{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T15:23:01Z","timestamp":1778772181688,"version":"3.51.4"},"reference-count":37,"publisher":"American Diabetes Association","issue":"1","license":[{"start":{"date-parts":[[2021,11,5]],"date-time":"2021-11-05T00:00:00Z","timestamp":1636070400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/content\/license"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,1,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>To compare the mental health experiences associated with coronavirus disease 2019 (COVID-19) in adults with and without diabetes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>Between 29 May 2020 and 30 June 2020, 2,176 U.S. adults completed an online survey including demographics, COVID-19 experiences, depression (eight-item Patient Health Questionnaire) and anxiety (seven-item Generalized Anxiety Disorder) symptoms, perceived stress (10-item Perceived Stress Scale), resilience (Brief Resilience Scale), and diabetes-related distress (in participants with diabetes) (17-item Diabetes Distress Scale).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Mean age was 49.6 years (SD 16.9); participants were primarily women (80.0%) and White (88.3%), with an annual household income of \u2265$60,000 (57.6%). One hundred reported a diagnosis of type 1 diabetes (4.6%), 304 type 2 diabetes (13.9%), and 145 prediabetes (6.6%). Nearly one-third (29.7%) indicated decreases in income attributable to the pandemic. Participants with type 1 diabetes had higher levels of diabetes distress than participants with type 2 diabetes (P &amp;lt; 0.05), with moderate severity in both groups. Participants with type 2 diabetes had significantly more comorbidities and COVID-19 risk factors than all other groups (all P &amp;lt; 0.01). After controlling for covariates, participants with type 2 diabetes reported significantly more depressive symptoms than those without diabetes (P &amp;lt; 0.05) and lower levels of resilience (P &amp;lt; 0.05). Subgroup analyses by sex and age indicated that women and younger adults, particularly those age 18\u201334 years, reported significantly more depression and anxiety symptoms, stress, and diabetes-related distress and lower levels of resilience than men and adults age \u226551 years.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>In this naturalistic observational study, participants with type 2 diabetes reported more depression, lower resilience, and significantly more COVID-19 risk factors and medical comorbidities than participants without diabetes. Overall, our participants demonstrated worse depression and anxiety symptoms during compared with before the pandemic.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc21-0769","type":"journal-article","created":{"date-parts":[[2021,11,5]],"date-time":"2021-11-05T16:20:14Z","timestamp":1636129214000},"page":"42-58","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":19,"title":["Emotional Correlates of the COVID-19 Pandemic in Individuals With and Without Diabetes"],"prefix":"10.2337","volume":"45","author":[{"given":"Barbara A.","family":"Myers","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Klingensmith","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4021-8824","authenticated-orcid":false,"given":"Mary","family":"de Groot","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1167","published-online":{"date-parts":[[2021,11,5]]},"reference":[{"key":"2022051611065753500_B1","unstructured":"World Health Organization\n          . Coronavirus disease (COVID-19) advice for the public. Accessed 30 November 2020. Available at https:\/\/www.who.int\/emergencies\/diseases\/novel-coronavirus-2019\/advice-for-public"},{"key":"2022051611065753500_B2","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1111\/jcap.12297","article-title":"Addressing the mental health needs of children\/adolescents, families, and ourselves during our unprecedented COVID-19 times","volume":"33","author":"Lusk","year":"2020","journal-title":"J Child Adolesc Psychiatr Nurs"},{"key":"2022051611065753500_B3","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1177\/0020764020927047","article-title":"Impact of social distancing on mental health during the COVID-19 pandemic: An urgent discussion","volume":"66","author":"Carvalho Aguiar Melo","year":"2020","journal-title":"Int J Soc Psychiatry"},{"key":"2022051611065753500_B4","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1177\/0706743720926676","article-title":"Mental health of communities during the COVI-19 pandemic","volume":"65","author":"Vigo","year":"2020","journal-title":"Can J Psychiatry"},{"key":"2022051611065753500_B5","doi-asserted-by":"crossref","first-page":"e59","DOI":"10.1093\/geronb\/gbaa153","article-title":"COVID-19 as a stressor: Pandemic expectations, perceived stress, and negative affect in older adults","volume":"76","author":"Whitehead","year":"2020","journal-title":"J Gerontol"},{"key":"2022051611065753500_B6","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.jad.2020.08.001","article-title":"Impact