Browse > Article
http://dx.doi.org/10.24986/anxmod.2020.16.1.9

Association of Depressive/Anxiety Symptoms with Ego Resilience and Social Conflict/Support in Patients with Diabetes Mellitus  

Jung, Hoe-Woon (Department of Psychiatry, Chosun University Hospital)
Kim, Sang Hoon (Department of Psychiatry, Chosun University Hospital)
Park, Sang Hag (Department of Psychiatry, Chosun University Hospital)
Kim, Seung-Gon (Department of Psychiatry, Chosun University Hospital)
Kim, Jung Ho (Department of Psychiatry, Chosun University Hospital)
Seo, Eun Hyun (Premedical Science, Chosun University College of Medicine)
Yoon, Hyung-Jun (Department of Psychiatry, Chosun University Hospital)
Publication Information
Anxiety and mood / v.16, no.1, 2020 , pp. 9-17 More about this Journal
Abstract
Objective : The purpose of this study was to investigate the association of depressive/anxiety symptoms with psychosocial factors including ego resilience, social conflict, and social support as well as hemoglobin A1c in patients with diabetes mellitus (DM). Methods : The subjects were 144 patients with DM. Depressive/anxiety symptoms were evaluated by the Hospital Anxiety and Depression Scale. Sociodemographic factors, hemoglobin A1c, ego resilience, social conflict, and social support were measured. Multiple regression analyses were performed to examine the impact of hemoglobin A1c, ego resilience, social conflict, and social support on depressive/anxiety symptoms. Results : A total of 32.6% and 24.3% of participants were identified with depressive and anxiety symptoms, respectively. Depressive/anxiety symptoms positively correlated with the social conflict score. Conversely, ego resilience and social support negatively correlated with depressive/anxiety symptoms. In the final model of the multiple regression analyses, ego resilience was associated with a lower level of depressive (β=-0.083, p=0.019)/anxiety (β=-0.125, p=0.001) symptoms whereas social conflict was related to a higher level of depressive (β=0.353, p=0.011)/anxiety (β=0.460, p=0.003) symptoms. Also, hemoglobin A1c positively associated with anxiety symptoms (β=0.495, p=0.012) whereas social support negatively related to depressive symptoms (β=-0.464, p=0.004). Conclusion : We found possible risk and protective psychosocial factors of underlying depressive/anxiety symptoms among patients with DM. Our findings suggest that enhancing ego resilience and social support as well as decreasing social conflict would be crucial in the prevention and management of depressive/anxiety symptoms in patients with DM.
Keywords
Diabetes mellitus; Depression; Anxiety; Ego resilience; Social conflict; Social support;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Kim IS. The relationship between social-environmental factors and psychological distress among Korean women in poverty [dissertation]. Seoul: Seoul National Univ.; 1994.
2 Cho SH. The probability of break-up in families of the unemployed: from the perspective of the unemployed breadwinner [dissertation]. Seoul: Seoul National Univ.;1999.
