Ethnic differences in the relationship between depression and health-related quality of life in persons with Type 2 Diabetes

Abstract

This study examined ethnic differences in the relationship between depressive symptoms and eight aspects of health-related quality of life and the moderating effects of glycemic control and socio-demographic factors in persons with type 2 diabetes. Data from 190 people of Native Hawaiian, Japanese, Filipino, and mixed-ethnic ancestries with type 2 diabetes were analyzed. Using the SF-36 Health Survey (SF-36), the eight aspects of health-related quality of life examined were Physical Functioning, Role-Physical Functioning, Role-Emotional Functioning, Social Functioning, Bodily Pain, Vitality, General Health, and Health Transition. Depressive symptoms were measured using the Center for Epidemiological Studies - Depression (CES-D) scale. Results indicated that seven of the eight SF-36 subscales were significantly correlated with CES-D scores in the combined sample, controlling for glycemic control, social support, and socio-demographic variables. Significant ethnic differences in the relationship between CES-D scores and the SF-36 subscale scores of Physical Functioning, Bodily Pain, General Health, Vitality, and Role-Physical Functioning subscales were found. Differential moderating effects were found across ethnic groups and across SF-36 subscales for glycemic control, sex, marital status, education level, and social support. The results and implications of this study were discussed in the context of past studies and cultural explanations for the ethnic differences were explored.