{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T09:34:39Z","timestamp":1793266479186,"version":"4.5.0"},"reference-count":50,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["SAGE Open Medicine"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>The psychological distress of people living with diabetes is increased and associated with poorer glycemic outcomes and self-care. We aimed to examine the frequency of depression, anxiety, and diabetes-related distress (DRD) of individuals with type 2 diabetes (T2D) in primary care (PC) and their comparative associations with clinical, self-care, and socio-demographic characteristics, testing for possible different roles on glycemic control and self-care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This is a cross-sectional study of 182 adults with a T2D diagnosis of at least six months, recruited between August 2019-March 2020 and May-October 2020, from an urban PC unit. Participants were screened for symptoms of depression (Patient Health Questionnaire-9 (PHQ-9)), anxiety (Generalized Anxiety Disorder-7 (GAD-7)), and DRD (Diabetes Distress Scale (DDS)). Clinical, self-care, and socio-demographic parameters were recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The frequency of clinically significant symptoms of depression was 16.6%, (PHQ-9 score \u2a7e10), anxiety 17.7% (GAD-7 score \u2a7e10), and DRD 22.6% (DDS score \u2a7e2). All PHQ-9, GAD-7, and DDS scores intercorrelated, and higher scores were found to be associated with female gender, lower income, and prior diagnosis of depression. Higher PHQ-9 and GAD-7 scores were found to be associated with lower education, more hypoglycemia episodes, more blood glucose self-tests and antidepressant or benzodiazepine use. The retired\/housewives scored significantly lower in GAD-7 and DDS compared to the unemployed participants. Higher DDS scores were associated with higher glycated hemoglobin, higher fasting plasma glucose, and insulin use. It was also noted that higher PHQ-9 scores were associated with lower uric acid levels and were significantly higher in the sedentary lifestyle group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>DRD was associated with poorer glycemic outcomes while depressive symptoms were associated with lower physical activity perhaps sharing different roles for glycemic control and self-care. The psychological burden of individuals with T2D may be considered in PC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20503121221096605","type":"journal-article","created":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T20:20:41Z","timestamp":1652905241000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":30,"title":["Depression, anxiety, and diabetes-related distress in type 2 diabetes in primary care in Greece: Different roles for glycemic control and self-care"],"prefix":"10.1177","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1265-3351","authenticated-orcid":false,"given":"Kyriakos","family":"Kintzoglanakis","sequence":"first","affiliation":[{"name":"Local Health Team Unit of Thebes, Thebes, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Gkousiou","sequence":"additional","affiliation":[{"name":"Private Practice, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paraskevi","family":"Vonta","sequence":"additional","affiliation":[{"name":"Local Health Team Unit of Thebes, Thebes, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agisilaos","family":"Sagmatopoulos","sequence":"additional","affiliation":[{"name":"Health Center of Erythres, Erythres, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiota","family":"Copanitsanou","sequence":"additional","affiliation":[{"name":"General Hospital of Piraeus \u201cTzaneio,\u201d Piraeus, Greece"},{"name":"Department of Nursing Science, National and Kapodistrian University of Athens, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,5,12]]},"reference":[{"key":"bibr1-20503121221096605","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.8040"},{"key":"bibr2-20503121221096605","doi-asserted-by":"publisher","DOI":"10.1037\/a0040408"},{"key":"bibr3-20503121221096605","volume":"42","author":"Diabetes Canada Clinical Practice Guidelines Expert Committee","year":"2018","journal-title":"Can J Diabetes"},{"key":"bibr4-20503121221096605","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12620"},{"key":"bibr5-20503121221096605","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2005.01644.x"},{"key":"bibr6-20503121221096605","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12245"},{"key":"bibr7-20503121221096605","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2020.107748"},{"key":"bibr8-20503121221096605","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"bibr9-20503121221096605","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(15)00135-7"},{"key":"bibr10-20503121221096605","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12428"},{"key":"bibr11-20503121221096605","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcd.2012.11.002"},{"key":"bibr12-20503121221096605","doi-asserted-by":"publisher","DOI":"10.2337\/dc10-1970"},{"key":"bibr13-20503121221096605","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2008.02533.x"},{"key":"bibr14-20503121221096605","doi-asserted-by":"publisher","DOI":"10.2337\/dc09-1238"},{"key":"bibr15-20503121221096605","doi-asserted-by":"publisher","DOI":"10.1037\/hea0000131"},{"key":"bibr16-20503121221096605","doi-asserted-by":"publisher","DOI":"10.2337\/dc09-2175"},{"key":"bibr17-20503121221096605","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2015.11.010"},{"key":"bibr18-20503121221096605","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcjd.2016.02.014"},{"key":"bibr19-20503121221096605","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-1553"},{"key":"bibr20-20503121221096605","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13448"},{"key":"bibr21-20503121221096605","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-008-1113-x"},{"key":"bibr22-20503121221096605","doi-asserted-by":"publisher","DOI":"10.1177\/2470547020961538"},{"key":"bibr23-20503121221096605","doi-asserted-by":"publisher","DOI":"10.1007\/s42000-020-00237-3"},{"key":"bibr24-20503121221096605","doi-asserted-by":"publisher","DOI":"10.1186\/1756-0500-1-101"},{"key":"bibr25-20503121221096605","doi-asserted-by":"publisher","DOI":"10.2174\/1871530317666171120154002"},{"key":"bibr26-20503121221096605","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw106"},{"key":"bibr27-20503121221096605","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2001.016009606.x"},{"key":"bibr28-20503121221096605","unstructured":"National Diabetes Services Scheme (NDSS). 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