3 Khaledi M, Haghighatdoost F, Feizi A, Aminorroaya A. The prevalence of comorbid depression in patients with type 2 diabetes: an updated systematic review and meta-analysis on huge number of observational studies. Acta Diabetol 2019;56:631-650.   DOI
4 Chyun DA, Melkus GD, Katten DM, Price WJ, Davey JA, Grey N, et al. The association of psychological factors, physical activity, neuropathy, and quality of life in type 2 diabetes. Biol Res Nurs 2006;7:279-288.   DOI
5 Mendes R, Martins S, Fernandes L. Adherence to Medication, Physical Activity and Diet in Older Adults With Diabetes: Its Association With Cognition, Anxiety and Depression. J Clin Med Res 2019;11:583-592.   DOI
6 Santos FR, Bernardo V, Gabbay MA, Dib SA, Sigulem D. The impact of knowledge about diabetes, resilience and depression on glycemic control: a cross-sectional study among adolescents and young adults with type 1 diabetes. Diabetol Metab Syndr 2013;5:55.   DOI
7 DeNisco S. Exploring the relationship between resilience and diabetes outcomes in African Americans. J Am Acad Nurse Pract 2011;23:602-610.   DOI
8 Wu SF, Young LS, Yeh FC, Jian YM, Cheng KC, Lee MC. Correlations among social support, depression, and anxiety in patients with type-2 diabetes. J Nurs Res 2013;21:129-138.   DOI
9 Barefoot JC, Burg MM, Carney RM, Cornell CE, Czajkowski SM, Freedland KE, et al. Aspects of social support associated with depression at hospitalization and follow-up assessment among cardiac patients. J Cardiopulm Rehabil 2003;23:404-412.   DOI
10 Grav S, Hellzen O, Romild U, Stordal E. Association between social support and depression in the general population: the HUNT study, a cross-sectional survey. J Clin Nurs 2012;21:111-120.   DOI
11 Collins MM, Corcoran P, Perry IJ. Anxiety and depression symptoms in patients with diabetes. Diabet Med 2009;26:153-161.   DOI
12 Kim JB. Psychosocial issues related to diabetes mellitus. J Korean Soc Biol Ther Psychiatry 2001;7:288-295.
13 Anderson RJ, Grigsby AB, Freedland KE, de Groot M, McGill JB, Clouse RE, et al. Anxiety and poor glycemic control: a meta-analytic review of the literature. Int J Psychiatry Med 2002;32:235-247.   DOI
14 Ingerski LM, Anderson BJ, Dolan LM, Hood KK. Blood glucose monitoring and glycemic control in adolescence: contribution of diabetes- specific responsibility and family conflict. J Adolesc Health 2010;47:191-197.   DOI
15 Lustman PJ, Anderson RJ, Freedland KE, de Groot M, Carney RM, Clouse RE. Depression and poor glycemic control: a meta-analytic review of the literature. 2000;23:934-942.   DOI
16 Cambra K, Galbete A, Forga L, Lecea O, Ariz MJ, Moreno-Iribas C, et al. Sex and age differences in the achievement of control targets in patients with type 2 diabetes: results from a population-based study in a South European region. BMC Fam Pract 2016;17:144.   DOI
17 Collier A, Ghosh S, Hair M, Waugh N. Gender differences and patterns of cardiovascular risk factors in Type 1 and Type 2 diabetes: a population-based analysis from a Scottish region. Diabet Med 2015;32:42-46.   DOI
18 Jeon BH, Kim HW, Kim HJ, Lim MH, Lee SB, Paik KC, et al. The relationship of anxiety symptoms and depressive symptoms to glycemic control in diabetic patients. Korean J Psychosomatic Med 2008;16:95-102.
19 Williams LB, Laffel LM, Hood KK. Diabetes-specific family conflict and psychological distress in paediatric Type 1 diabetes. Diabet Med 2009;26:908-914.   DOI
20 WHO. WHO Diabetes fact sheets. Available at http://www.who.int/news-room/fact-sheets/detail/diabetes [accessed on July 15, 2019].
21 Korean Diabetes Association. Diabetes fact sheet in Korea 2018. Seoul: Korean Diabetes Association;2018
22 Li R, Bilik D, Brown MB, Zhang P, Ettner SL, Ackermann RT, et al. Medical costs associated with type 2 diabetes complications and comorbidities. Am J Manag Care 2013;19:421-430.
