depression-specific items. Obesity was significantly related to depression-nonspecific items. Several factors are correlated with depression symptoms in diabetes patients. Additionally, control of somatic disturbance and performance impairment of depression should be regarded as important components of appropriate diabetes care to ensure diabetes control and med- ication adherence. Keywords Depression . Diabetes . Cardiovascular disease . Risk factors . Adherence . Outcomes Introduction Diabetes and cardiovascular disease (CVD) have now become the main public health challenge of the twenty-first century [1]. This concern came through the rising number of diabetes cases, in addition to the consideration of CVD as the leading cause of death worldwide [2–4]. Diabetes is associated with twofold to threefold increased risk of cardiovascular disease and cardiovascular mortality [5]. Other risk factors for CVD include hypertension, smoking, hypercholesterolemia, obesi- ty, physical inactivity, noncompliance with a medical regimen, and depression [6–8]. Symptoms of depression predict future coronary events for initially healthy individuals, as well as a poor prognosis for those who suffer from established CVD [8]. Among diabetes patients, depression is associated with higher incidence of coronary heart disease [9]. Although there is, currently, no direct evidence that screening for depression leads to im- proved outcomes in cardiovascular populations, depression should be taken into account by cardiologists in the manage- ment of CHD as it has been linked with increased morbidity and mortality, poorer risk factor modification, lower rates of cardiac rehabilitation, and reduced quality of life [10]. Few studies investigated the relation between depressive symptoms and CVD risk factors among diabetes patients [11–15]. However, these studies were limited in their scope. To our knowledge, this study is the first study that provides a * Reema A. Karasneh reemas80@hotmail.com 1 Department of Public Health, Community Medicine and Family Medicine, Jordan University of Science and Technology, Irbid, Jordan 2 Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan 3 Department of Pharmacy, Royal Medical Services, Amman, Jordan Int J Diabetes Dev Ctries DOI 10.1007/s13410-015-0382-4