Background: Depression affects 33% of women with type 2 diabetes (T2D) and leads to increased risks of premature mortality. Fluctuation and variation of depressive presentations can hinder clinical identification.
Purpose: We aimed to identify and examine subgroups characterized by distinct depressive symptom trajectories among women with T2D.
Methods: This retrospective analysis leveraged the Women's Interagency HIV Study data to identify depressive symptom trajectories based on the Center for Epidemiological Studies Depression scores (2014-2019) among women with and without HIV. Descriptive statistics characterized sample demographics (eg, age, race, income), clinical indices (eg, hemoglobin A1C [HbA1c], BMI, HIV status), and psychosocial experiences (eg, discrimination, social support, anxiety, pain). We used growth mixture modeling to identify groups defined by distinct depressive symptom trajectories and parametric and non-parametric tests to examine demographic, clinical, and psychosocial differences across subgroups.
Results: Among the 630 women included, the mean age was 50.4 (SD = 8.3) years, 72.4% identified as Black and non-Hispanic, and 68.2% were living with HIV. Five subgroups were identified and distinguished by severity and symptom type. Participants with lower incomes (P = .01), lower employment (P < .0001), lower social support (P = .0001), and experiences of discrimination (P < .0001) showed greater membership in threshold, moderate, and severe depressive subgroups. Subgroup membership was not associated with metabolic indices (BMI, HbA1c) or HIV status. Anxiety, pain, and loneliness (all P = .0001) were worse in subgroups with higher depressive symptoms.
Conclusions: Among women with T2D, depressive symptom trajectories differ across clinical and social contexts. This study advances precision by delineating subgroups within a broad clinical category.
Keywords: HIV care; chronic illness; depression; quantitative methods; women’s health.
This study looked at how depression affects women with type 2 diabetes (T2D), especially those living with HIV. Depression is widespread among women with T2D and HIV, and it often makes these chronic conditions worse. However, depression can look very different from person to person, making early identification a challenge for healthcare providers. Researchers found women with T2D may experience different kinds and courses of depressive symptoms over time. By analyzing existing data from a large ongoing HIV study, they identified 5 distinct groups of women based on their depression severity and the type of symptoms they reported. Factors like lower income, less social support, and experiences of discrimination were linked to more severe depression groups, while other health indicators, like body mass index or HIV status, did not show a clear relationship. The findings highlight the importance of understanding mental health in various social and clinical contexts and the need to disentangle depression, which can be an overly broad term, to develop more personalized and effective therapies.
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