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Social Support and the Association of Type 2 Diabetes and Depressive and Anxiety Disorders Among Low-income Adults Seen in Primary Care Clinics

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Abstract

This study examined the association of social support (SS) and affective disturbance among low-income primary care patients with no chronic illnesses vs. those with type 2 diabetes vs. those with other chronic illnesses. The sample was predominantly middle aged (47.2 years old), African American (74%) and female (80%), with an average individual monthly income of approximately $500. Participants (N = 326) were administered the Diagnostic Interview Schedule, IV and the Interpersonal Support Evaluation List. Logistic regression results indicated that each standard deviation decrease in SS, increased the odds of having a depressive or anxiety disorder diagnosis by .618 OR (CI .472, .808, p < .000) for all study participants; .438 OR (95% CI .195, .987, p = .046) for those with hypertension, asthma and/or arthritis; and .326 OR (95% CI .141, .755, p = .009) for those with type 2 diabetes. Results suggest that SS may serve an important role in the association between stress and depression/anxiety diagnoses among low-income, primary care patients.

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References

  • Albright, T. L., Parchman, M., & Burge, S. K. (2001). RRNeST investigators: Predictors of self-care behavior adults with type 2 diabetes: An RRNeST study. Family Medicine, 33, 354–360.

    PubMed  CAS  Google Scholar 

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, (4th ed.). Washington, DC: Author.

    Google Scholar 

  • Anderson, R. J., Freedland, K. E., Clouse, R. E., & Lustman, P. J. (2001). The prevalence of comorbid depression in adults with diabetes: A meta-analysis. Diabetes Care, 24, 1069–1078.

    Article  PubMed  CAS  Google Scholar 

  • Anderson-Loftin, W., & Moneyham, L. (2000). Long-term disease management needs of southern African Americans with diabetes. The Diabetes Educator, 26, 821–832.

    PubMed  CAS  Google Scholar 

  • Bradshaw, B. (2002). The role of the family in managing therapy in minority children with type 2 diabetes mellitus. Journal of Pediatric Endocrinology and Metabolism, 15(Suppl 1), 547–551.

    PubMed  Google Scholar 

  • Brantley, P. J., Scarinci, I. C., Carmack, C. L., Boudreaux, E., Streiffer, R. H., & Givler, D. N. (1999). Prevalence of high-risk behaviors and obesity among low-income patients attending primary care clinics in Louisiana. Journal of the Louisiana Medical Society, 151, 126–135.

    CAS  Google Scholar 

  • Broadhead, W. E., Kaplan, B. H., & James, S. A. (1983). The epidemiologic evidence for a relationship between social support and health. American Journal of Epidemiology, 117, 521–537.

    PubMed  CAS  Google Scholar 

  • Brown, G. W., Andrews, B., Harris, T., Adler, Z., & Bridge, L. (1986). Social support, self-esteem and depression. Psychological Medicine, 16, 813–831.

    Article  PubMed  CAS  Google Scholar 

  • Center for Disease Control (CDC). (2005). Social support and health-related quality of life among older adults, Missouri, 2000. Morbidity and Mortality Weekly Report, 54, 433–437.

    Google Scholar 

  • Clark, V. R. (2001). The perilous effects of racism on blacks. Ethnicity and Disease, 11, 769–772.

    PubMed  CAS  Google Scholar 

  • Cobb, S. (1976). Social support as a moderator of life stress. Psychosomatic Medicine, 3, 300–314.

    Google Scholar 

  • Cohen, S., Mermelstein, R., Kamarch, T., & Hoverman, H. (1985). Measuring the functional components of social support. In I. Sarason & B. Sarason (Eds.), Social support: Theory, research, and applications. Dordrecht: Martinus Nijhoff.

    Google Scholar 

  • Cohen, S., & Syme, S. L. (1985). Social support and health. Orlando: Academic Press.

    Google Scholar 

  • Cohen, S., & Wills, T. A. (1985). Stress, social support and the buffering hypothesis. Psychological Bulletin, 98, 310–357.

    Article  PubMed  CAS  Google Scholar 

  • Cohen, S. (1988). Psychosocial models of the role of social support in the etiology of physical disease. Health Psychology, 7, 269–297.

    Article  PubMed  CAS  Google Scholar 

  • Connell, C. M., Davis, W. K., Gallant, M. P., & Sharp, P. S. (1994). Impact of social support, social cognitive variables, and perceived threat on depression among adults with diabetes. Health Psychology, 13, 262–273.

    Article  Google Scholar 

  • Gallant, M. P. (2003). The influence of social support on chronic illness self-management: A review and directions for research. Health Education Behavior, 30, 170–195.

    Article  PubMed  Google Scholar 

  • Gazmararian, J. A., James, S. A., & Lepkowski, J. M. (1995). Depression in black and white women: The role of marriage and socioeconomic status. Annals of Epidemiology, 5, 455–463.

