Association of cognitive-emotional regulation strategies to depressive symptoms in type 2 diabetes patients.

AIM: The present cross-sectional observational study aimed to investigate the relation between cognitive-emotional regulation strategies and depressive symptoms in type 2 diabetes patients in the context of sociodemographic and clinical factors, of diabetes distress, perception of illness consequences and previous depression. METHOD: Multiple logistic regression was performed on the responses of 354 adults with type 2 diabetes (58.5% women; mean ± SD age: 61.14 ± 8.5 years; diabetes duration: 9.7 ± 6.4 years; BMI: 30.9 ± 5.3 kg/m2). Depressive symptoms were present in 16.9% and diabetes distress in 45.5%. Participants completed questionnaires on depression (BDI-II), cognitive-emotional regulation strategies (CERQ), diabetes distress (DDS), illness perceived consequences (IPQ-R). RESULTS: Of the cognitive-emotional strategies, lower positive reappraisal of diabetes (OR:0.49;CI:0.34-0.70) and increased catastrophizing (OR:2.08; CI:1.47-2.91) were found to increase the likelihood of experiencing depressive symptoms in the presence of higher diabetes distress (OR: 1.53; CI:1.07-2.19), increased negative perception of diabetes consequences (OR:2.02; CI:1.34-3.06) and the presence of previous depression (OR:4.18; CI:2.03-8.63). CONCLUSION: To our knowledge, this is the first study to report on cognitive-emotional regulation strategies in type 2 diabetes and provides evidence for the beneficial influence of positive reappraisal and adverse effect of catastrophizing on depressive symptoms in the context of diabetes distress, perceived consequences of diabetes and previous history of depression.

Depression in romanian patients with type 2 diabetes: prevalence and risk factors.

BACKGROUND AND AIMS: Co-existing major depression was found to have a negative impact on the diabetes outcome and the quality of life. The aim of the present study was to assess the prevalence of depressive symptoms in Romanian diabetes patients and to identify the risk factors associated with depression. METHODS: A total of 144 type 2 diabetes patients were included in the study. Five models of presumed predictors were used to assess the risk factors for depressive symptoms, using hierarchical regression analysis. Together with demographics, disease, lifestyle predictors, previous depressive symptoms and diabetes distress were taken into account. RESULTS: In our sample the prevalence of depression was 12.6%. Main risk factors for depressive symptoms were previous depressive symptoms which were associated with depression in both Model 4 (ß=0.297, p=0.013) and Model 5 (ß=0.239, p=0.017) and diabetes distress in Model 5 (ß=0.540, p≤0.001). Employment (ß =-0.276, p=0.029) and increased number of diabetes complications (ß=0.236, p=0.017) became significant when diabetes distress was added to the analysis. CONCLUSIONS: The overall prevalence of depressive symptoms was found to be in range with the prevalence identified in the literature. Previous depression and diabetes distress were both independently associated with depression, confirming the bidirectional relationship between depression and diabetes distress. Due to the consequences for daily living, screening for diabetes distress and depression should be done in primary care units both by physicians and trained nurses.

Children's and adolescents' snacking: interplay between the individual and the school class.

OBJECTIVE: In schools, perceived norms of classmates facilitate but can also inhibit unhealthy food intake in children and adolescents. However, the role of actual class behaviors and attitudes is less established. Thus, the present study examined classmates' actual eating behavior and food preferences in relation to actual food intake. In addition, it tested whether these normative effects are facilitated by corresponding individual and class food preferences or a positive social self-concept. METHODS: The food preferences, social self-concept, and unhealthy snacking frequency of 734 Finnish, 829 German, and 555 Romanian children and adolescents (aged 8-19) from 127 school-classes were assessed. RESULTS: Multilevel analysis at individual and class level showed that classmates shared similar snacking habits (14.7% variance). Moreover, the unhealthy food preference of a school-class was associated with its collective snacking [[Formula: see text], p < 0.001, PRV = 0.32). This effect was facilitated by individual, unhealthy food preferences [[Formula: see text], p < 0.001, PRV = 0.57] and a positive social self-concept [[Formula: see text], p = 0.015, PRV = 0.12]. CONCLUSIONS: Actual class norms are related to children's and adolescents' eating, but their impact depends on individual differences in preferences and social self-concept.