Diabetes and Mental Health Issues

Diabetes and Mental Health Issues

I have always believed that there is a clear connection between the prevalence of diabetes and mental health issues, especially depression. To me it makes sense. A person who manages the long term effects of a chronic disease would seem to have a greater incidence of depression and other mental conditions than the normal population.

Why would I think that? Well for one I suffer from depression and very naturally I cast my own issues on the entire population. I think that is a natural reaction. When a person has a chronic ailment and they have a co issue (depression); it is easy for them to believe everyone suffers the same fate. Perhaps it is a way to lessen the stigma of having depression or it is natural transference. Either way I believe my reaction is more common than not.

I guess I just assumed my experience was universal. It turns out the research is not conclusive. Some researchers have found a greater incidence of mental health issues among diabetics and no significant difference between diabetics and the average population. Here is a thumb nail review.

In 1992 Rubin and Peyrot published a review of literature which concluded that various researchers had published articles which suggested that diabetics have no more incidences of mental health issues than the average population. However they also concluded that while not statistically significant Diabetics do suffer more mental health issues on average than the regular population.

In 2003 Kruse, Schmitz, and Thefeld, published an article that said in part:

“PWD were not more likely to meet DSM-IV criteria for at least one mental disorder than subjects without diabetes. However, a different diagnostic pattern was observed: PWD had an increased prevalence of current anxiety disorders but not of somatoform and substance abuse disorders. Overall levels of psychiatric comorbidity were higher in these patients than in the general population sample, which did not comprise PWD”

This basically restates the same conclusion as the prior referenced literature review. Basically there is no significantly increased prevalence of mental health issues. It also goes on to say that while not significant an increased prevalence did occur.

Then there is a 2007 paper based on a UK study conducted by: Das-Munshi, Stewart, Ismail, Bebbington, Jenkins, and Prince found in part that:

“People with diabetes are more likely to suffer from common mental disorders, a finding which is highly relevant, given that psychiatric comorbidity in people with diabetes is also associated with higher levels of functional impairment, impaired quality of life, and difficulties with diabetes self-care.”
This is not much different than the other studies. However it is more clearly and perhaps more alarmingly stated.

So the take away is that yes additional mental issues do occur, however the incidence of those issues may not be significant when measured against the general population. I do think that my advice for teenagers who are first diagnosed to consider psychological counseling is justified. Again this is just me and it reflects my personal experiences.

What are your experiences?



The excerpt below makes a stronger case (I think)than your citations. Generally speaking T1s and T2s psychological approach is different. T1s don't blame themselves, they do get angry, rage, fatigue and depression. Often T2s msee the condition as partly their own fault (because that's what doctor's tell them if only they had exercised and lost weight...). Before counseling, education as to how to recognize when you are depressed might be a very good aid to all PWDs. I was depressed so long before diagnosis that I though it was normal. I did not know that anger can be a symptom.

Published in final edited form as:
Am J Med. 2008 November; 121(11 Suppl 2): S8–15.
doi: 10.1016/j.amjmed.2008.09.008

The reported prevalence of depression in patients with diabetes varies widely, a fact that may be accounted for by methodologic differences and limitations of existing epidemiologic studies. Factors such as inclusion of patients without distinguishing between type 1 and type 2 diabetes, self-reported depressive symptoms versus clinically diagnosed depression, and lack of documentation regarding relevant factors associated with the disease state (e.g., number of diabetes complications, other medical comorbidity) may confound clinical study results and skew prevalence rates. A meta-analysis that included 39 studies6 demonstrated that 11% of patients with diabetes met the criteria for comorbid major depressive disorder (MDD) and 31% experienced significant depressive symptoms; in addition, the prevalence of depression in patients with diabetes was significantly higher in women than men (28% and 18%, respectively; P <0.0001). In the controlled studies, the odds of having depression were twice as great in patients with diabetes as in their nondiabetic counterparts (odds ratio [OR], 2.0; 95% confidence interval [CI], 1.8 to 2.2).

Very true. I have observed this in my own family and know that depression, even in a home filled with love and faith, can show up and try to take over. My brothers and our family face each day where diabetes is present by encouraging one another, supporting and being there for each other, and through prayer and scripture verses that remind us to have faith, hope, be strong and keep going forward. Depression is a room of darkness where someone struggles to find the light switch. Family, friends, and faith make all the difference.

Never ever been depressed and have been T1D for 39 years. If I had a moment of being "down", never thought nor applied that to the Diabetes in any way. I know I'm human and that means there will be good, bad, indifferent. Depression may be more genetic perhaps as I also am not aware of any family member being depressed.