Difference between the prevalence of symptoms of depression and anxiety in non-diabetic smokers and in patients with type 2 diabetes with and without nicotine dependence

Diabetology & Metabolic Syndrome

Paulo Tannús Jorge⁵  Miguel Tanús Jorge⁵  Rogério de Melo Costa Pinto⁵  MariaLuizaMendonçaPereira Jorge²  Juliana de Souza Andréo³  Mariana Tanus Jorge⁴  LudmillaDell’IsolaPelegriniMelo Ferreira⁴  Simone Franco Osme¹ 

[1] Departamento de Clínica Médica, Federal University of Uberlandia, Uberlândia, MG, 38400-902, Brazil;Endocrinology Clinic, Clinical Hospital, Federal University of Uberlândia, Uberlândia, MG, Brazil;Departament of Psychology, Clinical Hospital, Federal University of Uberlândia, Uberlândia, MG, Brazil;Institute of Psychology, Federal University of Uberlândia, Uberlândia, MG, Brazil;Program in Health Sciences, Medicine College, Federal University of Uberlândia, Uberlândia, MG, Brazil

关键词: Anxiety;    Depression;    Diabetes mellitus;    Nicotine dependence;    Smoking;   

Others  :  814881
DOI  :  10.1186/1758-5996-4-39

 received in 2012-04-24, accepted in 2012-08-09,  发布年份 2012

【 摘 要 】

Background

Individuals with diabetes who are smokers have higher risks of cardiovascular disease, premature death, and microvascular complications. The present study aims to determine the prevalence of symptoms of depression and anxiety in smokers with type 2 diabetes mellitus (T2D) and to evaluate if the prevalence of symptoms of depression and anxiety differ between the three groups studied (patients with T2D who smoke; patients with T2D who do not smoke; smokers without T2D), and finally determine if the degree of nicotine dependence is related to symptoms of anxiety and depression in smokers (with or without T2D).

Methods

Three study groups were formed: 46 T2D smokers (DS), 46 T2D non-smokers (D), and 46 smokers without diabetes (S), totaling 138 participants. Hospital Anxiety and Depression (HAD) scale and Fagerström Test were applied.

Results

The prevalence of symptoms of depression and anxiety in smokers with T2D was 30.4% and 50%, respectively. There was no significant difference in the proportion of individuals with symptoms of anxiety (p = 0.072) or depression (p = 0.657) in the DS group compared to group D or S. Among male patients with T2D, the smokers had a higher prevalence of anxiety symptoms (19.6%) than non-smokers (4,3%) (p = 0,025). The prevalence of high nicotine dependence among smokers with and without T2D was 39.1% and 37.1%, respectively (p = 0.999). Fagerström scores showed no significant correlation with the scores obtained on the subscale of anxiety (p = 0,735) or depression (p = 0,364).

Conclusions

The prevalence of depression and anxiety among smokers with and without diabetes and non-smokers T2D is similar. Among male individuals with T2D, the smokers have more symptoms of anxiety than the non-smokers. There is no difference in the prevalence of nicotine dependence among smokers with and without diabetes. The presence of symptoms of anxiety or depression is similar between patients who are dependent and not dependent on nicotine.

