Association of depression and anxiety with clinical, sociodemographic, lifestyle and environmental factors in South Asian and white European individuals at high risk of diabetes

Diabet Med. 2019 Sep;36(9):1158-1167. doi: 10.1111/dme.13986. Epub 2019 Jun 30.

Abstract

Aim: To investigate the prevalence and correlates of depressive and anxiety symptoms within South Asian and white European populations at high risk of developing Type 2 diabetes.

Methods: Data were collected at baseline, and at 12, 24 and 36 months from 1429 white European individuals (age 64±7 years, 35.8% women) and 160 South Asian individuals (age 59±9 years, 30.6% women) who were at high risk of Type 2 diabetes and who took part in two Type 2 diabetes prevention trials in Leicestershire, UK. The Hospital Anxiety and Depression Scale was administered during each study visit. Clinical, sociodemographic, lifestyle and environmental data were collected.

Results: At baseline, the burden of depressive symptoms varied by ethnic group and gender, with 9.9% of white European men, 14.9% of white European women, 23.6% of South Asian men and 29.2% of South Asian women exceeding the cut-off score for mild-to-severe depression. During the course of the study and after adjustment for clinical, sociodemographic, lifestyle and environmental factors, depressive symptoms remained higher in the South Asian compared to the white European participants [score higher by 1.5, 95% CI 0.9-2.1]. Levels of anxiety were also higher in the South Asian participants, although associations were attenuated after adjustment. Social deprivation, BMI, proximity to fast-food outlets and physical activity were correlates for depression in both the South Asian and white European participants.

Conclusions: A higher burden of depressive symptoms was consistently evident among the South Asian individuals, even after adjustment for multiple covariates. It is important to understand both the reasons why these differences are present, to help reduce health inequalities, and whether higher levels of depressive symptoms affect the uptake of and retention rates in diabetes prevention programmes in South Asian communities.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anxiety / complications
  • Anxiety / epidemiology*
  • Anxiety / ethnology
  • Asia / ethnology
  • Asian People / statistics & numerical data*
  • Depression / complications
  • Depression / epidemiology*
  • Depression / ethnology
  • Diabetes Mellitus, Type 2 / etiology
  • Environment
  • Female
  • Humans
  • Life Style* / ethnology
  • Male
  • Middle Aged
  • Prediabetic State / epidemiology*
  • Prediabetic State / ethnology
  • Prediabetic State / psychology*
  • Risk Factors
  • Social Environment
  • Socioeconomic Factors
  • United Kingdom / epidemiology
  • White People / statistics & numerical data*