Abstract
AimsThe objective of this study is to investigate whether type of depressive symptoms (i.e. cognitive-affective or somatic) is related to a patient-perceived need for professional psychological care in individuals with diabetes.MethodsIn total 2266 participants were recruited as part of the screening procedure for a multi-center randomized controlled trial on the treatment of depressive symptoms among individuals with diabetes. Individuals were invited to complete Beck Depression Inventory-II (BDI-II). Patients with elevated depressive symptoms (BDI-II ≥14) were interviewed about their psychological care need. Based on their care needs patients were categorized into: unmet need, no need, met need and unclear need. These groups were compared on type of depressive symptoms, as categorized into cognitive-affective symptoms and somatic symptoms.Results568 eligible individuals had elevated depressive symptoms, of whom 519 were reached. Among these depressed individuals, 19.7% (102 of 519) had an unmet need for psychological care. Participants with an unmet need were younger (p<0.001) and had higher total depression scores compared to the group with no need (p<0.001). They also scored higher on cognitive-affective symptoms (p<0.001), whereas somatic symptoms did not significantly differ (p = 0.232). Logistic regression revealed that cognitive-affective symptoms predicted an unmet need (p = 0.001). However, overall predictive capacity of type of depressive symptoms on care needs was weak.ConclusionsCognitive-affective symptoms of depression—but not somatic symptoms—were associated with an unmet need for psychological care among depressed individuals with diabetes. Future research is needed to reveal better predictors explaining the discrepancy between distress and low care needs in order to optimize screening procedures.
Highlights
Participants with an unmet need were younger (p
Future research is needed to reveal better predictors explaining the discrepancy between distress and low care needs in order to optimize screening procedures
Depressive symptoms are a common comorbidity in diabetes mellitus type 1 and 2, with a prevalence as high as 31% [1] which is two to three times higher compared to individuals without diabetes [2,3]
Summary
Depressive symptoms are a common comorbidity in diabetes mellitus type 1 and 2, with a prevalence as high as 31% [1] which is two to three times higher compared to individuals without diabetes [2,3]. Improvement of psychological outcomes and recovery is associated with significant reductions in work disability and healthcare costs [8] and has been found to be cost-effective [9] These findings stress the importance of early detection and treatment of depressive symptoms among individuals with diabetes. The majority of patients receive antidepressant medication, which have been found to be effective in reducing depressive symptoms [14] Another effective treatment option is psychotherapy, which includes a variety of treatments such as cognitive behavioral therapy and problem-solving therapy. A final depression treatment option involves collaborative care, which combines antidepressant medication and psychotherapy
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