Depression and diabetes: treatment and health-care delivery

Petrak, Frank; Baumeister, Harald; Skinner, Timothy; Brown, Alex; Holt, Richard

doi:10.1016/s2213-8587(15)00045-5

Cited by 164 publications

(139 citation statements)

References 94 publications

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“…There are several possible explanations for the increased risk of suicide associated with diabetes. Depressive symptoms and suicidal ideation are common in patients with diabetes, both of which are associated with increased risk of completed suicide (10,11,79). Apart from depression, other mental health problems are also common in diabetes patients, which can also lead to increased risk of suicide (80,81).…”

Section: Discussionmentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Suicide risk in patients with diabetes: a systematic review and meta-analysis

Wang

Shi

et al. 2017

European Journal of Endocrinology

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Background: Previous studies investigating the risk of suicide in diabetes patients reported controversial findings. We did a systematic review and meta-analysis to comprehensively estimate the risk and incidence rate of suicide in diabetic patients. Methods: PubMed, EMBASE and PsycINFO were searched for eligible studies. Random-effects meta-analysis was used to calculate the relative risk (RR) and the incidence rate of suicide in diabetes patients. We also calculated the proportion of deaths attributable to suicide among diabetes patients. Results: 54 studies were finally included, including 28 studies on the suicide risk associated with diabetes, 47 studies on the incidence rate of suicide and 45 studies on the proportion of deaths attributable to suicide. Meta-analysis showed that diabetes could significantly increase the risk of suicide (RR = 1.56; 95% CI: 1.29-1.89; P < 0.001). Subgroup analysis showed that the RR of suicide associated with type 1 diabetes was 2.25 (95% CI: 1.50-3.38; P < 0.001). The pooled incidence rate of suicide in patients with diabetes was 2.35 per 10 000 person-years (95% CI: 1.51-3.64). The pooled proportions of long-term deaths attributable to suicide in type 1 diabetes patients and type 2 diabetes patients were 7.7% (95% CI: 6.0-9.8) and 1.3% (95% CI: 0.6-2.6), respectively. Conclusion: This meta-analysis suggests that diabetes can significantly increase the risk of suicide. Suicide has an obvious contribution to mortality in diabetic patients, especially among type 1 diabetes patients. Effective strategies to decrease suicide risk and improve mental health outcomes in diabetes patients are needed.

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Section: Discussionmentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Suicide risk in patients with diabetes: a systematic review and meta-analysis

Wang

Shi

et al. 2017

European Journal of Endocrinology

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“…A recent review of treatment and health-care delivery for depression and diabetes [13] suggested a stepped approach, with step 1 being for mild depression (or subthreshold depression causing impairment). They suggest that after suicide and acute distress have been excluded, this approach is best carried out with a flexible patient-centered approach which can involve face-to-face and internet-based elements, but is likely to contain both approaches for most people.…”

Section: Discussionmentioning

confidence: 99%

“…The depression scale (PHQ-9): 9-item measure of depressive symptoms (PHQ-9) [16]. Categories of depression severity based on PHQ-9 scores are none-minimal (0-4), mild (5-9), moderate (10)(11)(12)(13)(14), moderately severe (15)(16)(17)(18)(19) and severe (20)(21)(22)(23)(24)(25)(26)(27) 2. The physical symptoms (PHQ-15)-screening measure for somatization [17] 3.…”

Section: Methodsmentioning

confidence: 99%

“…There is growing recognition that depression and diabetesrelated distress are overlapping but sufficiently different constructs to both be worthy of attention in view of their different properties and treatment goals [12,13]. The goals for 'depression', are symptom relief, suicide avoidance, relapse prevention and return to normal function, while the goals for diabetes-related distress are related to improved selfmanagement and adjustment to diabetes and HbA1c levels [13].…”

Section: Introductionmentioning

confidence: 99%

“…The goals for 'depression', are symptom relief, suicide avoidance, relapse prevention and return to normal function, while the goals for diabetes-related distress are related to improved selfmanagement and adjustment to diabetes and HbA1c levels [13].…”

Section: Introductionmentioning

confidence: 99%

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The Importance of Screening for Mild Depression in Adults with Diabetes

Wilhelm¹,

Reddy²,

Crawford³

et al. 2017

Transl Biomed

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Aim: While the impact of major depression on diabetes has gained increasing attention, the role of minor depression is less well investigated. This observational study compared three groups of adults with Type 1 (T1DM) or Type 2 (T2DM) diabetes mellitus: with me) no depressive symptoms (NODEP), ii) mild depressive symptoms (MILD) and iii) moderate-to-severe symptoms (MOD/SEVERE)-on diabetes distress, psychological distress, anxiety and somatic symptoms, quality of life and HbA1c levels.Methods: 245 outpatients attending two hospital diabetes services (27% with T1DM; 73% with T2DM) completed self-report measures including patient health questionnaire (PHQ), problem areas in diabetes (PAID) scale and short form health survey (SF12). Participants were interviewed by a psychiatrist and HbA1c levels recorded.Results: Half the sample reported depressive symptoms on the PHQ-9 (29% in the MILD group, 21% in MOD/ SEVERE and the remaining 50% in the NODEP group). Compared to the NODEP group, MILD group participants had significantly higher levels of diabetes distress, psychological distress, anxiety and somatic symptoms and significantly lower mental-health related quality of life. Participants in the MOD/SEVERE group had significantly higher levels of diabetes distress, psychological distress, anxiety, and somatic symptoms than either of the other two groups, and significantly lower quality of life. The groups did not differ significantly on HbA1c.Conclusions: Mild symptoms of depression in patients with diabetes are common and are associated with higher levels of diabetes distress, psychological distress, anxiety and somatic symptoms and lower quality of life.Addressing mild depression provides a potential avenue for preventing clinical depression in patients with diabetes.

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