Abstract
Aim: While the impact of major depression on diabetes has gained increasing attention, the role of minor depression is less well investigated. This observational study compared three groups of adults with Type 1 (T1DM) or Type 2 (T2DM) diabetes mellitus: with me) no depressive symptoms (NODEP), ii) mild depressive symptoms (MILD) and iii) moderate-to-severe symptoms (MOD/SEVERE)-on diabetes distress, psychological distress, anxiety and somatic symptoms, quality of life and HbA1c levels. Methods: 245 outpatients attending two hospital diabetes services (27% with T1DM; 73% with T2DM) completed self-report measures including patient health questionnaire (PHQ), problem areas in diabetes (PAID) scale and short form health survey (SF12). Participants were interviewed by a psychiatrist and HbA1c levels recorded. Results: Half the sample reported depressive symptoms on the PHQ-9 (29% in the MILD group, 21% in MOD/ SEVERE and the remaining 50% in the NODEP group). Compared to the NODEP group, MILD group participants had significantly higher levels of diabetes distress, psychological distress, anxiety and somatic symptoms and significantly lower mental-health related quality of life. Participants in the MOD/SEVERE group had significantly higher levels of diabetes distress, psychological distress, anxiety, and somatic symptoms than either of the other two groups, and significantly lower quality of life. The groups did not differ significantly on HbA1c. Conclusions: Mild symptoms of depression in patients with diabetes are common and are associated with higher levels of diabetes distress, psychological distress, anxiety and somatic symptoms and lower quality of life. Addressing mild depression provides a potential avenue for preventing clinical depression in patients with diabetes.
Highlights
Depression is common and burdensome in patients with diabetes
Psychological and pharmacological interventions are effective in reducing depression in people with diabetes and lifestyle factors and some pharmacological treatments improve glycaemic control [5]
This study aimed to contribute to the growing body of knowledge about mild symptoms of depression in people with diabetes (T1DM or Type 2 diabetes mellitus (T2DM)) by comparing groups with three depression symptoms categories on a range of variables (diabetes distress, psychological distress, anxiety and somatic symptoms, depression history, quality of life and glycosylated haemoglobin (HbA1c) levels)
Summary
Depression is common and burdensome in patients with diabetes. Depression is associated with poor diabetes self-management and poorer prognosis in terms of disease severity, complications, and mortality [3,4]. Psychological and pharmacological interventions are effective in reducing depression in people with diabetes and lifestyle factors and some pharmacological treatments improve glycaemic control [5]. The importance of screening for and addressing depression in people with diabetes is recognized in the guidelines of several countries and by the International Diabetes Federation [6]. A recent editorial stated that “clinicians must ensure that depression is recognized and treated as rigorously as the physical complications of diabetes that are generally prioritized” (p 393) [7]
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