Coexistent Mental Health Disorders in Diabetic Patients

As the world celebrates the world diabetes day today the 14^th November 2018 it is important to note that persons living with diabetes  may be particularly vulnerable to developing mental health disorders because diabetes is considered one of the most psychologically and behaviorally demanding chronic medical conditions. Studies have shown that diabetes is more prevalent in psychiatric patients than in the general population. Depression, anxiety and schizophrenia are just a few of the mental health co morbidities seen amongst persons living with diabetes. Co morbid psychiatric illness has further been linked to worse health outcomes in diabetic patients.

Co morbid Mental Health Disorders

Even nonclinical levels of depressive symptoms and minor depression have been associated with problems with adherence, risk of complications, functional impairment, higher medical costs, and death.  Increased severity of depressive symptoms has been connected to a greater probability of emergency department, primary care, specialty care, medical inpatient, and mental health costs. Depressive symptoms have been found to be more persistent in amongst persons living with diabetes compared with those without the disease. Fear of diabetes complications can lead to anxiety in persons with diabetes. Anxiety and depression were linked to more perceived symptoms of diabetes, longer anticipated duration of illness, more serious diabetes complications, worse diabetes control, greater healthcare use and costs, decreased medication adherence, and higher mortality rates.

Importance of Integrated Care

Strategies to improve the detection and treatment of mental health disorders in persons living  with diabetes are critical in order to improve function and decrease disability. Evidence from several controlled trials suggests that the detection and treatment of depression improves glycemic control. However, depression and anxiety are under detected and under treated in diabetic patients; these conditions are recognized in <50% of diabetic patients who have them. Diabetic patients should be regularly screened for symptoms of anxiety and depression since they are at higher risk for these conditions.

Reference

Thomas., LT. (2015) Co existent mental health disorders in diabetic patients. US Pharmacist, 40(11):37-42

For further reading https://www.uspharmacist.com/article/coexistent-mental-health-disorders-in-diabetic-patients