Abstract
IntroductionClinical psychological features may impact a person’s aptitude to deal with chronic diseases, leading to emotional distress, suffering, and a worse perceived quality of life (QoL). Chronic diseases are largely represented, and their incidence is constantly increasing all over the world. Type 2 Diabetes Mellitus (T2DM) is one of the most common chronic diseases and it is very difficult to manage, demanding long term self-management, which improves the perceived QoL. The aim of this study was to explore defense mechanisms, depression, QoL, time since diagnosis, and metabolic control in T2DM patients.Methods51 patients with T2DM were assessed through a psychodiagnostic battery: Beck Depression Inventory-II, the 36-Item Short Form Health Survey, including indexes of Physical and Mental Component Summary and the Defense Mechanisms Inventory. Times since DM diagnosis and glycated hemoglobin values were detected.ResultsParticipants were mainly female (62.74%), with a mean age of 66.1 years. T2M time since diagnosis was 11.77 years (SD = 7.1). Mild depression was detected (with an overall score between 13 and 19). Projection was significantly associated with higher depression and with lower physical well-being; Principalization was negatively associated with depression and positively with both physical and mental well-being. Turning Against Self correlated positively with physical well-being and negatively with mental well-being. Reversal was associated with lower depression and higher mental well-being. A negative high correlation emerged between depression and mental well-being. Finally, a significant relationship was found between Projection and higher time since diagnosis (r = 0.31, p < 0.05).ConclusionThe correlations between defense mechanisms, depression and health-related QoL highlight the potential personification and protagonization, which may increase over time due to the illness intrusiveness and worsening of diabetes symptoms. The positive association between defensive strategies and well-being measures should be cautiously considered.
Highlights
Clinical psychological features may impact a person’s aptitude to deal with chronic diseases, leading to emotional distress, suffering, and a worse perceived quality of life (QoL)
Looking at the mean values of the defense mechanisms examined through Defense Mechanisms Inventory (DMI), compared to norms differentiated by gender of the Italian sample (Ihilevich and Gleser, 1994), Principalization was higher than one standard deviation in male
It is acknowledged that Type 2 Diabetes Mellitus (T2DM) may incite distress, as patients suffer with a need to self-manage such chronic disease, recurrently detect blood glucose levels, and show adequate compliance adherence (Marshall et al, 1997; Marchini et al, 2018), which facilitate the avoidance of unhealthy behavior and outcomes
Summary
Clinical psychological features may impact a person’s aptitude to deal with chronic diseases, leading to emotional distress, suffering, and a worse perceived quality of life (QoL). It is known that diabetes is one of the most common chronic diseases in the world and it is very difficult to manage, demanding long term self-management through constant blood glucose monitoring, a balanced diet, physical exercises and medical treatment, which improve perceived QoL (Conversano et al, 2009; Veltri et al, 2012; Palagini et al, 2016; Marchini et al, 2018; Catalano et al, 2019b; Conversano, 2019; Guicciardi et al, 2019; Martino et al, 2019d,c; Merlo, 2019; Quattropani et al, 2019; Lenzo et al, 2020) Both adequate compliance and adherence prevent its relative outcomes leading to a lower risk of developing related complications (American Diabetes Association, 2018). Demographical and physical characteristics, such as body mass index (BMI) and smoking and alcohol consumption, could predict depression in Type 2 Diabetes Mellitus (T2DM) (Bouwman et al, 2010; Rosa et al, 2019). Smith et al (2013) observed a significant correlation between diabetes, anxiety symptoms and anxiety disorders, and highlighted that a fruitful psychological adjustment to diabetes is significantly associated with a better metabolic control, self-care and higher QoL
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