Disease Control Among Patients With Diabetes and Severe Depressive Symptoms

Werremeyer, Amy; Maack, Brody; Strand, Mark; Barnacle, Mykell; Petry, Natasha

doi:10.1177/2150131915627423

Cited by 10 publications

(10 citation statements)

References 53 publications

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“…In our analysis, poor glycemic control was an independent risk factor for depressive symptoms (PHQ-9 score ≥5) in both patients with type 1 or type 2 diabetes. Our results concurred with some ( 21 – 23 ) but not all studies ( 24 ). This may be due to multidimensional factors such as host factors, treatment regimens, health care systems, quality of care, and ongoing support that may influence glycemic control ( 15 ).…”

Section: Discussionsupporting

confidence: 93%

High Prevalence of Depressive Symptoms in Patients With Type 1 and Type 2 Diabetes in Developing Countries: Results From the International Diabetes Management Practices Study

et al. 2020

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Depression is common in people with diabetes, but data from developing countries are scarce. We evaluated the prevalence and risk factors for depressive symptoms in patients with diabetes using data from the International Diabetes Management Practices Study (IDMPS). RESEARCH DESIGN AND METHODSIDMPS is an ongoing multinational, cross-sectional study investigating quality of care in patients with diabetes in real-world settings. Data from wave 5 (2011), including 21 countries, were analyzed using the 9-item Patient Health Questionnaire (PHQ-9) to evaluate depressive symptoms. Logistic regression analyses were conducted to identify risk factors of depressive symptoms. RESULTSOf 9,865 patients eligible for analysis, 2,280 had type 1 and 7,585 had type 2 diabetes (treatment: oral glucose-lowering drugs [OGLD] only, n 5 4,729; OGLDs plus insulin, n 5 1,892; insulin only, n 5 964). Depressive symptoms (PHQ-9 score $5) were reported in 30.7% of those with type 1 diabetes. In patients with type 2 diabetes, the respective figures were 29.0% for OGLDs-only, 36.6% for OGLDs-plus-insulin, and 46.7% for insulin-only subgroups. Moderate depressive symptoms (PHQ-9 score 10-19) were observed in 8-16% of patients with type 1 or type 2 diabetes. Female sex, complications, and low socioeconomic status were independently associated with depressive symptoms. In type 1 diabetes and in the type 2 diabetes OGLDs-only group, depression was associated with poor glycemic control. CONCLUSIONSDepressive symptoms are common in patients with diabetes from developing countries, calling for routine screening, especially in high-risk groups, to reduce the double burden of diabetes and depression and their negative interaction.

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Section: Discussionsupporting

confidence: 93%

High Prevalence of Depressive Symptoms in Patients With Type 1 and Type 2 Diabetes in Developing Countries: Results From the International Diabetes Management Practices Study

et al. 2020

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“…The Patient Health Questionnaire (PHQ) was employed to examine the depression symptoms, and a cutoff score of 15 or higher has been defined as major depression. 14 , 15 …”

Section: Methodsmentioning

confidence: 99%

Risk of Cardiovascular Disease Mortality in Relation to Depression and 14 Common Risk Factors

Jia¹,

Li²

2021

IJGM

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Background Depression has been linked to a worse prognosis of Cardiovascular disease (CVD), and these two diseases share a variety of common risk factors such as unhealthy lifestyles and chronic medical conditions. However, the potential role of these common risk factors in modulating the association between depression and CVD mortality and whether the co-occurrence of depression and a specific common risk factor has a cumulative impact on CVD mortality are still largely unknown. Methods We pooled data from 2005–2014 of Nation health and nutritional examination survey, leading to a study population of 22,177 adults. The Patient Health Questionnaire was employed to assess the depression symptoms, and information on CVD mortality was obtained from the linked mortality file of NHANES. Fourteen common risk factors of depression and CVD were included in this study. Results Based on the interaction analyses, we found overweight was protective for the risk of CVD death in depressive participants, but not in people without depression. Moreover, relative risk-based analyses indicated a mutually promotive effect of depression and baseline CVD or living alone on CVD mortality. Conclusion The novel findings in our study may facilitate risk stratification in the clinical programs targeting CVD mortality and help to shed light on the differential pathophysiological mechanisms in the depression-mediated elevation of CVD mortality.

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“…Episodes of depression in individuals with diabetes are likely to last longer and have a higher chance of recurrence compared to those without diabetes (50). Episodes of severe hypoglycemia have been correlated with the severity of depressive symptoms (51,52). Major depressive disorder has been found to be underdiagnosed in people with diabetes (53).…”

Section: Major Depressive Disordermentioning

confidence: 99%

Diabetes and Mental Health

Robinson¹,

Coons²,

Haensel³

et al. 2018

Canadian Journal of Diabetes

129

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The experience of living with diabetes is often associated with concerns specific to the illness and can cause conditions, such as diabetes distress, psychological insulin resistance and the persistent fear of hypoglycemic episodes.• A wide range of psychiatric disorders, including major depressive disorder, bipolar and related disorders, schizophrenia spectrum and other psychotic disorders, anxiety disorders, sleep disorders, eating disorders and stress-related disorders are more prevalent in people with diabetes compared to the general population.• People living with diabetes and depressive disorders are at increased risk for earlier all-cause mortality compared to people living with diabetes without a history of depression.• All individuals with diabetes should be regularly screened for the presence of diabetes distress, as well as symptoms of common psychiatric disorders.• Compared to those with diabetes only, individuals with diabetes and mental health concerns have decreased participation in diabetes self-care, a decreased quality of life, increased functional impairment, increased risk of complications associated with diabetes, and increased health-care costs.• Cognitive behaviour therapy, patient-centred approaches (e.g. motivational interviewing), stress management, coping skills training, family therapy and collaborative case management should be incorporated into primary care. Self-management skills, educational interventions that facilitate adaptation to diabetes, addressing co-occurring mental health issues, reducing diabetes-related distress, fear of hypoglycemia, and psychological insulin resistance are all helpful.• Individuals taking psychiatric medications, particularly (but not limited to) atypical antipsychotics, benefit from regular screening of metabolic parameters to identify glucose dysregulation, dyslipidemia and weight gain throughout the course of the illness so that appropriate interventions can be instituted. KEY MESSAGES FOR PEOPLE WITH DIABETES• Living with diabetes can be burdensome and anxiety provoking, with the constant demands taking a psychological toll. As a result, many people experience distress, decreased mood and disabling levels of anxiety. Diabetes is often associated with a significant emotional burden, distress over the self-care regimen and stress in relationships (with family and friends, as well as health-care providers).• It is important to recognize your emotions and talk to your friends, family and members of your diabetes health-care team about how you are feeling. Your team can help you to learn effective coping skills and direct you to support services that can make a difference for you.• Mood and anxiety disorders are particularly common in people with diabetes. Eating, sleeping and stress-related disorders are also common. Speak to your health-care providers about any concerns you have if you think you may be developing any of these problems.• Mental health disorders can affect your ability to cope with and care for your diabetes. In view of this, it is jus...

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Disease Control Among Patients With Diabetes and Severe Depressive Symptoms

Cited by 10 publications

References 53 publications

High Prevalence of Depressive Symptoms in Patients With Type 1 and Type 2 Diabetes in Developing Countries: Results From the International Diabetes Management Practices Study

High Prevalence of Depressive Symptoms in Patients With Type 1 and Type 2 Diabetes in Developing Countries: Results From the International Diabetes Management Practices Study

Risk of Cardiovascular Disease Mortality in Relation to Depression and 14 Common Risk Factors

Diabetes and Mental Health

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