Depression Clinical Trial
Official title:
A Multicentre Study to Investigate the Prevalence and Factors Associated With Depression in Chinese Patients With Type 2 Diabetes
The investigators aim to:
1. Estimate the prevalence of depression in a consecutive cohort of Chinese patients
diagnosed with Type 2 Diabetes (T2D) living in areas of China with different
socioeconomical affluence
2. Examine patients' awareness of the frequent coexistence of these 2 conditions
3. Analyze the associations between depression and T2D, in particularly the role of
metabolic control, socioeconomical status and cognitive-psychological-behavioral
factors
4. To document the predisposing, precipitating and perpetuating factors for depression and
their interrelationships in Chinese type 2 diabetic patients
Overall objectives of this multicentre study are to document;
1. the prevalence and diagnosis rates of depression in type 2 diabetic (T2D) patients
attending 7 centres in 4 major cities in China including Hong Kong (HK), Shanghai (SH),
Guangzhou (GZ) and Beijing (BJ)
2. the predisposing, precipitating and perpetuating factors for depression and their
interrelationships in Chinese T2D patients
This study includes two phases. In the phase I pilot study, the investigators shall confirm
and compare the validity of Patient Health Questionnaire (PHQ-9) and Clinical
Epidemiological Scale for Depression (CESD) in predicting depression in Chinese T2D patients
using the SCID as a gold standard. Other questionaires which measure personal and external
factors, diabetes associated distress and anxiety, quality of life, mental wellness, self
efficacy, health-related behavior and compliance will also be used to document possible
predisposing, precipitating and perpetuating factors for depression in diabetes. These
results will be used to select a set of tools which are most informative in the evaluation
of depression and mental wellness in T2D patients based on their predictions for health
behavior, compliance and metabolic control. A random sample of 100 T2D patients will be
recruited from 3 Diabetes Centres in GZ, BJ and HK who will complete a full set of
questionnaires and structured clinical assessments using a web-based electronic portal. In
each of the three centres, all patients found to have positive symptoms for mild to severe
depression by PHQ9 or CESD (PHQ>10 and/or CES>16) and a random sample of 20 subjects with no
or mild symptoms will undergo face-to-face interview by psychiatrists using the following
instruments: SCID, BDI, SSI-28 (somatization), Coping (Brief Cope 28, Chinese version).
In Phase II, the investigators shall use a subset of the most informative questionaires to
document the rates of depression (diagnosed and undiagnosed) and
cognitive-psychological-behavioral factors in a consecutive cohort of Chinese patients with
T2D and its associations with metabolic control and psychological behavioral factors. In
each of the 7 participating centres in HK, SH, BJ and GZ, 500 consecutive patients will
undergo comprehensive clinical assessments for risk factors, complications and medications
the JADE (Joint Asia Diabetes Evaluation) e-portal, giving a total of 3500 patients.
This survey which documents the rate of depression in T2D patients using similar
methodologies will provide a comprehensive data set for exploratory analysis of the
multicausality and heterogeneity of clinical presentation and risk factors in Chinese
populations. Once this cohort is established and subject to availability of future funding,
they can be followed up prospectively to validate and discover risk factors for new onset of
depression. Apart from raising awareness, these data are essential in our design of care
models and interventions to tailor the unmet needs of these patients. Data from this study
will also provide insights into the effects of rapid acculturation and migration on the
double burden of diabetes and depression in Chinese populations.
;
Observational Model: Cohort, Time Perspective: Cross-Sectional
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