【 授权许可】

   
2012 Osme et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Patja K, Jousilahti P, Hu G, Valle T, Qiao Q, Tuomilehto J: Effects of smoking, obesity and physical activity on the risk of type 2 diabetes in middle-aged Finnish men and women. J Intern Med 2005, 258(4):356-362.
• [2]Wen CP, Cheng TY, Tsai SP, Hsu HL, Chan HT, Hsu CC: Exploring the relationships between diabetes and smoking: with the development of glucose equivalent concept for diabetes management. Diabetes Res Clin Pract 2006, 73(1):70-76.
• [3]Willi C, Bodenmann P, Ghali WA, Faris PD, Cornuz J: Active smoking and the risk of type 2 diabetes: a systematic review and meta-analysis. JAMA 2007, 298(22):2654-2664.
• [4]International Diabetes Federation: The IDF Diabetes Atlas . 5th edition. Brussels: International Diabetes Federation; 2011.
• [5]World Health Organization: WHO report on the global tobacco epidemic, 2011: warning about the dangers of tobacco . Geneva: World Health Organization; 2010:164.
• [6]Ministry of Health: Smoking prevalence in Brazil - Data from epidemiological studies in Brazilian capitals. Rio de Janeiro: Center for Prevention and Surveillance (Coordenação de Prevenção e Vigilância - CONPREV)/National Cancer Institute (Instituto Nacional do Câncer - INCA) / Ministry of Health (Ministério da Saúde - MS) . 2004. http://www.saude.rs.gov.br/dados/Prevalencia_Tabagismo_Brasil_Inquerito_Domiciliar.pdf webcite>. Accessed on: 11/06/11
• [7]Leitão Filho FS, Galduróz JCF, Noto AR, Nappo SA, Carlini EA, Nascimento OA, et al.: Randomized survey on the prevalence of smoking in the largest cities of Brazil. J Bras Pneumol 2009, 35(12):1204-1211.
• [8]Ford ES, Mokdad AH, Gregg EW: Trends in cigarette smoking among US adults with diabetes: findings from the Behavioral Risk Factor Surveillance System. Prev Med 2004, 39(6):1238-1242.
• [9]American Diabetes Association: Standards of medical care in diabetes. Diabetes Care 2011, 34(suppl 1):S11-S61.
• [10]Eliasson B: Cigarette smoking and diabetes. Prog Cardiovasc Dis 2003, 45(5):405-413.
• [11]Castro MGT, Oliveira MS, Araújo RB, Pedroso RS: Relationship between gender and depressive and anxiety symptoms in smokers. Rev Psiquiatr 2008, 30(1):25-30.
• [12]Collins MM, Corcorant P, Perry IJ: Anxiety and depression symptoms in patients with diabetes. Diabet Med 2009, 26(2):153-161.
• [13]Breslau N, Kilbey M, Andreski P: Nicotine dependence, major depression, and anxiety in young adults. Arch Gen Psychiatr 1991, 48(12):1069-1074.
• [14]Spangler JG, Summerso JH, Bell RA, Konen JC: Smoking status and psychosocial variables in type 1 diabetes mellitus. Addict Behav 2001, 26(1):21-29.
• [15]Lloyd CE, Dyer PH, Barnett AH: Prevalence of symptoms of depression and anxiety in a diabetes clinic population. Diabet Med 2000, 17(3):198-202.
• [16]Reichert J, Araújo AJ, Gonçalves CMC, Godoy I, Chatkin JM, Sales MPU, et al.: Guidelines for smoking cessation. J Bras Pneumol 2008, 34(10):845-880.
• [17]Pouwer F: Should we screen for emotional distress in type 2 diabetes mellitus? Nat Rev Endocrinol 2009, 5(12):665-671.
• [18]American Diabetes Association: Clinical practice recommendations - smoking and diabetes. Diabetes Care 2004, 27(suppl 1):S74-S75.
• [19]Botega NJ, Pondé MP, Medeiros P, Lima MG, Guerreiro CAM: Validation of the Hospital Anxiety and Depression (HAD) scale in ambulatory patients with epilepsy. J Bras Psiquiatr 1998, 47(6):285-289.
• [20]McHale M, Hendrikz J, Dann F, Kenardy J: Screening for depression in patients with diabetes mellitus. Psychosom Med 2008, 70(8):869-874.
• [21]Strine TW, Mokdad AH, Balluz LS, Gonzalez O, Crider R, Berry JT, et al.: Depression and anxiety in the United States: findings from the 2006 Behavioral Risk Factor Surveillance System. Psychiatr Serv 2008, 59(12):1383-1390.
• [22]Anderson RJ, Freedland KE, Clouse RE, Lustman PJ: The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care 2001, 24(6):1069-1078.
• [23]Nouwen A, Winkley K, Twisk J, Lloyd CE, Peyrot M, Ismail K, et al.: European Depression in Diabetes (EDID) Research Consortium: type 2 diabetes mellitus as a risk factor for the onset of depression: a systematic review and meta-analysis. Diabetologia 2010, 53(12):2480-2486.
• [24]Nichols GA, Brown JB: Unadjusted and adjusted prevalence of diagnosed depression in type 2 diabetes. Diabetes Care 2003, 26(3):744-749.
• [25]Khuwaja AK, Lalani S, Dhanani R, Azam IS, Rafique G, White F: Anxiety and depression among outpatients with type 2 diabetes: a multi-centre study of prevalence and associated factors. Diabetol Metab Syndr 2010, 2:72. BioMed Central Full Text
• [26]Bouwman V, Adriaanse MC, Van’t Riet E, Snoek FJ, Dekker JM, Nijpels G: Depression, anxiety and glucose metabolism in the general dutch population: the new hoorn study. PLoS One 2010, 5(4):e9971.
