June 17, 2014
New Study Finds Depression Misdiagnoses In Type 2 Diabetics
Rebekah Eliason for redOrbit.com – Your Universe Online
People suffering from diabetes are known to often struggle with depression as well. According to new research, the symptoms of depression among people with type 2 diabetes can significantly be reduced by interventions for “diabetes distress.”
This finding suggests that what doctors are usually labeling as depression may not be a co-morbid psychiatric disorder. Instead researchers believe the depression may be a reaction to the stress of living with a disease that is difficult and complex to manage.
In a second study, researchers emphasized the importance of treating type 1 diabetes patients for depression regardless of the cause. They discovered that the more signs of depression reported by the patient, the greater the person’s risk of death.
"Because depression is measured with scales that are symptom-based and not tied to cause, in many cases these symptoms may actually reflect the distress that people are having about their diabetes, and not a clinical diagnosis of depression," said lead author Lawrence Fisher, PhD, ABPP, Professor of Family and Community Medicine at the University of California, San Francisco.
For this study, Fisher and his research team designed diabetes-specific measures of distress in order to reflect the patient’s level of worry regarding the disease. In addition, patients were asked to fill out the Patient Health Questionnaire, which provided a measure of depressive symptoms.
Patients who reported a high amount of distress regarding their disease and also exhibited high levels of depressive symptoms were given one of three treatments designed to reduce stress related to diabetes rather than directly addressing the depressive symptoms.
The first group participated in an online diabetes self-management program. A second group also participated in the online program but additionally received individual assistance to help problem solve the specific issues causing their diabetes distress. The third group of patients received personalized health risk information, which was followed by general educational material about diabetes sent through the mail. Each group also received personal phone calls throughout the study.
Over a twelve-month period, all three interventions significantly reduced distress about the disease and lowered depressive symptoms. The reductions were maintained by patients throughout the course of the study. Fisher said overall, 84 percent of those scoring above 10 on the PHQ8 (maximum 27, with 10 being moderate depression) reduced their levels of depression to below 10 following the interventions. For all three interventions, the reductions were evenly distributed.
"What's important about this," said Fisher, "is that many of the depressive symptoms reported by people with type 2 diabetes are really related to their diabetes, and don't have to be considered psychopathology. So they can be addressed as part of the spectrum of the experience of diabetes and dealt with by their diabetes care team."
This study was presented at the American Diabetes Association’s 74th Scientific Sessions.