Martha Sajatovic1, Douglas Gunzler, Douglas Einstadter, Charles Thomas, Richard A McCormick, Adam T Perzynski, Stephanie Kanuch, Kristin A Cassidy, Neal V Dawson. 1. Dr. Sajatovic and Ms. Cassidy are with the Department of Psychiatry, Case Western Reserve University School of Medicine and University Hospitals Case Medical Center, Cleveland, Ohio (e-mail: martha.sajatovic@uhhospitals.org ). Dr. Gunzler, Dr. Einstadter, Mr. Thomas, Dr. Perzynski, Ms. Kanuch, and Dr. Dawson are with the Center for Health Care Research and Policy, Case Western Reserve University and MetroHealth Medical Center, Cleveland. Dr. McCormick is with the Center for Health Care Research and Policy, Case Western Reserve University.
Abstract
OBJECTIVE: Data from 157 individuals with serious mental illness and comorbid diabetes enrolled in an ongoing treatment study were used to examine clinical correlates of diabetes control. METHODS: Factors assessed included depressive symptoms (Montgomery-Åsberg Depression Rating Scale), global psychopathology severity (Brief Psychiatric Rating Scale), and glycosylated hemoglobin (HbA1c), a biomarker of diabetes control. RESULTS: Seventy-seven participants had depression, 40 had schizophrenia, and 40 had bipolar disorder. Most were moderately to severely depressed with poor diabetes control. No correlation between diagnosis and diabetes control was found after adjustment for gender, race, health literacy, diabetes duration, and diabetes knowledge. Greater depression severity and longer diabetes duration were related to poorer diabetes control. Lower severity of global psychopathology was related to poorer diabetes control, perhaps because of overall low levels of psychosis and mania. CONCLUSIONS: People with serious mental illness and diabetes face multiple challenges, which, along with severe depression, may impede diabetes self-management.
OBJECTIVE: Data from 157 individuals with serious mental illness and comorbid diabetes enrolled in an ongoing treatment study were used to examine clinical correlates of diabetes control. METHODS: Factors assessed included depressive symptoms (Montgomery-Åsberg Depression Rating Scale), global psychopathology severity (Brief Psychiatric Rating Scale), and glycosylated hemoglobin (HbA1c), a biomarker of diabetes control. RESULTS: Seventy-seven participants had depression, 40 had schizophrenia, and 40 had bipolar disorder. Most were moderately to severely depressed with poor diabetes control. No correlation between diagnosis and diabetes control was found after adjustment for gender, race, health literacy, diabetes duration, and diabetes knowledge. Greater depression severity and longer diabetes duration were related to poorer diabetes control. Lower severity of global psychopathology was related to poorer diabetes control, perhaps because of overall low levels of psychosis and mania. CONCLUSIONS:People with serious mental illness and diabetes face multiple challenges, which, along with severe depression, may impede diabetes self-management.
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