    Article  PubMed  CAS  Google Scholar 

  • Grigsby, A. B., Anderson, R. J., Freedland, K. E., Clouse, R. E., & Lustman, P. J. (2002). Prevalence of anxiety in adults with diabetes: A systematic review. Journal of Psychosomatic Research, 53, 1053–1060.

    Article  PubMed  Google Scholar 

  • Holahan, C. K., & Holahan, C. J. (1987). Self-efficacy, social support, and depression in aging: A longitudinal analysis. Journal of Gerontology, 42, 65–68.

    PubMed  CAS  Google Scholar 

  • Hough, E. S., Brumitt, G. A., & Templin, T. N. (1999). Social support, demands of illness, and depression in chronically ill urban women. Health Care Women International, 20, 349–362.

    Article  CAS  Google Scholar 

  • Ilias, I., Hatzimichelakis, E., Souvatzoglou, A., Anagnostopoulou, T., & Tselebis, A. (2003). Perception of family support is correlated with glycemic control in Greeks with diabetes. Psychological Reports, 88, 929–930.

    Article  Google Scholar 

  • Jackson, J. S., Brown, T. N., Williams, D. R., Torres, M., Sellers, S. L., & Brown, K. (1996). Racism and the physical and mental health status of African Americans: A thirteen year national panel study. Ethnicity and Disease, 6, 132–147.

    PubMed  CAS  Google Scholar 

  • Jackson-Triche, M. E., Greer Sullivan, J., Wells, K. B., Rogers, W., Camp, P., & Mazel, R. (2000). Depression and health-related quality of life in ethnic minorities seeking care in general medical settings. Journal of Affective Disorders, 58, 89–97.

    Article  PubMed  CAS  Google Scholar 

  • Kahn, R. S., Wise, P. H., Kennedy, B. P., & Kawachi, I. (2000). State income inequality, household income, and maternal mental and physical health: Cross-sectional national survey. British Medical Journal, 321, 1311–1315.

    Article  PubMed  CAS  Google Scholar 

  • Kessler, R. C., & McLeod, J. D. (1985). Social support and mental health in community samples. In S. Cohen & S. L. Syme (Eds.), Social support and health (pp. 219–238). Orlando: Academic Press, Inc.

    Google Scholar 

  • Lloyd, C. E., Wing, R. R., Orchard, T. J., & Becker, D. J. (1993). Psychosocial correlates of glycemic control: The Pittsburgh Epidemiology of Diabetes Complications (EDC) study. Diabetes Research and Clinical Practice, 21, 187–195.

    Article  PubMed  CAS  Google Scholar 

  • Lustman, P. J., Clouse, R. E., Griffith, L. S., Carney, R. M., & Freedland, K. E. (1997). Screening for depression in diabetes using the Beck Depression Inventory. Psychosomatic Medicine, 59, 24–31.

    PubMed  CAS  Google Scholar 

  • Lustman, P. J. (1988). Anxiety disorders in adults with diabetes. The Psychiatric Clinics of North America, 11, 419–432.

    PubMed  CAS  Google Scholar 

  • McDonald, P. E., Wykle, M. L., Misra, R., Suwonnaroop, N., & Burant, C. J. (2002). Predictors of social support, acceptance, health-promoting behaviors, and glycemic control in African–Americans with type 2 diabetes. Journal of the National Black Nurses Association, 13, 23–30.

    PubMed  Google Scholar 

  • Nagasawa, M., Smith, M. C., Barnes, J. H., Jr., & Fincham, J. E. (1990). Meta-analysis of correlates of diabetes patients’ compliance with prescribed medications. The Diabetes Educator, 16, 192–200.

    Article  PubMed  CAS  Google Scholar 

  • Okwumabua, J. O., Baker, F. M., Wong, S. P., & Pilgram, B. O. (1997). Characteristics of depressive symptoms in elderly urban and rural African Americans. Journal of Gerontology, 52A, M241–M246.

    Google Scholar 

  • Olfson, M., Shea, S., Feder, A., Fuentes, M., Namura, Y., & Weissman, M. M. (2000). Prevalence of anxiety, depression and substance disorders in an urban general medicine practice. Archives of Family Medicine, 9, 876–883.

    Article  PubMed  CAS  Google Scholar 

  • Ornish, D. (1988). Love and survival: The scientific basis for the healing power of intimacy. New York: Harper Collins.

    Google Scholar 

  • Outlaw, F. H. (1993). Stress and coping: The influence of racism on the cognitive appraisal processing of African Americans. Issues in Mental Health Nursing, 14, 399–409.

    Article  PubMed  CAS  Google Scholar 

  • Penninx, B. W. J. H., van Tilburg, T., Boeke, J. P., Deeg, D. J. L., Kriegsman, D. M. W., & van Eijk, J. T. M. (1998). Effects of social support and personal coping resources on depressive symptoms: Different for various chronic diseases? Health Psychology, 17, 551–558.

