C E Lloyd1, A Nouwen2, N Sartorius3, H U Ahmed4, A Alvarez5, S Bahendeka6, D Basangwa6, A E Bobrov7, S Boden1, V Bulgari8,9, L Burti10, S K Chaturvedi11, L C Cimino12, W Gaebel13, G de Girolamo8, T M Gondek14, M Guinzbourg de Braude5, A Guntupalli15, M G Heinze16, L Ji17, X Hong18, A Khan19, A Kiejna20,21, A Kokoszka22, T Kamala23, N M Lalic24, D Lecic Tosevski25, B Mankovsky26, M Li27, A Musau28, K Müssig29,30,31,32, D Ndetei33, G Rabbani34, S S Srikanta35, E G Starostina36, M Shevchuk37, R Taj19, O Vukovic25, W Wölwer13, Y Xin38. 1. The Open University, School of Health, Wellbeing and Social Care, UK. 2. Department of Psychology, Middlesex University, UK. 3. Association for the Improvement of Mental Health Programmes, Switzerland. 4. Child Adolescent & Family Psychiatry, National Institute of Mental Health (NIMH), Dhaka, Bangladesh. 5. Hospital Italiano de Buenos Aires, Argentina. 6. Mother Kevin Post Graduate Medical School, Uganda Martyrs University, Kampala, Uganda. 7. Federal Medical Research Centre for Psychiatry and Narcology, Moscow, Russia. 8. Psychiatric Epidemiology and Evaluation Unit, Saint John of God Clinical Research Centre, Brescia, Italy. 9. PhD School in Psychology, Catholic University of the Sacred Heart, Milan, Italy. 10. Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy. 11. National Institute of Mental Health & Neurosciences, Bangalore, India. 12. Indiana University, Indiana, USA. 13. Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany. 14. Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland. 15. School of Health, Wellbeing and Social Care, The Open University, UK. 16. Universidad Nacional Autónoma de México, Mexico City, Mexico. 17. People's Hospital, Peking University, Beijing, China. 18. Department of Psychological Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. 19. Pakistan Institute of Medical Sciences, Pakistan. 20. University of Lower Silesia, Wroclaw, Poland. 21. Department of Psychiatry, Medical University, Wroclaw, Poland. 22. II Department of Psychiatry, Medical University of Warsaw, Warszawa, Poland. 23. Diabetes Centre and Jnana Sanjeevini Medical Centre, Bangalore, India. 24. Clinic for Endocrinology, Belgrade University School of Medicine, Serbian Academy of Sciences and Arts, Belgrade. 25. Institute of Mental Health, Belgrade University School of Medicine, Serbian Academy of Sciences and Arts, Belgrade, Serbia. 26. Department of Diabetology, National Medical Academy for Postgraduate Education, Ukraine. 27. School of Nursing, Peking University, Beijing, China. 28. Africa Mental Health Foundation, Kenya. 29. Institute for Clinical Diabetology, German Diabetes Centre. 30. Leibniz Centre for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany. 31. Department of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany. 32. German Centre for Diabetes Research (DZD), München-Neuherberg, Germany. 33. University of Nairobi, Africa Mental Health Foundation, Kenya. 34. Popular Medical College, Dhaka, Bangladesh. 35. Samatvam Endocrinology Diabetes Centre and Jnana Sanjeevini Medical Centre, Bangalore, India. 36. Department of Endocrinology, Moscow Regional Clinical and Research Institute, Russia. 37. Department of Diabetology, National Medical Academy for Postgraduate Education, Kiev, Ukraine. 38. Clinical Research Centre, Peking University Sixth Hospital, Clinical Research Centre, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Centre for Mental Disorders (Peking University Sixth Hospital), Beijing, China.
Abstract
AIMS: To assess the prevalence and management of depressive disorders in people with Type 2 diabetes in different countries. METHODS: People with diabetes aged 18-65 years and treated in outpatient settings were recruited in 14 countries and underwent a psychiatric interview. Participants completed the Patient Health Questionnaire and the Problem Areas in Diabetes scale. Demographic and medical record data were collected. RESULTS: A total of 2783 people with Type 2 diabetes (45.3% men, mean duration of diabetes 8.8 years) participated. Overall, 10.6% were diagnosed with current major depressive disorder and 17.0% reported moderate to severe levels of depressive symptomatology (Patient Health Questionnaire scores >9). Multivariable analyses showed that, after controlling for country, current major depressive disorder was significantly associated with gender (women) (P<0.0001), a lower level of education (P<0.05), doing less exercise (P<0.01), higher levels of diabetes distress (P<0.0001) and a previous diagnosis of major depressive disorder (P<0.0001). The proportion of those with either current major depressive disorder or moderate to severe levels of depressive symptomatology who had a diagnosis or any treatment for their depression recorded in their medical records was extremely low and non-existent in many countries (0-29.6%). CONCLUSIONS: Our international study, the largest of this type ever undertaken, shows that people with diabetes frequently have depressive disorders and also significant levels of depressive symptoms. Our findings indicate that the identification and appropriate care for psychological and psychiatric problems is not the norm and suggest a lack of the comprehensive approach to diabetes management that is needed to improve clinical outcomes.
AIMS: To assess the prevalence and management of depressive disorders in people with Type 2 diabetes in different countries. METHODS:People with diabetes aged 18-65 years and treated in outpatient settings were recruited in 14 countries and underwent a psychiatric interview. Participants completed the Patient Health Questionnaire and the Problem Areas in Diabetes scale. Demographic and medical record data were collected. RESULTS: A total of 2783 people with Type 2 diabetes (45.3% men, mean duration of diabetes 8.8 years) participated. Overall, 10.6% were diagnosed with current major depressive disorder and 17.0% reported moderate to severe levels of depressive symptomatology (Patient Health Questionnaire scores >9). Multivariable analyses showed that, after controlling for country, current major depressive disorder was significantly associated with gender (women) (P<0.0001), a lower level of education (P<0.05), doing less exercise (P<0.01), higher levels of diabetes distress (P<0.0001) and a previous diagnosis of major depressive disorder (P<0.0001). The proportion of those with either current major depressive disorder or moderate to severe levels of depressive symptomatology who had a diagnosis or any treatment for their depression recorded in their medical records was extremely low and non-existent in many countries (0-29.6%). CONCLUSIONS: Our international study, the largest of this type ever undertaken, shows that people with diabetes frequently have depressive disorders and also significant levels of depressive symptoms. Our findings indicate that the identification and appropriate care for psychological and psychiatric problems is not the norm and suggest a lack of the comprehensive approach to diabetes management that is needed to improve clinical outcomes.
Authors: Xiaobo Liu; Yuxi Li; Li Guan; Xia He; Huiling Zhang; Jun Zhang; Juan Li; Dongling Zhong; Rongjiang Jin Journal: Front Med (Lausanne) Date: 2022-05-10