of COVID-19 pandemic on mental health in the general population: A systematic review","volume":"277","author":"Xiong","year":"2020","journal-title":"J Affect Disord"},{"key":"2022051611065753500_B7","doi-asserted-by":"crossref","first-page":"113190","DOI":"10.1016\/j.psychres.2020.113190","article-title":"The psychological and mental impact of coronavirus disease 2019 (COVID-19) on medical staff and general public \u2013 a systematic review and meta-analysis","volume":"291","author":"Luo","year":"2020","journal-title":"Psychiatry Res"},{"key":"2022051611065753500_B8","doi-asserted-by":"crossref","first-page":"e2019686","DOI":"10.1001\/jamanetworkopen.2020.19686","article-title":"Prevalence of depression symptoms in US adults before and during the COVID-19 pandemic","volume":"3","author":"Ettman","year":"2020","journal-title":"JAMA Netw Open"},{"key":"2022051611065753500_B9","doi-asserted-by":"crossref","first-page":"6469","DOI":"10.3390\/ijerph17186469","article-title":"Changes in physical activity and sedentary behavior in response to COVID-19 and their associates with mental health in 3052 US adults [published correction appears in Int J Environ Res Public Health 2020;17:6949]","volume":"17","author":"Meyer","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"2022051611065753500_B10","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1097\/JOM.0000000000001962","article-title":"Job insecurity and financial concern during the COVID-19 pandemic are associated with worse mental health","volume":"62","author":"Wilson","year":"2020","journal-title":"J Occup Environ Med"},{"key":"2022051611065753500_B11","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1093\/pubmed\/fdaa148","article-title":"COVID-19 restrictions and mental distress among American adults: evidence from Corona Impact Survey (W1 and W2)","volume":"42","author":"Kim","year":"2020","journal-title":"J Public Health (Oxf)"},{"key":"2022051611065753500_B12","unstructured":"U.S. Centers for Disease Control and Prevention\n          . People with certain medical conditions. Accessed 28 March 2021. Available at https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/need-extra- precautions\/people-with-medical-conditions.html"},{"key":"2022051611065753500_B13","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1007\/s42000-020-00246-2","article-title":"Diabetes is associated with increased risk for in-hospital mortality in patients with COVID-19: A systematic review and meta-analysis comprising 18,506 patients","volume":"20","author":"Palaiodimos","year":"2021","journal-title":"Hormones (Athens)"},{"key":"2022051611065753500_B14","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.pcd.2020.05.014","article-title":"Beyond the virus: ensuring continuity of care for people with diabetes during COVID-19","volume":"15","author":"Beran","year":"2021","journal-title":"Prim Care Diabetes"},{"key":"2022051611065753500_B15","doi-asserted-by":"crossref","first-page":"107748","DOI":"10.1016\/j.jdiacomp.2020.107748","article-title":"The early impact of the COVID-19 pandemic on adults with type 1 or type 2 diabetes: A national cohort study","volume":"34","author":"Fisher","year":"2020","journal-title":"J Diabetes Complications"},{"key":"2022051611065753500_B16","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1186\/s13098-020-00584-6","article-title":"Mental health in the era of COVID-19: prevalence of psychiatric disorders in a cohort of patients with type 1 and type 2 diabetes during the social distancing","volume":"12","author":"Alessi","year":"2020","journal-title":"Diabetol Metab Syndr"},{"key":"2022051611065753500_B17","volume-title":"Assets and the Poor: A New American Welfare Policy.","author":"Sherraden","year":"1991"},{"key":"2022051611065753500_B18","doi-asserted-by":"crossref","first-page":"626","DOI":"10.2337\/diacare.28.3.626","article-title":"Assessing psychosocial distress in diabetes: development of the diabetes distress scale","volume":"28","author":"Polonsky","year":"2005","journal-title":"Diabetes Care"},{"key":"2022051611065753500_B19","doi-asserted-by":"crossref","first-page":"259","DOI":"10.2337\/dc11-1572","article-title":"When is diabetes distress clinically meaningful?: establishing cut points for the Diabetes Distress Scale","volume":"35","author":"Fisher","year":"2012","journal-title":"Diabetes Care"},{"key":"2022051611065753500_B20","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: validity of a brief depression severity measure","volume":"16","author":"Kroenke","year":"2001","journal-title":"J Gen Intern Med"},{"key":"2022051611065753500_B21","volume-title":"Diagnostic and Statistical Manual of Mental Disorders.","author":"American Psychiatric Association","year":"2000","edition":"4th ed."