New data presented at the 2014 American Diabetes Association Scientific Sessions shows that symptoms of depression in patients with type 2 diabetes can be reduced through interventions for “diabetes distress.” This research suggests that depression may not be a comorbid psychiatric disorder but rather a reaction to living with a disease that is difficult to manage.
Lawrence Fisher, PhD, ABPP, Professor of Family and Community Medicine at the University of California, San Francisco, and colleagues developed diabetes-specific distress measure that reflect whether a patient had been worried about various diabetes-associated problems (eg, hypoglycemia). Patients were also asked to fill out the Patient Health Questionnaire (PHQ) to measure depressive symptoms.
Patients who reported high levels of distress and depressive symptoms were assigned 1 of 3 interventions, which were designed to reduce the distress associated with managing diabetes and not the symptoms of depression. The 3 interventions were: 1) online diabetes self-management program, 2) online program and individual assistance to resolve diabetes distress-related issues, and 3) personalized health risk information with diabetes educational material through the mail.
Overall, 84% of patients scoring >10 on the PHQ8 (10=moderate depression) reduced their levels of depression to <10 following the interventions. Reductions were evenly spread across all 3 interventions. Fisher and his team concluded that many of the reported depressive symptoms with type 2 diabetes are related to their diabetes and they do not have to be considered for psychopathology.
Another study conducted in patients with type 1 diabetes reinforced the importance of treating depressive symptoms regardless of their cause. Study data found that greater the depressive symptoms, the higher the patient’s mortality risk. These results support earlier findings that show greater depressive symptoms predicted the incidence of heart disease.
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