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Depression and diabetes: treatment and health-care delivery

Depression and diabetes: treatment and health-care delivery
Depression and diabetes: treatment and health-care delivery
Despite research efforts in the past 20 years, scientific evidence about screening and treatment for depression in diabetes remains incomplete and is mostly focused on North American and European health-care systems. Validated instruments to detect depression in diabetes, although widely available, only become effective and thus recommended if subsequent treatment pathways are accessible, which is often not the case. Because of the well known adverse effects of the interaction between depression and diabetes, treatment goals should focus on the remission or improvement of depression as well as improvement in glycaemic control as a marker for subsequent diabetes outcome. Scientific evidence evaluating treatment for depression in type 1 and type 2 diabetes shows that depression can be treated with moderate success by various psychological and pharmacological interventions, which are often implemented through collaborative care and stepped-care approaches. The evidence for improved glycaemic control in the treatment of depression by use of selective serotonin reuptake inhibitors or psychological approaches is conflicting; only some analyses show small to moderate improvements in glycaemic control. More research is needed to evaluate treatment of different depression subtypes in people with diabetes, the cost-effectiveness of treatments, the use of health-care resources, the need to account for cultural differences and different health-care systems, and new treatment and prevention approaches.
2213-8587
472-484
Petrak, F.
4d284218-9571-473b-b627-4470f6a0c2d3
Baumeister, H.
f23b8daf-4df6-4d62-9b99-86d26547a384
Skinner, T.C.
266ca58c-9a2e-4bc3-97b2-e9dc905b03ab
Brown, A.
b4ed9d8d-def6-4124-addd-53f59b8539a8
Holt, R.I.G.
d54202e1-fcf6-4a17-a320-9f32d7024393
Petrak, F.
4d284218-9571-473b-b627-4470f6a0c2d3
Baumeister, H.
f23b8daf-4df6-4d62-9b99-86d26547a384
Skinner, T.C.
266ca58c-9a2e-4bc3-97b2-e9dc905b03ab
Brown, A.
b4ed9d8d-def6-4124-addd-53f59b8539a8
Holt, R.I.G.
d54202e1-fcf6-4a17-a320-9f32d7024393

Petrak, F., Baumeister, H., Skinner, T.C., Brown, A. and Holt, R.I.G. (2015) Depression and diabetes: treatment and health-care delivery. The Lancet Diabetes & Endocrinology, 3 (6), 472-484. (doi:10.1016/S2213-8587(15)00045-5). (PMID:25995125)

Record type: Article

Abstract

Despite research efforts in the past 20 years, scientific evidence about screening and treatment for depression in diabetes remains incomplete and is mostly focused on North American and European health-care systems. Validated instruments to detect depression in diabetes, although widely available, only become effective and thus recommended if subsequent treatment pathways are accessible, which is often not the case. Because of the well known adverse effects of the interaction between depression and diabetes, treatment goals should focus on the remission or improvement of depression as well as improvement in glycaemic control as a marker for subsequent diabetes outcome. Scientific evidence evaluating treatment for depression in type 1 and type 2 diabetes shows that depression can be treated with moderate success by various psychological and pharmacological interventions, which are often implemented through collaborative care and stepped-care approaches. The evidence for improved glycaemic control in the treatment of depression by use of selective serotonin reuptake inhibitors or psychological approaches is conflicting; only some analyses show small to moderate improvements in glycaemic control. More research is needed to evaluate treatment of different depression subtypes in people with diabetes, the cost-effectiveness of treatments, the use of health-care resources, the need to account for cultural differences and different health-care systems, and new treatment and prevention approaches.

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More information

e-pub ahead of print date: 17 May 2015
Published date: June 2015
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 380217
URI: http://eprints.soton.ac.uk/id/eprint/380217
ISSN: 2213-8587
PURE UUID: 1974ab62-715b-46b3-aeec-02be76adaf6a
ORCID for R.I.G. Holt: ORCID iD orcid.org/0000-0001-8911-6744

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Date deposited: 07 Sep 2015 13:07
Last modified: 18 Feb 2021 16:56

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Contributors

Author: F. Petrak
Author: H. Baumeister
Author: T.C. Skinner
Author: A. Brown
Author: R.I.G. Holt ORCID iD

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