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Screening for depression in a diabetic outpatient population
Ella J Daly1, Madhukar H Trivedi, Philip Raskin
1Departments of Psychiatry, University of Texas Southwestern Medical School, , Dallas, TX, USA.
International Journal of Psychiatry in Clinical Practice
|June 19, 2014
Summary
This study found that a combined screening of the Patient Health Questionnaire (PHQ-2) and Quick Inventory of Depressive Symptomatology (QIDS-SR16) effectively identifies major depressive disorder (MDD) in diabetes patients, aiding treatment monitoring.
Area of Science:
- Endocrinology
- Psychiatry
- Clinical Psychology
Background:
- Depression is twice as common in diabetes patients, linked to poor glycemic control and complications.
- Untreated depression negatively impacts diabetes management, despite evidence linking treatment to improved glycemic control.
Purpose of the Study:
- To evaluate a combined screening strategy for depression in an outpatient diabetes population.
- To investigate the relationship between glycemic control (HbA1c) and depressive symptoms.
Main Methods:
- A two-stage screening using the Patient Health Questionnaire (PHQ-2) followed by the Quick Inventory of Depressive Symptomatology (QIDS-SR16) for positive screens.
- Glycemic control was assessed using glycosylated hemoglobin (HbA1c) levels.
- Ninety-two patients with diabetes participated in the study.
Main Results:
- A PHQ-2 cutoff of ≥3 identified major depressive disorder (MDD) in 37% of patients, with 27% reporting sub-threshold symptoms.
- Depressed patients reported significantly more symptoms including reduced interests, insomnia, poor concentration, and fatigue.
- A marginal association was observed between race, HbA1c, and depressive symptomatology.
Conclusions:
- The combined PHQ-2 and QIDS-SR16 strategy enables rapid detection of MDD in diabetes patients.
- This screening approach can monitor symptom progression and treatment effectiveness.
- Addressing depression is crucial for improving overall diabetes care and outcomes.
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