Depression in Adults with Diabetes

Lustman, Patrick J.; Griffith, Linda S.; Gavard, Jeffrey A.; Clouse, Ray E.

doi:10.2337/diacare.15.11.1631

Cited by 230 publications

(180 citation statements)

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“…Studies also repeatedly have found that the course of depression is more severe in diabetes, with high relapse rates following initial episodes and a protracted period of recovery in both children and adults Kovacs, Goldston, Obrosky, & Bonar, 1997;Lustman, Griffith, & Clouse, 1997;Lustman, Clouse, & Alrakawi, 1997). The problem of underdiagnosis of depression in patients with diabetes is significant, with as many as 2 of 3 cases remaining undetected, primarily because many symptoms of depression (e.g., fatigue) are also symptoms of diabetes (Lustman, Griffith, & Clouse, 1997). Depression is associated with many health behaviors that have a negative impact on diabetes management and metabolic control such as smoking, alcohol and other drug abuse, and dysregulation in appetite and eating.…”

Section: Psychosocial Adjustment and Qolmentioning

confidence: 99%

Diabetes and behavioral medicine: The second decade.

Gönder-Frederick¹,

Cox²,

Ritterband³

2002

Journal of Consulting and Clinical Psychology

166

144

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Diabetes management depends almost entirely on behavioral self-regulation. Behavioral scientists have continued a collaboration with other health systems researchers to develop a holistic approach to this disease. The authors summarized the literature in 4 major areas: self-management of diabetes, psychosocial adjustment and quality of life, neuropsychological impact, and psychobehavioral intervention development. Progress made in each of these areas over the past decade is highlighted, as are important issues that have not yet received sufficient scientific attention. Emerging areas likely to become central in behavioral research, such as diabetes prevention, are introduced. The future of behavioral medicine in diabetes is also discussed, including topics such as the changing role of psychologists in diabetes care, the urgent need for more and better intervention research, the growing importance of incorporating a health system-public health perspective, and obstacles to the integration of psychobehavioral approaches into routine health care delivery.A profound event in diabetes management during the past decade was the release of the 1993 report of the National Institutes of Health (NIH) funded Diabetes Control and Complications Trial (DCCT; DCCT Research Group, 1993), which radically altered both the goals and the philosophy of treatment of this disease. The DCCT was a controlled, prospective trial following more than 1,400 adults and adolescents with Type 1 diabetes (T1DM) over an average of 6.5 years. The results provided strong evidence that the use of intensive treatment regimens to maintain tighter glucose control can delay or prevent the development of at least some of the devastating long-term complications of diabetes, including retinopathy and nephropathy. Subsequent studies replicated these findings and demonstrated the benefits of maintaining tighter metabolic control for patients with Type 2 diabetes (T2DM; Ohkubo et al., 1995;Reichard, Nilsson, & Rosenqvist, 1993;Turner, Cull, & Holman, 1996).It is almost impossible to overestimate the impact of the DCCT on diabetes treatment and research. Seemingly overnight, large numbers of patients were expected to follow a demanding, intensive treatment regimen that previously had been recommended only for those who were most highly motivated and diligent in their diabetes self-management. Health care practitioners were also expected to know how to help patients achieve these lofty treatment goals. In addition to problems in implementing intensive treatment, questions arose concerning the effects of these regimens on quality of life (QOL) for patients. Intensive regimens also posed new dilemmas for health care practitioners and patients, not the least of which was the dramatic increase in risk for episodes of severe hypoglycemia when patients attempted to lower blood glucose (BG) levels. It quickly became clear that the greatest challenge to contemporary diabetes treatment was overcoming the many psychobehavioral and social-environmental barriers to optimal ...

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Section: Psychosocial Adjustment and Qolmentioning

confidence: 99%

Diabetes and behavioral medicine: The second decade.

Gönder-Frederick¹,

Cox²,

Ritterband³

2002

Journal of Consulting and Clinical Psychology

166

144

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“…Although the specific mechanisms through which psychological stress c m effect diabetes mellitus are not well-known, stress has been linked to poor glycemic control (Cox & Gonder-Frederick, 1992), decreased exercise (Goetsch, Abel & Pope, 1994), and even to the onset of the illness, particularly in people with type 2 diabetes (Lustman, 1988;Rubin & Peyrot, 1992). The relationship between stress and diabetes is, however, reciprocal, with stress affecting diabetes mellitus, and diabetes mellitus affecting levels of stress (Cox & Gonder-Frederick 1992 As with anxiety, depression in people with diabetes may occur for severd different reasons, including in response to the psychosocial hardships of the disease, biological changes directly related to the condition, or from previous biological or genetic factors making the individual vulnerable to depression (Lustman et al, 1992 One of the difficulties in diagnosing depression in people with diabetes is that many of the symptoms of depression, such as weight loss, changes in appetite, and fatigue, are also syrnptoms of diabetes and its treatment (Lustman, Amado & Wetzel, 1983;Lustman et al, 1992 (Cox & Gonder-Frederick, 1992). Research in this area generally shows the use of active coping strategies to relate positively to glycemic control, and negatively to depression and anxiety (Maes, Leventhal & DeRidder, 1996).…”

Section: Psycholoaical Adiustment To Diabetes Mellitusmentioning

confidence: 99%

Coping, control, and adjustment in type 2 diabetes.