23 Lloyd CE, Dyer PH, Barnett AH. Prevalence of symptoms of depression and anxiety in a diabetes clinic population. Diabet Med 2000;17: 198-202.   DOI
24 Anderson RJ, Freedland KE, Clouse RE, Lustman PJ. The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care 2001;24:1069-1078.   DOI
25 Holt RI, Phillips DI, Jameson KA, Cooper C, Dennison EM, Peveler RC. The relationship between depression and diabetes mellitus: findings from the Hertfordshire Cohort Study. Diabet Med 2009;26:641-648.   DOI
26 Grigsby AB, Anderson RJ, Freedland KE, Clouse RE, Lustman PJ. Prevalence of anxiety in adults with diabetes: a systematic review. J Psychosom Res 2002;53:1053-1060.   DOI
27 Camara A, Balde NM, Enoru S, Bangoura JS, Sobngwi E, Bonnet F. Prevalence of anxiety and depression among diabetic African patients in Guinea: association with HbA1c levels. Diabetes Metab 2015;41:62-68.   DOI
28 Egede LE, Ellis C, Grubaugh AL. The effect of depression on selfcare behaviors and quality of care in a national sample of adults with diabetes. Gen Hosp Psychiatry 2009;31:422-427.   DOI
29 Song MS, Cho YI. A study of depression, anxiety, stress response and self-care by gender in diabetic patients. Korean J Rehabil Nurs 2006;9:145-152.
30 Bystritsky A, Danial J, Kronemyer D. Interactions between diabetes and anxiety and depression: implications for treatment. Endocrinol Metab Clin North Am 2014;43:269-283.   DOI
31 Goldman LS, Nielsen NH, Champion HC. Awareness, diagnosis, and treatment of depression. J Gen Intern Med 1999;14:569-580.   DOI
32 Block JH, Block J. The role of ego-control and ego-resiliency in the organization of behavior. In: Colloness WA, editors. Development of cognition, affect, and social relations. Mahwah: Lawrence Erlbaum Associates;1980. p.39-101.
33 Block J, Kremen AM. IQ and ego-resiliency: conceptual and empirical connections and separateness. J Pers Soc Psychol 1996;70:349-361.   DOI
34 Johnson J, Gooding PA, Wood AM, Tarrier N. Resilience as positive coping appraisals: Testing the schematic appraisals model of suicide (SAMS). Behav Res Ther 2010;48:179-186.   DOI
35 Kyoung M, Min JA, Chae JH. Relationship of affective symptoms and resilience with childhood abuse in patients with depressive or anxiety disorders. Anx Mood 2013;9:68-73.
36 Cohen S, Wills TA. Stress, social support, and the buffering hypothesis. Psychol Bull 1985;98:310-357.   DOI
37 Jeon DJ, Kim SH, Park SH, Yoon HJ, Kim SG, Kim JH. The prevalence and psychological correlates of depressive symptoms in patients with hypertension. J Korean Soc Biol Ther Psychiatry 2019;25:213-221.
38 Westdahl C, Milan S, Magriples U, Kershaw TS, Rising SS, Ickovics JR. Social support and social conflict as predictors of prenatal depression. Obstet Gynecol 2007;110:134-140.   DOI
39 Katon WJ, Rutter C, Simon G, Lin EH, Ludman E, Ciechanowski, et al. The association of comorbid depression with mortality in patients with type 2 diabetes. Diabetes Care 2005;28:2668-2672.   DOI
40 Liu X, Yang X, Yao L, Zhang Q, Sun D, Zhu X, et al. Prevalence and related factors of depressive symptoms in hemodialysis patients in northern China. BMC Psychiatry 2017;17:128.   DOI
41 Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 1983;67:361-370.   DOI
42 Oh SM, Min KJ, Park DB. A study on the standardization of the Hospital Anxiety and Depression Scale for Koreans: a comparison of normal, depressed and anxious group. J Korean Neuropsychiatr Assoc 1999;38:289-296.
43 Kim EH, Park HS. The impacts of organizational job stress factors on organizational commitment: focusing on the effects of ego-resilience. Korean Gov Rev 2010;17:1-28.
44 Jang YJ. A study on the social networks of the low-income married women in urban area [dissertation]. Seoul: Seoul National Univ.;2001.
45 Park MK, Hwang SC. Low-income female single parents' depression and life satisfaction in accordance with the positive and negative functions of their social relation networks. Journal of Family Relations 2010;15:3-24.