Depression and Anxiety Among Partners of European-American and Latino Patients With Type 2 Diabetes
- Lawrence Fisher, PHD1,
- Catherine A. Chesla, RN, DNSc1,
- Marilyn M. Skaff, PHD1,
- Joseph T. Mullan, PHD1 and
- Richard A. Kanter, MD, FACE2
- 1University of California, San Francisco, California
- 2Northern California Kaiser Permanente, San Francisco, California
OBJECTIVE—To assess the levels of and the independent contributors to depressive affect and anxiety among partners of patients with type 2 diabetes.
RESEARCH DESIGN AND METHODS—The partners of 75 Latino and 113 European-American patients with type 2 diabetes were assessed for level of depressive affect and anxiety and for three groups of potential stressors: demographics (age, gender, and education), patient disease status (time since diagnosis, HbA1c, comorbidities, and BMI), and family stress (disease impact, spouse conflict, and family closeness). Dependent variables were partner depressive affect (Center for Epidemiological Studies-Depression scale) and anxiety (Symptom Checklist [SCL-90] anxiety). Predictors of partner depressive affect and anxiety and partner-patient concordance rates were computed.
RESULTS—Levels of depressive affect and anxiety and rates of likely depression (21.4%) were as high for partners as they were for patients. No differences were found on depressive affect or anxiety by ethnicity, but female partners scored higher than male partners on both measures. Partner-patient concordance rates were low. The family level variables accounted for the most variance in both depressive affect and anxiety, with demographics and disease status variables contributing modest or nonsignificant independent variance.
CONCLUSIONS—Partners of patients with type 2 diabetes experience levels of psychological distress as high or even higher than patients, especially if the partner is female. Low levels of concordance suggest that partners can be distressed even if patients are not. Many life stresses contribute to psychological distress among partners, not just disease-related indicators. The findings suggest the utility of evaluating both partners and patients using a life-centered rather than a disease-focused perspective.
- CES-D, Center for Epidemiological Studies-Depression scale
- MDD, major depressive disorder
- SCL-90, Symptom Checklist
Address correspondence and reprint requests to Lawrence Fisher, Department of Family & Community Medicine, Box 0900, University of California, San Francisco, CA 94143. E-mail:.
Received for publication 29 August 2001 and accepted in revised form 25 March 2002.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
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