The Inter-Relationships of Mental Disorders and Diabetes Mellitus

Menninger, William C.

doi:10.1192/bjp.81.333.332

Cited by 40 publications

(12 citation statements)

References 27 publications

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“…Blood ketone levels which were elevated during stress subsided when relative emotional security was achieved, without extra insulin or other therapeutic manipulation. 4. The mechanism involved in these changes is not yet established but the evidence adduced in this study suggests that it involves a stimulation of the pituitary-adrenal mechanism.…”

Section: Changes In the Hepatic Venous Bloodmentioning

confidence: 80%

“…years (3)(4)(5)(6)(7)(8)(9)(10)(11), but ketosis and coma have usually been attributed, as in the study of Rosen and Lidz ( 12), to willful abandonment of the prescribed regimen. The present communication concerns an experimental investigation of the effects of life situations upon some aspects of the glucose and ketone metabolism of normal and diabetic persons.…”

Section: Supported In Part By Grants From the Commonwealthmentioning

confidence: 99%

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Studies on Diabetes Mellitus: The Relation of Stressful Life Situations to the Concentration of Ketone Bodies in the Blood of Diabetic and Non-Diabetic Humans 1

Hinkle¹,

Conger²,

Wolf³

et al. 1950

J. Clin. Invest.

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Investigators have long been aware of the fact that pronounced metabolic fluctuations occur in diabetic humans in the absence of infection, trauma, or intercurrent disease, and despite faithful adherence to a previously adequate regimen. The possibility of "neurogenic" factors as a cause of such fluctuations was first considered after Claude Bernard's production of diabetes in experimental animals by puncture of the floor of the fourth ventricle. Later the diabetogenic effect of the anterior pituitary was discovered by Houssay, and more recently investigators have recognized the importance of the adrenal as well as pituitary hormones in diabetes. In fact, Conn and his collaborators have actually induced a state of temporary diabetes in healthy persons by the administration of pituitary adrenocorticotrophic hormone (1). This work has been paralleled by that of Selye (2), who elaborated the concept that the pituitary and adrenal were part of a general mechanism through which vertebrates adapt to threats to their integrity. Exposure to cold, exhausting exercise, and surgical operations have been considered among such threats or stresses which lead to the discharge of anterior pituitary and adrenal cortical hormones. Perhaps the commonest stresses that the human being encounters, however, are those concerned with problems of interpersonal relationship-words or events perceived by the individual and either consciously or unconsciously evaluated by him as threatening because of his past experience or conditioning.The likelihood that personal conflicts arising out of stressful life situations were germane to the course of diabetes mellitus has been pointed out by a number of investigators during the last 15 years (3-11), but ketosis and coma have usually been attributed, as in the study of Rosen and Lidz ( 12), to willful abandonment of the prescribed regimen. The present communication concerns an experimental investigation of the effects of life situations upon some aspects of the glucose and ketone metabolism of normal and diabetic persons. Simiilar studies on blood glucose and on fluid balance will be reported separately (13, 14). PROCEDUREThe subjects were patients from the Medical Clinics of the New York Hospital and volunteers from the hospital staff. The diabetic patients were average individuals encountered in a diabetic clinic, except that a relatively large proportion of the group were severe and labile diabetics. On each subject a detailed medical history was recorded as well as a physical examination and appropriate laboratory procedures. In addition, a detailed evaluation of his personality structure, life history, cultural background, present life situation, and significant conscious and unconscious conflicts, was undertaken through a series of interviews. Data were derived from discussion, questioning, associative procedures, dream analysis, social service case study, and psychologic tests. Moreover, the attitudes and motivations of the subject were assessed by observation of his behavior and reactions,...

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Section: Changes In the Hepatic Venous Bloodmentioning

confidence: 80%

Section: Supported In Part By Grants From the Commonwealthmentioning

confidence: 99%

Studies on Diabetes Mellitus: The Relation of Stressful Life Situations to the Concentration of Ketone Bodies in the Blood of Diabetic and Non-Diabetic Humans 1

Hinkle¹,

Conger²,

Wolf³

et al. 1950

J. Clin. Invest.

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“…In addition to these standard risk factors, it has long been suggested that risk of type 2 diabetes is increased by depression [2,3]. More recent reviews have continued to support this view [4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 89%

Does depression increase the risk of developing type 2 diabetes?