• [27]Ali S, Stone MA, Peters JL, Davies MJ, Khunti K: The prevalence of co-morbid depression in adults with Type 2 diabetes: a systematic review and meta-analysis. Diabet Med 2006, 23(11):1165-1173.
• [28]Breslau N, Johnson EO, Hiripi E, Kessler R: Nicotine dependence in the United States: prevalence, trends, and smoking persistence. Arch Gen Psychiatry 2001, 58(9):810-816.
• [29]Carmo JT, Pueyo AA: The adaptation to Portuguese of the Fagerström test for nicotine dependence (FTND) to evaluate the tolerance to nicotine dependence and smoking in Brazilians. Rev Bras Med 2002, 59(½):73-80.
• [30]Ayres M, Ayres Júnior M, Ayres DL, Santos AA: BioEstat – Statistical Applications in the areas of biomedical sciences . Belém/PA: Sociedade Civil Mamirauá; 2007:364.
• [31]Lloyd CE, Zgibor J, Wilson RR, Barnett AH, Dyer PH, Orchard TJ: Cross-cultural comparisons of anxiety and depression in adults with type 1 diabetes. Diabetes Metab Res Rev 2003, 19(5):401-407.
• [32]Waraich P, Goldner EM, Somers JM, Hsu L: Prevalence and incidence studies of mood disorders: a systematic review of the literature. Can J Psychiatry 2004, 49(2):124-138.
• [33]Bourdon KH, Rae DS, Locke BZ, Narrow WE, Regier DA: Estimating the prevalence of mental disorders in U.S. adults from the Epidemiologic Catchment Area Survey. Public Health Rep 1992, 107(6):663-668.
• [34]Kessler RC, Berglund P, Demler O, Jin R, Koretz D, Merikangas KR, et al.: National comorbidity survey replication. The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA 2003, 289(23):3095-3105.
• [35]Haug TT, Mykletun A, Dahl AA: Are anxiety and depression related to gastrointestinal symptoms in the general population? Scand J Gastroenterol 2002, 37(3):294-298.
• [36]Almeida-Filho N, Mari Jde J, Coutinho E, França JF, Fernandes J, Andreoli SB, et al.: Brazilian multicentric study of psychiatric morbidity. Methodological features and prevalence estimates. Br J Psychiatry 1997, 171:524-529.
• [37]Andrade L, Walters EE, Gentil V, Laurenti R: Prevalence of ICD-10 mental disorders in a catchment area in the city of São Paulo, Brazil. Soc Psychiatry Psychiatr Epidemiol 2002, 37(7):316-325.
• [38]Stefanello S, Marín-Léon L, Fernandes PT, Li LM, Botega NJ: Depression and anxiety in a community sample with epilepsy in Brazil. Arq Neuropsiquiatr 2011, 69(2B):342-348.
• [39]Botega NJ, Mitsuushi GN, Azevedo RC, Lima DD, Fanger PC, Mauro ML, et al.: Depression, alcohol use disorders and nicotine dependence among patients at a general hospital. Rev Bras Psiquiatr 2010, 32(3):250-256.
• [40]Delfini ABL, Roque AP, Peres RS: Symptoms of anxiety and depression in hospitalized adults: clinical screening in nursing. Gerais: Revista Interinstitucional de Psicologia 2009, 2(1):12-22.
• [41]Brandtner M, Bardagi M: Symptoms of depression and anxiety in students of a private University in Rio Grande do Sul. Gerais: Revista Interinstitucional de Psicologia 2009, 2(2):81-91.
• [42]D’El Rey GJF, Montiel JM, Dileve V, Jacob AP: Symptoms of anxiety in a nonclinical population area of the São Paulo, SP, Brazil. Arq Ciênc Saúde Unipar 2001, 5(3):235-238.
• [43]Grigsby AB, Anderson RJ, Freedland KE, Clouse RE, Lustman PJ: Prevalence of anxiety in adults with diabetes: a systematic review. J Psychosom Res 2002, 53(6):1053-1060.
• [44]Mykletun A, Stordal E, Dahl AA: Hospital Anxiety and Depression (HAD) scale: factor structure, item analyses and internal consistency in a large population. Br J Psychiatry 2001, 179(6):540-544.
• [45]Carroll D, Phillips AC, Thomas GN, Galé CR, Deary I, Batty GD: Generalized anxiety disorder is associated with metabolic syndrome in the Vietnam experience study. Biol Psychiatry 2009, 66(1):91-93.
• [46]Schmitz N, Kruse J, Kugler J: Disabilities, quality of life, and mental disorders associated with smoking and nicotine dependence. Am J Psychiatry 2003, 160(9):1670-1676.
• [47]Figlie NB, Pillon SC, Dunn J, Laranjeira R: The frequency of smoking and problem drinking among general hospital inpatients in Brazil – using the AUDIT and Fagerström questionnaires. Sao Paulo Med J 2000, 118(5):139-143.
• [48]Carvalho AA, Gomes L, Loureiro AM: Smoking in elderly patients admitted to long-term care facilities. J Bras Pneumol 2010, 36(3):339-346.
• [49]Fagerström K, Furberg H: A comparison of the Fagerström Test for Nicotine Dependence and smoking prevalence across countries. Addiction 2008, 103(5):841-845.
• [50]Grant BF, Hasin DS, Chou SP, Stinson FS, Dawson DA: Nicotine dependence and psychiatric disorders in the United States: results from the national epidemiologic survey on alcohol and related conditions. Arch Gen Psychiatry 2004, 61(11):1107-1115.
• [51]Jorge ML, de Oliveira VN, Resende NM, Paraiso LF, Calixto A, Diniz AL, et al.: The effects of aerobic, resistance, and combined exercise on metabolic control, inflammatory markers, adipocytokines, and muscle insulin signaling in patients with type 2 diabetes mellitus. Metabolism 2011, 60(9):1244-1252.