Relationship between self-rated health and current depression among patients with diabetes: Insights from the ۲۰۲۰ Korea health panel study

Background: Self-rated health (SRH) is a validated subjective measure that reflects not only the burden of chronic disease but also socioeconomic and psychological determinants associated with mortality. However, the direct relationship between SRH and current depressive symptoms among Korean adults with diabetes remains insufficiently characterized. This study aimed to determine the association between SRH and current depressive symptoms among Korean adults with diabetes. Methods: A cross-sectional study was conducted using secondary data from the ۲۰۲۰ Korea Health Panel Survey (KHPS). The analytical sample comprised ۱۵۱۰ adults with confirmed diabetes mellitus. The primary outcome, current depressive symptoms, was assessed using a single yes/no item. The main independent variable, self-rated health, was measured using a single-item question and categorized as either poor or good health. Both measures were obtained from the KHPS and analyzed as dichotomous variables. Additional covariates included sociodemographic and clinical or behavioral factors. Statistical analyses were performed using IBM SPSS Statistics version ۲۶.۰. Binary logistic regression was used to estimate adjusted odds ratios (aORs) and ۹۵% confidence intervals (CIs) for factors associated with current depressive symptoms. Results: Among the ۱,۵۱۰ participants, ۵۵۱ (۳۶.۵%) reported poor self-rated health, and ۱۷۴ (۱۱.۵%) exhibited current depressive symptoms. A significant association was observed between these primary variables; poor SRH was a robust factor independently associated with current depression (Adjusted odds ratio [aOR]=۲.۱۶; ۹۵%CI:۱.۳۵-۳.۴۶; p=۰.۰۰۱). In the fully adjusted regression model, the strongest covariate associated with depressive symptoms was anxiety (aOR=۳۳.۶۷; ۹۵% CI: ۱۹.۵۰-۵۸.۱۵; p < ۰.۰۰۱), followed by suicidal ideation (aOR=۳.۷۸; ۹۵% CI: ۲.۱۰-۶.۸۲; p < ۰.۰۰۱) and high perceived stress (aOR=۲.۶۱; ۹۵%CI:۱.۶۳-۴.۱۵; p < ۰.۰۰۱). Conversely, employment emerged as a significant protective factor against depression (aOR=۰.۴۱; ۹۵%CI:۰.۲۵-۰.۶۸; p<۰.۰۰۱). The adjusted model demonstrated excellent discriminatory capacity (AUC = ۰.۸۹۰; ۹۵% CI:۰.۸۶۲-۰.۹۱۸) and explained ۵۰.۷% of the variance in depressive symptoms (Nagelkerke R²=۰.۵۰۷). Conclusion: Poor SRH is a significant independent factor associated with current depression among Korean adults with diabetes. Subjective health perception should be recognized as a key marker of psychological risk. Routine SRH assessment should be integrated into diabetes care to facilitate the early identification of depression and enable timely psychosocial intervention.

کلیدواژه ها:

Depression ، Diabetes Mellitus ، Self-Rated Health ، Korea Health Panel Survey ، Psychological Vulnerability