Macrodimitris

Endler²

2001

Health Psychology

117

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The relationships of both coping strategies and perceived control to psychological and physiological adjustment were investigated in 115 adults (65 women, 50 men) with Type 2 diabetes. Results showed that (a) emotional preoccupation and palliative coping were positively correlated with depression and state anxiety, whereas perceived control was negatively correlated with depression, state anxiety, and hemoglobin A tc (HbA lc ); (b) instrumental coping predicted lower depression; (c) perceived control moderated the relationships between instrumental coping and depression, and emotional preoccupation coping and HbA lc ; and (d) emotional preoccupation coping mediated the relationships between perceived control and depression, and perceived control and state anxiety. Results are discussed in terms of the goodness-of-fit hypothesis (V. J. Conway & D. J. Terry, 1992), optimal coping, and the importance of perceived control in psychological and physiological adjustment.

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“…Entretanto, a prática tem mostrado que o diagnóstico da depressão no diabetes não é tão controverso como em outras condições médicas como, por exemplo, o câncer. Uma estratégia recomendada na literatura é a utilização de outros sintomas depressivos que não esses possivelmente decorrentes do diabetes 3 . …”

Section: Diagnóstico Da Depressão No Diabetesunclassified

Depressão e diabetes mellitus

Fráguas

Soares

Bronstein³

2009

Rev. psiquiatr. clín.

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ResumoO diabetes mellitus possui elevada prevalência, acometendo cerca de 7% da população brasileira. Em torno de 20% a 30% dos pacientes com diabetes apresentam depressão. A depressão pode atuar como um fator de risco para o desenvolvimento do diabetes, piorar seus sintomas e interferir com o autocuidado dos pacientes. Quando não tratada adequadamente, a depressão nesses pacientes tende a evoluir com elevada taxa de recorrência. Entre os tratamentos disponíveis, encontramos na literatura um benefício da psicoterapia, cognitiva ou cognitivo-comportamental, para melhora dos sintomas depressivos, mas sem evidência de um benefício no controle glicêmico. Os antidepressivos tricíclicos, em especial os com maior ação noradrenérgica, e os inibidores da monoaminoxidase (IMAOs) tendem a aumentar os níveis glicêmicos. A bupropiona não interfere na glicemia e há evidências de que os inibidores seletivos de recaptura de serotonina (ISRS) melhoram os níveis glicêmicos e podem reduzir a taxa de recaídas, mostrando-se boas opções de tratamento farmacológico. A eletroconvulsoterapia também é uma estratégia interessante para esses pacientes, recomendando-se, no entanto, monitorização da glicemia. Não foram encontrados estudos significativos sobre os demais antidepressivos disponíveis para comercialização. Fráguas R, et al. / Rev Psiq Clín. 2009;36(3):93-9Palavras-chave: Diabetes mellitus, depressão, tratamento, antidepressivo, prevalência, prognóstico. AbstractDiabetes mellitus has an estimated prevalence of 7% among Brazilian population. Around 20% to 30% of these patients have a depressive disorder. Depression can work as risk factor to the development of diabetes, can worse its symptoms and interfere with self-care. When not adequately treated, depressive disorder in these patients tends to have high rates of recurrence. Among the available treatments literature shows a benefit of psychotherapy, mainly cognitive or cognitive-behavioral, in ameliorating depressive symptoms, but without impact on glycaemic control. Tryciclic antidepressants, especially those with more noradrenergic profile, and monoamino oxidase inhibitors are associated with worsening of glycaemic control. Bupropion shows no action on glucose blood levels and there are evidences that serotonin selective reuptake inhibitors may improve the glycaemic levels and reduce the recurrence, being good choices to treat these patients. Electroconvulsive therapy is an interesting treatment to these patients, but monitoring of blood glucose is recommended. We did not find data about other antidepressants. R, et al. / Rev Psiq Clín. 2009;36(3):93-9 Fráguas

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Depression in Adults with Diabetes

Cited by 230 publications

References 0 publications

Diabetes and behavioral medicine: The second decade.

Diabetes and behavioral medicine: The second decade.

Coping, control, and adjustment in type 2 diabetes.

Depressão e diabetes mellitus

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