Depression care critical for diabetics

I have written many times about the importance of early and effective treatment for depression.

When intervention is not used, depression is usually a chronic condition that can worsen over time and cause many negative health consequences even leading to premature death in many cases.

It has also long been known that many other chronic illnesses such as diabetes tend to be worse when there is also co-existing depression.

One study examined mortality rates among older depressed patients who also had diabetes.

Comparing usual care with a specific depression care management strategy, this study found patients were significantly less likely to die over a five year period if they received depression care management than if they received usual care.

Both groups received treatment from general practice clinics in several major cities in the US – half of the clinics were told to continue treating their patients as usual and the other half had their usual treatment supplemented with the specific depression care management strategies.

Clinics with extra intervention strategies had trained depression care managers who offered recommendations to physicians and helped patients to properly follow treatment plans. Care managers also monitored depression treatment for response and side effects and gave follow up care at regular intervals or when clinically necessary.

Among the study subjects with depression and diabetes, this focused depression management led to fewer deaths at a five year follow up.

These findings highlight the necessity of specifically dealing with depression in individuals with chronic illness such as diabetes.

Interestingly, individuals involved in this study who were depressed but did not have diabetes experienced no difference in mortality rates between usual care practices and the depression care management strategy – which suggests the depression care specifically lessened the influence of diabetes on mortality risk among those with both depression and diabetes.

These results likely had to do with better treatment adherence by those receiving the additional intervention. Depression is a condition that greatly affects motivation and ability to focus – making depressed individuals notoriously bad at following the advice and treatment plans of their doctors.

Of course, when people experience both depression and another serious chronic illness such as diabetes, treatment adherence is even more important. If a person fails to adequately follow diabetes treatment, negative health consequences and even death can result.

In this study, the added monitoring and follow up from the depression care managers helped to ensure patients were properly following depression treatment. With depression adequately managed, patients were probably more likely to adhere to their diabetes treatment as well.

More research is needed into this area, but this study provides one more reminder of the importance of timely and effective depression treatment. Your overall health could depend on it.

More States of Mind articles

About the Author

Paul Latimer has over 25 years experience in clinical practice, research, and administration.

After obtaining his medical degree from Queen's University in Kingston, Ontario, he did psychiatric training at Queen's, Oxford and Temple Universities. After his residency he did a doctorate in medical science at McMaster University where he was also a Medical Research Council of Canada Scholar.

Since 1983 he has been practicing psychiatry in Kelowna, BC, where he has held many administrative positions and conducted numerous clinical trials.

He has published many scientific papers and one book on the psychophysiology of the functional bowel disorders.

He is an avid photographer, skier and outdoorsman.

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The views expressed are strictly those of the author and not necessarily those of Castanet. Castanet does not warrant the contents.

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