Prevalence and associated factors of depressive symptoms in Chinese diabetic patients: A study based on Andersen’s behavioral model

Table 1 Predisposing characteristics and depressive symptoms of patients with diabetes mellitus

Variables	Total			Depressed			Not depressed			P value
	n	Unweighted	Weighted	n	Unweighted	Weighted	n	Unweighted	Weighted
Total	1673	100.0%	100.0%	693	100.0%	100.0%	980	100.0%	100.0%	-
Age (mean ± SD)	1673	63.14 ± 8.99	63.80 ± 9.28	693	63.25 ± 9.07	63.82 ± 9.30	980	63.06 ± 8.93	63.78 ± 9.27	0.936
Sex										< 0.001
Female	914	54.6%	52.1%	458	66.1%	67.1%	456	46.5%	42.3%
Male	759	45.4%	47.9%	235	33.9%	32.9%	524	53.5%	57.7%
Education										< 0.001
Not formally educated	310	18.5%	15.5%	173	25.0%	22.2%	137	14.0%	11.2%
Primary or middle school	1083	64.7%	64.2%	449	64.8%	67.9%	634	64.7%	61.8%
High school and above	280	16.7%	20.3%	71	10.2%	9.9%	209	21.3%	27.0%
Marital status										< 0.001
Single/divorced/widowed	231	13.8%	12.9%	131	18.9%	17.9%	100	10.2%	9.7%
Married/cohabitation	1442	86.2%	87.1%	562	81.1%	82.1%	880	89.8%	90.3%

Table 2 Enabling resources and depressive symptoms of patients with diabetes mellitus

Variables	Total			Depressed			Not depressed			P value
	n	Unweighted	Weighted	n	Unweighted	Weighted	n	Unweighted	Weighted
Total	1673	100.0%	100.0%	693	100.0%	100.0%	980	100.0%	100.0%	-
Residence										< 0.001
Rural areas	999	59.7%	49.3%	460	66.4%	55.0%	539	55.0%	45.5%
Urban areas	479	28.6%	37.1%	150	21.6%	29.7%	329	33.6%	41.9%
Combination zone	195	11.7%	13.7%	83	12.0%	15.3%	112	11.4%	12.6%
Personal income (mean ± SD)	1673	4881 ± 31882	5471 ± 38410	693	1957 ± 9270	1839 ± 9137	980	6949 ± 40803	7835 ± 48663	0.003
Months of living with children (mean ± SD)	1673	3.48 ± 6.14	3.28 ± 5.75	693	3.62 ± 6.32	3.34 ± 5.87	980	3.37 ± 6.02	3.24 ± 5.68	0.735
Social activity										0.003
No	675	40.3%	38.4%	317	45.7%	43.8%	358	36.5%	34.9%
Yes	998	59.7%	61.6%	376	54.3%	56.2%	622	63.5%	65.1%

Table 3 Healthcare needs and depressive symptoms of patients with diabetes mellitus

Variables	Total			Depressed			Not depressed			P value
	N	Unweighted	Weighted	n	Unweighted	Weighted	n	Unweighted	Weighted
Total	1673	100.0%	100.0%	693	100.0%	100.0%	980	100.0%	100.0%	-
Self-rated health										< 0.001
Poor	733	43.8%	41.0%	445	64.2%	60.8%	288	29.4%	28.2%
Fair	753	45.0%	48.1%	219	31.6%	34.8%	534	54.5%	56.7%
Good	187	11.2%	10.9%	29	4.2%	4.4%	158	16.1%	15.1%
Pain										< 0.001
None	540	32.3%	35.5%	130	18.8%	20.2%	410	41.8%	45.4%
Mild	721	43.1%	43.2%	292	42.1%	43.5%	429	43.8%	43.0%
Severe	412	24.6%	21.3%	271	39.1%	36.3%	141	14.4%	11.6%
BADL impairment										< 0.001
No	1250	74.7%	77.4%	421	60.8%	63.9%	829	84.6%	86.2%
Yes	423	25.3%	22.6%	272	39.2%	36.1%	151	15.4%	13.8%
Disability										< 0.001
No	940	56.2%	58.6%	312	45.0%	48.5%	628	64.1%	65.3%
Yes	733	43.8%	41.4%	381	55.0%	51.5%	352	35.9%	34.7%
Sleep duration (mean ± SD)	1673	6.06 ± 1.99	6.10 ± 1.90	693	5.59 ± 2.16	5.65 ± 2.07	980	6.39 ± 1.78	6.39 ± 1.72	< 0.001

BADL: Basic activities of daily living.

