Introduction There is considerable evidence for diabetes reducing quality of life. The impact of such a diagnosis on mental health is less well understood and was subsequently explored here. Methods Online PHQ-9 scores (which calculate the severity of depression), Diabetes Distress Screening Scale (DDSS) and EQ-5D-5L (quality-of-life) questionnaires were completed by patients with diabetes, followed by the extraction of data where possible from responders’ clinical records. Results A total of 133 people submitted questionnaires. However, not all data items could be completed by each patient; 35% (45/130) had type I diabetes mellitus (T1DM); 55% (64/117) were women. The overall median age of 117 responders was 60 (IQR 50–68 years). The median aggregated response scores were: EQ-5D-5L 0.74 (IQR 0.64–0.85) (lower quality of life than UK population median of 0.83), DDSS 1.9 (IQR1.3–2.7) (≥ 2 indicates moderate distress) and PHQ-9 5 (IQR2-11) (≥ 5 indicates depression). Higher diabetes distress (DDSS)/lower quality of life EQ-5D-5L/higher depressive symptoms (PHQ-9) linked to female sex (DDSS 0.5/25% above median), younger age (< 50 years DDSS 0.7/35% above median), fewer years after diagnosis (< 10 years DDSS 0.8/40% above median), and obesity (BMI > 35 DDSS 0.6/30% above median). Additionally, a HbA1c reading of ≤ 48 mmol/mol was associated with higher DDSS scores, as did a reduction of more than 5 mmol/mol in HbA1c over the last three HbA1c measurements. The 30 individuals with a history of prescribed antidepressant medication also showed higher diabetes distress scores (DDSS 0.9, equating to 45% above the median). The DDSS score elevation came from an increase in emotional burden and regimen-related distress. DDSS scores were not significantly linked to diabetes type, insulin use, absolute level/change in blood glucose HbA1c. Physician-related distress showed a similar pattern. Conclusions A low level of stress in relation to diabetes management may be associated with lower HbA1c. The larger impact of diabetes on mental health in younger women/people with shorter diabetes duration should be noted when considering psychosocial intervention/behavior change messaging. Physician-related distress is a potentially remediable factor. However, this sample was self-selecting, limiting generalization to other samples.
BackgroundThe COVID-19 pandemic globally impacted healthcare provision. Prescribing changes of common medications can be used as a marker for new diagnoses.AimTo describe how psychotropic prescribing in England was affected by the COVID-19 pandemic.MethodsPrimary Care Prescribing data for different classes of drug from March 2017 - February 2022 were considered. To capture the impact during periods of restricted access to health services for new diagnoses/existing conditions, repeat prescriptions/episodic prescribing were included with account taken of historical trend.The pre-pandemic prescriptions issued each month from March 2017 - February 2020 were linearly extrapolated forward to give an expected annual growth (EAG). The monthly average expected prescriptions for the pandemic period (March 2020–February 2022) were compared with this.ResultsPhysical health medications had lower monthly prescriptions during the pandemic with antibiotics down -12.2%(EAG -1.4%). Most repeat prescriptions were for bronchodilators -1.8%(EAG 0%), hypertension and heart failure -1.3%(EAG 1%), and lipid regulating drugs at -0.1%(EAG 2.3%). Mental Health monthly prescribing increased with hypnotics/anxiolytics by 0.6%(EAG -2.4%), antipsychotics by 0.5%(EAG 2.7%) and antidepressants by 0.3% (EAG 4.9%) The three main antidepressant were: Sertraline grew by 21% so its share of total anti-depressants increased from 22.7% to 24.6% (+8%), Mirtazapine grew by 16% so share increased from 13.0% to 13.6% (+5%), Venlafaxine grew by 11% so share stayed at 6.3%(0%).ConclusionThe increase in anxiolytic/hypnotic prescribing above trend links to pandemic effects on anxiety/worry. The slight increase in antipsychotic prescribing may relate to antipsychotic use in care homes.
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