Cosgrove¹,

Sargeant

Griffin

2008

Occupational Medicine

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Background Members of a scheme awarding injury pensions may allege that the onset of diabetes was precipitated or caused by depression induced by work in order to claim an injury award. AimsTo quantify the association between depression and subsequent development of type 2 diabetes in order to determine whether an individual in a pension scheme that awards injury pensions, who develops type 2 diabetes, should be awarded an injury pension, if the development of the diabetes followed a work-related depressive episode. MethodsElectronic and hand literature searches up to December 2006. Relative risk estimates from cohort studies of adults were pooled using fixed and random effects models. Attributable risk fraction was calculated using the Levin formula. ResultsThe presence of depression or depressive symptoms was associated with increased risk of subsequently developing type 2 diabetes. The pooled fully adjusted relative risk estimate from the three highest quality studies was 1.25 (95% CI: 1.02-1.48) and was homogenous. However, depression was no more frequent among those with and without prevalent, but previously undiagnosed, type 2 diabetes.Conclusion Depression is associated with subsequent development of type 2 diabetes. However, the relative risk estimate is small and only 20% of cases of diabetes can be attributed to depression in people with both conditions. Further research is needed to determine possible causal mechanisms for the association and to ascertain whether depression and diabetes may have a common aetiology.

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“…This increased prevalence has been noted for decades in people with SMI, notably in people with schizophrenia and other severe psychotic disorders (3). The exact cause of this relationship is unknown, but newer antipsychotic agents likely play some role (4).…”

mentioning

confidence: 99%

Glucose Control and Medication Adherence Among Veterans With Diabetes and Serious Mental Illness: Does Collocation of Primary Care and Mental Health Care Matter?

et al. 2014

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OBJECTIVEPersons with serious mental illness (SMI) may benefit from collocation of medical and mental health healthcare professionals and services in attending to their chronic comorbid medical conditions. We evaluated and compared glucose control and diabetes medication adherence among patients with SMI who received collocated care to those not receiving collocated care (which we call usual care). RESEARCH DESIGN AND METHODSWe performed a cross-sectional, observational cohort study of 363 veteran patients with type 2 diabetes and SMI who received care from one of three Veterans Affairs medical facilities: two sites that provided both collocated and usual care and one site that provided only usual care. Through a survey, laboratory tests, and medical records, we assessed patient characteristics, glucose control as measured by a current HbA 1c , and adherence to diabetes medication as measured by the medication possession ration (MPR) and self-report. RESULTSIn the sample, the mean HbA 1c was 7.4% (57 mmol/mol), the mean MPR was 80%, and 51% reported perfect adherence to their diabetes medications. In both unadjusted and adjusted analyses, there were no differences in glucose control and medication adherence by collocation of care. Patients seen in collocated care tended to have better HbA 1c levels (b = 20.149; P = 0.393) and MPR values (b = 0.34; P = 0.132) and worse self-reported adherence (odds ratio 0.71; P = 0.143), but these were not statistically significant. CONCLUSIONSIn a population of veterans with comorbid diabetes and SMI, patients on average had good glucose control and medication adherence regardless of where they received primary care.

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The Inter-Relationships of Mental Disorders and Diabetes Mellitus

Cited by 40 publications

References 27 publications

Studies on Diabetes Mellitus: The Relation of Stressful Life Situations to the Concentration of Ketone Bodies in the Blood of Diabetic and Non-Diabetic Humans 1

Studies on Diabetes Mellitus: The Relation of Stressful Life Situations to the Concentration of Ketone Bodies in the Blood of Diabetic and Non-Diabetic Humans 1

Does depression increase the risk of developing type 2 diabetes?

Glucose Control and Medication Adherence Among Veterans With Diabetes and Serious Mental Illness: Does Collocation of Primary Care and Mental Health Care Matter?

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