2007 Final Program - Society of Behavioral Medicine

2007 SBM Annual Meeting & Scientific Sessions March 21-24, 2007 FINAL PROGRAM
Rapid Communications Posters Thursday, March 22, 2007 • 6:30 PM-8:00 PM • Poster Session B
Poster Session B:
Adherence; Behavioral Medicine in
Medical Settings; Biological Mechanisms
in Health and Behavior Change;
Complementary and Alternative Medicine;
Diversity Issues; Environmental and
Contextual Factors in Health and Behavior Change;
Lifespan; Quality of Life; Spirituality;
Translation of Research to Practice
Exhibit Hall A&B
2416
DEPRESSION, PATIENT ADHERENCE AND GLYCEMIC
CONTROL IN TYPE 2 DIABETES
Susan Nash, PhD, Luis Rustveld, PhD and Valory Pavlik, PhD
Baylor College of Medicine, Houston, TX.
The prevalence of depression among patients with type 2 diabetes
is recognized and better assessment and control of depression
is suggested to improve treatment adherence. However, some
researchers report no clear relationship between depression
and biological markers of adherence. This study examined
the relationships among self-reported adherence, depression
and glycemic control, and whether depression moderated the
relationship between adherence and glycemic control. Data were
collected from 232 patients (mean age = 56.6 ± 10.3) with type
2 diabetes (24.1% non-Hispanic white, 31.9% non-Hispanic
black, and 44.0% Hispanic) recruited from public and private
primary care clinics in a cross-cultural validation study of a brief
neuropsychological test battery. A medical history form assessed
sociodemographics, health status, medications, and reported
adherence to medical recommendations. The Beck Depression
Inventory was administered with the test battery, and laboratory
measures were obtained at follow-up testing. Univariate analysis
revealed no association between total Beck scores and glycemic
control (β = 0.02, Exp (β) = 1.0, p = 0.17), but self-reported
adherence was significantly associated with glycemic control (β
= 0.38, Exp (β) = 1.5, p = 0.002). Inclusion of depression in the
model slightly attenuated the relationship between self-reported
adherence and glycemic control (β = 0.35, Exp (β) = 1.4, p =
0.007). In multivariate analysis, self-reported adherence remained a
significant predictor of glycemic control (β = -0.67, Exp (β) = 0.5,
p = 0.036) after adjusting for the interaction term of depression
and adherence, age, duration of diabetes and medication use. The
interaction term between depression and adherence was nonsignificant
in the multivariate model. In this sample of primary
care patients, self-reported adherence was a stable and independent
predictor of glycemic control, and the relationship between
adherence and control was not affected by depressive symptoms.
Exploration of other comorbidities may enhance understanding of
the relationships among depression, self-reported adherence, and
glycemic control.
CORRESPONDING AUTHOR: Susan Nash, PhD, Family and
Community Medicine, Baylor College of Medicine, Houston, TX,
77098; sgnash@bcm.tmc.edu
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2417
IS IT BETTER TO LOSE AND REGAIN THAN TO NEVER
HAVE LOST AT ALL? THE IMPACT OF WEIGHT REGAIN
ON METABOLIC RISK FACTORS
Lisa M. Nackers, BA, Vanessa A. Milsom, MS, Lauren M. Gibbons,
BA, Ninoska DeBraganza, MSESS, Katie A. Rickel, MS and Michael
G. Perri, PhD
Clinical and Health Psychology, University of Florida, Gainesville, FL.
According to the Institute of Medicine, reductions in body weight
of 5% or more in obese individuals are associated with clinically
significant improvements in metabolic risk factors for disease.
However, long-term follow-up evaluations indicate that treatmentinduced
weight reductions are not well maintained, and little is
known about the effects of weight regain on changes in metabolic
risk factors. The present study examined the impact of weight regain
on metabolic risk factors by comparing a group of individuals (n
= 65) who lost > 5% and regained weight (i.e., “Regainers”) with
a group (n=121) who lost > 5% and maintained their reductions
(i.e., “Maintainers”) and a group (n=53) who failed to achieve a
5% reduction (“Non-losers”). These groups were drawn from a
sample of middle-aged (mean = 59.2 yr) obese women (mean BMI
= 36.6) who participated in a 6-month weight-loss intervention and
who were followed for an additional 12 months. At final followup,
the “Maintainers,” “Regainers,” and “Non-losers” had mean
net weight changes of -14.1 kg, -1.3 kg, and +1.1 kg, respectively.
The “Maintainers” showed significant reductions in systolic blood
pressure, glycemic control (HbA1c), and triglycerides (all ps<
.0001). The “Regainers” had significant reductions in systolic
blood pressure and glycemic control (ps