Depression, anxiety, distress and other disorders causing serious psychological distress (SPD) are known to frequently complicate the health care of people with diabetes (Anderson et al 2001; Fisher et al 2012; Grigsby et al 2002). Among the spectrum of psychological disorders, there is considerable literature to support an association between depression and diabetes (Goldney et al 2004). Depression is frequently cited to be more common in people with diabetes than in the general population and the presence of complications is associated with a lower quality of life (Scottish Intercollegiate Guidelines Network [SIGN] 2010). Furthermore, depression in people with diabetes is associated with higher blood glucose levels, poorer adherence to therapeutic regimens (whether pharmacological or therapeutic lifestyle changes), more medical complications, and higher hospitalisation rates. According to Mitchell et al (2013) major depression is associated with an increased number of known cardiac risk factors in people with diabetes and a higher incidence of coronary heart disease; therefore, attention should be paid to screening and treatment of depression in people with diabetes.
In 2001, the Diabetes, Attitudes, Wishes and Needs (DAWN) study showed that more than two in five people with diabetes reported poor psychological wellbeing; many people experienced emotional stress related to their diabetes; and more than a third of health care providers did not feel equipped to adequately address patients’ psychological needs.
There may be a range of psychological and social factors that can impact on the ability of people with diabetes to manage their condition, and it is unclear whether the burden of managing diabetes causes psychological and social problems or vice versa. Therefore, assessment and appropriate management of psychological issues are important throughout the lifespan of people with diabetes, and should be a routine component of the diabetes consultation (Chiang et al 2014).
