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Diabetes and depression have been linked in a number of studies. Major depressive disorder (MDD) is at least twice as prevalent among people with diabetes (both type 1 and type 2) as compared to the general population (where point prevalence ~5%) [Anderson et al, 2001]. There is also evidence to suggest a higher recurrence rate of MDD in diabetes patients [Peyrot, Rubin 1999].



Depression as a contribuiting cause to onset of diabetes

The aetiology of depression (MDD and sub clinical forms) in diabetes is unclear. MDD has also been shown to independently predict incidence of onset of type 2 diabetes [Eaton et al., 1996; Kawamaki et al., 1999].However, to date, the underlying mechanisms, whether behavioural, biological, or genetic are unknown.



Depression as a factor in diabetes treatment compliance

Depression has been found to be associated with poorer self-care and metabolic control [Lustman et al, 2000; Ciechanowski et al., 2000] and a three-fold increased risk of diabetes-related complications, including heart disease and stroke[De Groot et al., 2001].

Assessment

Depression under-diagnosised and consequently under-treatmented of in diabetes patients [cf. Gerber et al., 1989; Thompson et al., 2000].

Main article: Psychological assessment in diabetes

Treatment implications

The little research available suggests that cognitive behaviour therapy and anti-depressant medication are as effective in those with diabetes as in those without, with beneficial effects on glycaemic control. However, there are indications that in 50% of depressed patients pharmacotherapy does not lead to full remission of depression. Further research is required to understand the role of disease-specific factors in the pharmacological and psychotherapeutic treatment of depression in type 2 diabetes [Lustman et al., 1998 a,b].

Research groups

European Depression In Diabetes Research Consortium [1]


See also

References & Bibliography

Key texts

Books

Papers

  • Anderson RJ, Freedland KE, Clouse RE, Lustman PJ. The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care 2001;24:1069--78.
  • Ciechanowski PS, Katon WJ, Russo JE. Depression and diabetes: impact of depressive symptoms on adherence, function, and costs. Arch Intern Med 2000;160:3278--85.
  • Katon W, Von Korff M, Ciechanowski P, et al. Behavioral and clinical factors associated with depression among individuals with diabetes. Diabetes Care 2004;27:914--20.
  • Katon WJ, Von Korff M, Lin EH, et al. The Pathways study: a randomized trial of collaborative care in patients with diabetes and depression. Arch Gen Psychiatry 2004;61:1042--9.
  • Pouwer, François, Skinner, T. Chas, Pibernik-Okanovic, Mirjana, Beekman, Aartjan T.F., Cradock, Sue, Szabo, Silvija, Metelko, Zeljko and Snoek, Frank J. (2005) Serious diabetes-specific emotional problems and depression in a Croatian-Dutch-English Survey from the European Depression in Diabetes Research Consortium[EDID]. Diabetes Research and Clinical Practice, 70, (2), 166-173. (doi:10.1016/j.diabres.2005.03.031)

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External links

Ctegory:Depression

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