Does heterogeneity of depression matter in the nexus between sedentary behavior and depression among patients with diabetes?

Abstract

BACKGROUND: Depression and sedentary behavior (SB) are prevalent co-morbidities of diabetes. However, heterogeneity of depression complicates understanding the SB and depression nexus. This study investigated the associations of SB with depression and the four dimensions of depressive symptoms (negative affect, positive affect, somatic symptoms, and interpersonal problems), as well as the moderating effect of gender among patients with diabetes.METHODS: A total of 351 diabetes patients attending endocrinology clinic in a Nigerian tertiary hospital had their SB and depressive symptoms assessed with the use of the International Physical Activity Questionnaire Short Form and Center for Epidemiologic Studies Depression Scale (CES-D).RESULTS: There was positive association between SB and total CES-D score, and separate and non-uniform positive associations of SB with the four dimensions of depression. Of all the dimensions of depression, somatic symptoms had the strongest association with SB. The impact of SB on overall depression and on negative affect, positive affect, and interpersonal problems was significantly higher in women than men.CONCLUSIONS: These findings suggest that all dimensions of depression present with distinct link with SB. Overall, the impact of SB on depression was more likely to be expressed as somatic symptoms than any other dimension of depression. Furthermore, the influence of SB on depressive symptoms differed by gender in patients with diabetes. Thus, breaking SB may reduce depressive symptoms especially somatization in patients with diabetes while gender-specific strategies may be warranted to tackle impact of SB on depression in diabetes.