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Perspectives

Depression or diabetes distress? The importance of screening in adults with type 2 diabetes

Peter Baldwin, Janine Clarke, Jane Gunn, Lesley Campbell, Mark Harris, Kay Wilhelm, Nick Zwar, Judy Proudfoot

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© DEMAERRE/ISTOCKPHOTO MODEL USED FOR ILLUSTRATIVE PURPOSES ONLY
© DEMAERRE/ISTOCKPHOTO MODEL USED FOR ILLUSTRATIVE PURPOSES ONLY

Abstract

Psychological distress is common in people with type 2 diabetes and is linked with poorer health outcomes. Although depression and diabetes distress are related, they are distinct constructs that differentially impact biological and behavioural diabetes outcomes. Screening for both depression and diabetes distress may help personalise care and inform referral pathways for people with type 2 diabetes.

Key Points

  • Many patients with diabetes experience emotional distress. Although this may mimic depression, it can reflect a patient’s emotional adjustment to a chronic disease.
  • Both depressive symptoms and diabetes distress can be assessed using questionnaires such as the Patient Health Questionnaire 9 and the Diabetes Distress Scale.
  • Diabetes distress comes from four main sources: cognitive distress, interpersonal distress, regimen distress and distress arising from interactions with healthcare providers.
  • Individualised treatment is a central principle of type 2 diabetes management and can be optimised by considering a patient’s emotional distress profile in conjunction with their overall treatment goals.

Figures

© DEMAERRE/ISTOCKPHOTO MODEL USED FOR ILLUSTRATIVE PURPOSES ONLY
© DEMAERRE/ISTOCKPHOTO MODEL USED FOR ILLUSTRATIVE PURPOSES ONLY