Depression in Patients with Diabetes

Abstract

Background: Comorbidity of depression - diabetes is a very important public health problem, both by increasing the consumption of medical services and the cost of health. Clinical care involves the development of effective strategies for recognizing depression and the implementation of personalized therapies according to the needs of each patient. Aims: To introduce an objective approach for recognising early symptoms of depression in patients with clinical diagnose of diabetes and adapting treatment for each of them. Method: There are two important theories on the occurrence of depression in diabetic patients: first, in which diabetic depression is the result of modified biochemical factors involved in the onset, exacerbation or remission of depression and diabetes, followed by a second hypothesis where depression is the result of psychosocial requirements imposed by diabetes. Results and Discussion: Studies show that depression increases the risk of developing diabetes, but depressive symptoms are more common in patients with type I and type II diabetes with micro and macro vascular chronic complications. For people with diabetes and various depression diagnoses, the treatment can improve the quality of life and the glycemic level. Emotional problems associated with diabetes and / or chronic complications and the presence of atypical features of mood disorders in diabetic patients indicate that depressive episodes have a higher recurrence and longer duration of manifestation, with an increased incidence between the association of diabetes mellitus and the depression. Conclusion: In Romania, patients with depression are stigmatized and on many occasions they do not ask for professional help. Different mental disorders such as depression are still underdiagnosed and not properly treated in different aspects (social, economic, cultural, intellectual) of people`s life with diabetes. Although obvious benefits have been demonstrated through an extensive interdisciplinary global approach of the treatment in diabetic patients, there are still many barriers for integrating all methods of treatment for depressive disorders.