Rates of major depressive disorder and depressive symptoms are often high among adults with type 2 diabetes, study data presented at the 52nd European Association for the Study of Diabetes Annual Meeting show.
“However, our study suggests that there is a lack of joined up care for people with diabetes and depression — both the physical and psychological aspects of diabetes need to be considered if we are to improve overall well-being and support good self-management,” Catherine E. Lloyd, PhD, professor of health studies at The Open University in Milton Keynes, United Kingdom, told Endocrine Today.
Catherine E. Lloyd
Lloyd and colleagues evaluated data from the International Prevalence and Treatment Study on 200 people from each of the following countries: Argentina, Bangladesh, China, Germany, India, Italy, Kenya, Mexico, Pakistan, Poland, Russia, Serbia, Thailand, Uganda and Ukraine. Participants had a mean diabetes duration of 8.8 years and mean age of 54.1 years. Ten percent of participants were diagnosed with major depressive disorder, which was similar to rates of past major depressive disorder (10.3%), but higher than rates of recurrent major depressive disorder (5.1%). The lowest rates of diagnosis were found in Uganda (1%), Kenya (2.7%) and India (2%), and the highest rate was found in Bangladesh (29.9%).
Forty-three percent of participants with a current major depressive disorder diagnosis also reported a past episode, and 32.3% reported recurrent episodes.
A diabetes diagnosis was documented in up to 29% of participants with major depressive disorder. Depressive symptoms were associated with diabetes-related distress in each country (P < .01) and overall (P < .05).
Lower well-being scores on the WHO-5 Well-being Index, older age, longer duration, higher HbA1c and history of diabetes complications were associated with the Problem Areas in Diabetes scale.
“Screening for symptoms of depression and identifying emotional distress associated with diabetes are both important if we are to improve care,” Lloyd told Endocrine Today. “Identifying whether the patient is experiencing symptoms of depression or distress associated with having diabetes, or both, can help provide care and treatment that is tailored to meet the needs of that individual. Longitudinal studies, which examine the care pathways of those with comorbid diabetes and depression are urgently required in order to identify the most appropriate ways of treating these patients. The care pathways are likely to differ according to the care setting and the life context of the individual but this needs to be confirmed in further research.” – by Amber Cox
Lloyd CE, et al. Poster 817. Presented at: 52nd EASD Annual Meeting; Sept. 12-16, 2016; Munich.
Disclosure: Lloyd reports receiving a grant from the Association for the Improvement of Mental Health Programmes.