},{"key":"2022051611065753500_B22","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: the GAD-7","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch Intern Med"},{"key":"2022051611065753500_B23","article-title":"Perceived stress in a probability sample of the United States","volume-title":"The Social Psychology of Health.","author":"Cohen","year":"1988"},{"key":"2022051611065753500_B24","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1080\/10705500802222972","article-title":"The brief resilience scale: assessing the ability to bounce back","volume":"15","author":"Smith","year":"2008","journal-title":"Int J Behav Med"},{"key":"2022051611065753500_B25","doi-asserted-by":"crossref","first-page":"e665","DOI":"10.1097\/PEC.0000000000002255","article-title":"Burnout and resiliency trends in pediatric emergency medicine fellows","volume":"36","author":"Zargham","year":"2020","journal-title":"Pediatr Emerg Care"},{"key":"2022051611065753500_B26","doi-asserted-by":"crossref","first-page":"6461","DOI":"10.3390\/ijerph17186461","article-title":"Resilience moderates negative outcome from stress during the COVID-19 pandemic: a moderated-mediation approach","volume":"17","author":"Havnen","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"2022051611065753500_B27","doi-asserted-by":"crossref","first-page":"6366","DOI":"10.3390\/ijerph17176366","article-title":"COVID-19 pandemic: age-related differences in measures of stress, anxiety and depression in Canada","volume":"17","author":"Nwachukwu","year":"2020","journal-title":"Int J Environ Res Public Health"},{"issue":"303","key":"2022051611065753500_B28","first-page":"1","article-title":"Prevalence of depression among adults aged 20 and over: United States, 2013-2016","author":"Brody","year":"2018","journal-title":"NCHS Data Brief"},{"key":"2022051611065753500_B29","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1186\/s12888-016-0800-2","article-title":"Depression among people with type 2 diabetes mellitus, US National Health and Nutrition Examination Survey (NHANES), 2005-2012","volume":"16","author":"Wang","year":"2016","journal-title":"BMC Psychiatry"},{"issue":"378","key":"2022051611065753500_B30","first-page":"1","article-title":"Symptoms of generalized anxiety disorder among adults: United States, 2019","author":"Terlizzi","year":"2020","journal-title":"NCHS Data Brief"},{"key":"2022051611065753500_B31","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1007\/s11892-015-0660-z","article-title":"The detection and management of diabetes distress in people with type 1 diabetes","volume":"15","author":"Sturt","year":"2015","journal-title":"Curr Diab Rep"},{"key":"2022051611065753500_B32","doi-asserted-by":"crossref","first-page":"e2020685118","DOI":"10.1073\/pnas.2020685118","article-title":"Pandemic precarity: COVID-19 is exposing and exacerbating inequalities in the American heartland","volume":"118","author":"Perry","year":"2021","journal-title":"Proc Natl Acad Sci USA"},{"key":"2022051611065753500_B33","doi-asserted-by":"crossref","first-page":"e002035","DOI":"10.1136\/bmjdrc-2020-002035","article-title":"Increased stress, weight gain and less exercise in relation to glycemic control in people with type 1 and type 2 diabetes during the COVID-19 pandemic","volume":"9","author":"Ruissen","year":"2021","journal-title":"BMJ Open Diabetes Res Care"},{"key":"2022051611065753500_B34","unstructured":"U.S. Centers for Disease Control and Prevention\n          . COVID-19 weekly cases and deaths per 100,000 population by age, race\/ethnicity, and sex. Accessed 28 March 2021. Available at https:\/\/covid.cdc.gov\/covid-data-tracker\/#demographicsovertime"},{"key":"2022051611065753500_B35","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1037\/a0040408","article-title":"Psychological conditions in adults with diabetes","volume":"71","author":"de Groot","year":"2016","journal-title":"Am Psychol"},{"key":"2022051611065753500_B36","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1016\/S0140-6736(20)30460-8","article-title":"The psychological impact of quarantine and how to reduce it: rapid review of the evidence","volume":"395","author":"Brooks","year":"2020","journal-title":"Lancet"},{"key":"2022051611065753500_B37","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s40200-020-00667-1","article-title":"Prevalence and severity of depression, anxiety, stress and perceived stress in hospitalized patients with COVID-19","volume":"19","author":"Zandifar","year":"2020","journal-title":"J Diabetes Metab Disord"}],"container-title":["Diabetes Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/45\/1\/42\/636322\/dc210769.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/45\/1\/42\/636322\/dc210769.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,16]],"date-time":"2022-05-16T11:08:54Z","timestamp":1652699334000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/care\/article\/45\/1\/42\/139006\/Emotional-Correlates-of-the-COVID-19-Pandemic-in"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,5]]},"references-count":37,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,11,5]]},"published-print":{"date-parts":[[2022,1,1]]}},"URL":"https:\/\/doi.org\/10.2337\/dc21-0769","relation":{},"ISSN":["0149-5992"],"issn-type":[{"value":"0149-5992","type":"print"}],"subject":[],"published":{"date-parts":[[2021,11,5]]}}}