To determine levels of depression and anxiety symptoms among adults with diabetes and identify factors associated with increased risk.


This study administered self-report symptom inventories to patients at the beginning (n = 634) and end (n = 578) of an outpatient diabetes education program. Subjects (n = 246) contacted by mail 6 months later completed the same instruments.


Rates of disturbance for depression (41.3%; 95% CI: 37.4–45.2%) and anxiety (49.2%; 95% CI: 45.3–53.1%) were higher than those typical in the general population (10–20%). Probability of disturbance ranged from 5–7% for those with the lowest risk profile to 82–92% for those with the highest risk profile. Diabetes-related complications were the only disease factor associated with significantly increased risk of disturbance. Women and those with less education were at much higher risk. Only 13% of those followed for 6 months were disturbed at all three time-points.


Diabetes is associated with increased risk of psychological disturbance, especially for those with more diabetes-related complications. Sociodemographic factors account for much of the risk differential among people with diabetes.

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