    Article  PubMed  CAS  Google Scholar 

  • Regier, D. A., Farmer, M. E., Rae, D. S., Myers, J. K., Kramer, M., Robins, L. N., et al. (1993). One-month prevalence of mental disorders in the United States and sociodemographic characteristics: The epidemiologic catchment area study. Acta Psychiatry Scandinavia, 88, 35–47.

    Article  CAS  Google Scholar 

  • Robins, L. N., Cottler, L., Bucholz, K., Compton, W., North, C. S., & Rourke, K. M. (1999). Diagnostic Interview Schedule version IV. St. Louis: Washington University School of Medicine.

    Google Scholar 

  • Ruggiero, L., Spirito, A., Bond, A., Coustan, D., & McGarvey, S. (1990). Impact of social support and stress on compliance in women with gestational diabetes. Diabetes Care, 13, 441–443.

    Article  PubMed  CAS  Google Scholar 

  • Simon, G., Ormel, J., VonKorff, M., & Barlow, W. (1995). Health care costs associated with depressive and anxiety disorders in primary care. The American Journal of Psychiatry, 152, 352–357.

    PubMed  CAS  Google Scholar 

  • Stafford, R. S., Saglam, D., Causino, N., Starfield, B., Culpepper, L., Marder, W. D., & Blumenthal, D. (1999). Trends in adult visits to primary care physicians in the United States. Archives of Family Medicine, 8, 26–32.

    Article  PubMed  CAS  Google Scholar 

  • Taylor, S. E., & Seeman, T. E. (1999). Psychosocial resources and the SES-health relationship. Annals of the New York Academy of Sciences, 896, 210–225.

    Article  PubMed  CAS  Google Scholar 

  • Thomas, J. L., Jones, G. N., Scarinci, I. C., & Brantley, P. J. (2002). A descriptive and comparative study of the prevalence of depressive and anxiety disorders in low-income adults with type 2 diabetes and other chronic illnesses. Diabetes Care, 26, 2311–2317.

    Article  Google Scholar 

  • Uchino, B. N., Cacioppo, J. T., & Kiecolt-Glaser, J. K. (1996). Social support reduces cardiovascular reactivity to psychosocial challenge: A laboratory model. Psychosomatic Medicine, 46, 7–14.

    Google Scholar 

  • Wallhagen, M. I. (1999). Social support in diabetes. Diabetes Spectrum, 12, 254–260.

    Google Scholar 

  • Wasserman, L. I., & Trifonova, E. A. (2006). Diabetes mellitus as a model of psychosomatic and somatopsychic interrelationships. The Spanish Journal of Psychology, 9, 75–85.

    PubMed  Google Scholar 

  • Weich, S., Churchill, R., Lewis, G., & Mann, A. (1997). Do socioeconomic risk factors predict the incidence and maintenance of psychiatric disorder in primary care? Psychological Medicine, 27, 73–80.

    Article  PubMed  CAS  Google Scholar 

  • Weinger, K. (2007). Psychosocial issues and self-care. American Journal of Nursing, 107, 34–38.

    PubMed  Google Scholar 

  • Willoughby, D. F., Kee, C., & Demi, A. (2000). Women’s psychosocial adjustment to diabetes. Journal of Advanced Nursing, 32, 1422–1430.

    Article  PubMed  CAS  Google Scholar 

  • Wittchen, H. U., Kessler, R. C., Beesdo, K., Krause, P., Hofler, M., & Hoyer, J. (2002). Generalized anxiety and depression in primary care: Prevalence, recognition and management. Journal of Clinical Psychiatry, 63, 24–34.

    PubMed  Google Scholar 

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Acknowledgment

This work was supported by a grant from the National Institute of Mental Health (R01 MH1194).

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Authors and Affiliations

  1. Department of Medicine, University of Minnesota, G254 Mayo Memorial Building, MMC 451, 420 Delaware Street, SE, Minneapolis, MN, 55455, USA

    Janet L. Thomas

  2. Louisiana State University Health Sciences Center, Baton Rouge, LA, USA

    Glenn N. Jones

  3. Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA

    Isabel C. Scarinci

  4. Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA

    Phillip J. Brantley

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  1. Janet L. Thomas
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  2. Glenn N. Jones
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  3. Isabel C. Scarinci
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  4. Phillip J. Brantley
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Correspondence to Janet L. Thomas.

Additional information

This paper was awarded the Lifescan Diabetes Research Award at the 23rd Annual Meeting of the Society of Behavioral Medicine.

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Thomas, J.L., Jones, G.N., Scarinci, I.C. et al. Social Support and the Association of Type 2 Diabetes and Depressive and Anxiety Disorders Among Low-income Adults Seen in Primary Care Clinics. J Clin Psychol Med Settings 14, 351–359 (2007). https://doi.org/10.1007/s10880-007-9089-0

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