Table 4 Health behaviors and depressive symptoms of patients with diabetes mellitus

Variables	Total			Depressed			Not depressed			P value
	n	Unweighted	Weighted	n	Unweighted	Weighted	n	Unweighted	Weighted
Total	1673	100.0%	100.0%	693	100.0%	100.0%	980	100.0%	100.0%	-
Outpatient visit (mean ± SD)	1673	0.57 ± 1.63	0.58 ± 1.54	693	0.77 ± 2.08	0.77 ± 1.96	980	0.44 ± 1.19	0.46 ± 1.18	< 0.001
Hospitalization (mean ± SD)	1673	0.50 ± 1.11	0.50 ± 1.06	693	0.66 ± 1.39	0.65 ± 1.30	980	0.39 ± 0.83	0.41 ± 0.86	< 0.001
Health service satisfaction										0.002
Dissatisfied	321	19.2%	19.4%	159	22.9%	24.1%	162	16.5%	16.3%
Neutral	744	44.5%	45.6%	308	44.4%	46.9%	436	44.5%	44.8%
Satisfied	608	36.3%	35.0%	226	32.6%	29.0%	382	39.0%	38.9%
DM treatment										0.724
No	341	20.4%	18.0%	142	20.5%	17.5%	199	20.3%	18.3%
Yes	1332	79.6%	82.0%	551	79.5%	82.5%	781	79.7%	81.7%
Blood glucose test (mean ± SD)	1673	20.2 ± 60.0	25.2 ± 69.8	693	22.7 ± 76.4	24.9 ± 79.5	980	18.4 ± 44.9	25.4 ± 62.7	0.885
Smoking										< 0.001
No	999	59.7%	58.4%	457	65.9%	66.9%	542	55.3%	52.8%
Yes	674	40.3%	41.6%	236	34.1%	33.1%	438	44.7%	47.2%
Drinking										< 0.001
No	1186	70.9%	68.3%	534	77.1%	75.2%	652	66.5%	63.8%
Yes	487	29.1%	31.7%	159	22.9%	24.8%	328	33.5%	36.2%

Table 5 Variables associated with depressive symptoms in patients with diabetes mellitus in the logistic regression analysis

Variables	Model 1		Model 2		Model 3		Model 4
	OR	SE	OR	SE	OR	SE	OR	SE
Predisposing characteristic
Age	0.985a	0.006	0.984a	0.006	0.976b	0.008	0.984	0.009
Sex: Male	0.447b	0.051	0.436b	0.051	0.522b	0.069	0.426b	0.106
Education1
Primary or middle	0.830	0.128	0.912	0.138	0.980	0.183	0.929	0.219
High school and above	0.335b	0.070	0.416b	0.087	0.459b	0.112	0.432a	0.141
Marital status: Married	0.954	0.147	0.883	0.143	0.860	0.151	0.634a	0.136
Enabling resource
Residence2
Urban areas	-	-	0.673a	0.114	0.877	0.155	1.004	0.191
Combination zone	-	-	1.128	0.241	1.268	0.233	1.536	0.361
Personal income	-	-	0.986	0.020	1.006	0.024	1.020	0.024
Months of living with children	-	-	0.977	0.025	0.966	0.028	1.002	0.034
Social activity: Yes	-	-	0.814a	0.083	0.920	0.108	0.846	0.121
Healthcare need
Self-rated health3
Fair	-	-	-	-	0.475b	0.063	0.458b	0.074
Good	-	-	-	-	0.379b	0.109	0.247b	0.070
Pain4
Mild	-	-	-	-	1.204	0.206	1.440a	0.249
Severe	-	-	-	-	2.372b	0.424	2.644b	0.532
BADL impairment: Yes	-	-	-	-	2.112b	0.270	1.886b	0.323
Disability: Yes	-	-	-	-	1.267	0.158	1.332	0.201
Sleep duration	-	-	-	-	0.676b	0.101	0.642a	0.118
Health behaviors
Outpatient visit	-	-	-	-	-	-	1.081	0.050
Hospitalization	-	-	-	-	-	-	1.006	0.063
Health service satisfaction5
Neutral	-	-	-	-	-	-	0.902	0.174
Satisfied	-	-	-	-	-	-	0.579b	0.121
DM treatment: Yes	-	-	-	-	-	-	0.912	0.162
Blood glucose test	-	-	-	-	-	-	1.005	0.053
Smoking: Yes	-	-	-	-	-	-	1.200	0.258
Drinking: Yes	-	-	-	-	-	-	1.255	0.252

^aP < 0.05, SE (weighted) in parentheses.

^bP < 0.01, SE (weighted) in parentheses.

¹Reference group: Not formally educated.

²Reference group: Rural areas.

³Reference group: Poor.

⁴Reference group: None.

⁵Reference group: Dissatisfied.

BADL: Basic activities of daily living; OR: Odds ratio.