Abstract
INTRODUCTION: Depressive tendencies associated with difficulty in the treatment of type 1 diabetes (T1D) could hinder appropriate intervention. Factors related to depressive tendencies in Japan remain unclear, though recent advances in medication may have affected them. MATERIALS AND METHODS: Three hundred and fifty-two Japanese patients with T1D registered in the Juntendo-Aso Type 1 Diabetes (JAT-1) Cohort Study were divided into two groups based on depressive tendencies assessed with the Beck Depression Inventory-II score. We compared background characteristics of the patients between the groups and also analyzed additional clinical factors and quality of life scores. RESULTS: The patients with a Beck Depression Inventory-II score ≧14 (35.5%) are classified as having depressive tendencies. Compared to the individuals without depressive characteristics, those with depressive tendencies had significantly higher proportions of females, welfare recipients, and shift workers; a higher proportion of individuals with microvascular complications; higher diastolic pressure; eating out or taking out food more frequently for dinner; lower protein intake; and higher scores in the total score of diabetes-related problem domains and Pittsburgh Sleep Quality Index. Multiple regression analysis revealed that diastolic blood pressure, welfare recipient status, total score of diabetes-related problem domains (PAID), and Pittsburgh Sleep Quality Index were significantly associated factors with BDI-II score, and the PAID score showed the strongest association. CONCLUSIONS: This study revealed that diabetes-specific psychological burden, evaluated with the PAID score, is strongly associated with depressive tendencies. Routine use of the PAID could support the strategies to prevent depression in people with type 1 diabetes by identifying those at risk.