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. 2024 Jun;61(6):725-734.
doi: 10.1007/s00592-024-02248-7. Epub 2024 Mar 2.

Depression, anxiety, and health-related quality of life in normal weight, overweight and obese individuals with diabetes: a representative study in Germany

Benedict Herhaus  1 , Johannes Kruse  2   3 , Andreas Hinz  4 , Elmar Brähler #  5   6 , Katja Petrowski #  7
Affiliations

Depression, anxiety, and health-related quality of life in normal weight, overweight and obese individuals with diabetes: a representative study in Germany

Benedict Herhaus et al. Acta Diabetol. 2024 Jun.

Abstract

Objective: Diabetes in the course of lifetime is related to a higher risk for mental disorders. The present study addresses the comparison of individuals with diabetes and non-diabetic individuals in depressive symptoms, generalized anxiety symptoms, and health-related quality of life. Furthermore, mediator effect of BMI and health-related quality of life (HRQOL) on the association between diabetes, depression, and generalized anxiety was analyzed.

Methods: In this cross-sectional study, the three questionnaires PHQ-9, GAD-7, EQ-5D-5L were measured in a representative sample of the German population (N = 2386). In addition, the presence of diabetes and BMI were assessed via self-report.

Results: There were higher values in depressive and anxiety symptoms as well as lower score in HRQOL in individuals with diabetes compared to non-diabetic individuals. Obese individuals with diabetes showed the highest rates in depressive symptoms and generalized anxiety as well as lowest score in HRQOL. With regard to the mediator analyses, association between diabetes, depressive symptoms, and anxiety symptoms is partially mediated by the BMI and fully mediated by the HRQOL.

Conclusions: In conclusion, individuals with diabetes have an increased risk in the development of depressive and anxiety symptoms as well as lower health-related quality of life. Future research and strategies in the public health policies among individuals with diabetes should take into account that the association between diabetes, depression, and anxiety is mediated by BMI and HRQOL.

Keywords: Anxiety; Depression; Diabetes; Health-related quality of life; Obesity.

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Conflict of interest statement

The authors have no conflict of interest to disclose.

Figures

Fig. 1
Fig. 1
Comparison of individuals with diabetes and non-diabetic individuals across different BMI classes in in the PHQ-9, GAD-7 and EQ-5D. *: p ≤ 0.05; ***: p ≤ 0.001
Fig. 2
Fig. 2
BMI as mediator of the effect of diabetes on depression symptoms and generalized anxiety symptoms including covariates gender and age. ***: p ≤ 0.001.
Fig. 3
Fig. 3
EQ-5D-5L as mediator of the effect of diabetes on depression symptoms and generalized anxiety symptoms including covariates gender and age. *: p ≤ 0.05; **: p ≤ 0.01; ***: p ≤ 0.001
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