Associations between comorbid anxiety, diabetes control, and overall medical burden in patients with serious mental illness and diabetes

Laura A Bajor; Douglas Gunzler; Douglas Einstadter; Charles Thomas; Richard McCormick; Adam T Perzynski; Stephanie W Kanuch; Kristin A Cassidy; Neal V Dawson; Martha Sajatovic

doi:10.1177/0091217415589307

journal article May 01, 2015

Associations between comorbid anxiety, diabetes control, and overall medical burden in patients with serious mental illness and diabetes

Laura A Bajor Douglas Gunzler Douglas Einstadter Charles Thomas

Richard McCormick Adam T Perzynski Stephanie W Kanuch Kristin A Cassidy Neal V Dawson Martha Sajatovic

The International Journal of Psychiatry in Medicine Vol. 49 No. 4 pp. 309-320 · SAGE Publications

View at Publisher Save 10.1177/0091217415589307

Abstract

Objective While previous work has demonstrated elevation of both comorbid anxiety disorders and diabetes mellitus type II in individuals with serious mental illness, little is known regarding the impact of comorbid anxiety on diabetes mellitus type II outcomes in serious mental illness populations. We analyzed baseline data from patients with serious mental illness and diabetes mellitus type II to examine relationships between comorbid anxiety, glucose control as measured by hemoglobin A1c score, and overall illness burden. Methods Using baseline data from an ongoing prospective treatment study involving 157 individuals with serious mental illness and diabetes mellitus type II, we compared individuals with and without a comorbid anxiety disorder and compared hemoglobin A1c levels between these groups to assess the relationship between anxiety and management of diabetes mellitus type II. We conducted a similar analysis using cumulative number of anxiety diagnoses as a proxy for anxiety load. Finally, we searched for associations between anxiety and overall medical illness burden as measured by Charlson score. Results Anxiety disorders were seen in 33.1% ( N = 52) of individuals with serious mental illness and diabetes mellitus type II and were associated with increased severity of depressive symptoms and decreased function. Hemoglobin A1c levels were not significantly different in those with or without anxiety, and having multiple anxiety disorders was not associated with differences in diabetes mellitus type II control. However, depressive symptoms were significantly associated with higher hemoglobin A1c levels. Neither comorbid anxiety nor anxiety load was significantly associated with overall medical burden. Conclusion One in three people with serious mental illness and diabetes mellitus type II had anxiety. Depressive symptoms were significantly associated with Hb1Ac levels while anxiety symptoms had no relation to hemoglobin A1c; this is consistent with previously published work. More studies are needed to better understand the relationship between depression, anxiety, and health management in people with serious mental illness and diabetes mellitus type II.

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Details

Published: May 01, 2015
Vol/Issue: 49(4)
Pages: 309-320
License: View

Authors

L

Laura A Bajor

VA Boston Healthcare Center, USA; Harvard Medical School, USA

D

Douglas Gunzler