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The Diabetes Attitudes Wishes and Needs (DAWN)-SMI study: a cross-sectional comparison of the psychosocial impact of diabetes in adults with and without severe mental illness

The Diabetes Attitudes Wishes and Needs (DAWN)-SMI study: a cross-sectional comparison of the psychosocial impact of diabetes in adults with and without severe mental illness
The Diabetes Attitudes Wishes and Needs (DAWN)-SMI study: a cross-sectional comparison of the psychosocial impact of diabetes in adults with and without severe mental illness
Aims: people with severe mental illness (SMI) are 2-3 times more likely to have diabetes than the general population. Little is known about the impact of living with diabetes for people with SMI. This study investigates psychosocial problems, and diabetes self-management for people with SMI and diabetes.

Methods: we compared cross-sectional survey data collected from 258 adults with diabetes and SMI in England with 500 adults with diabetes from the UK sample of the second Diabetes Attitudes, Wishes and Needs study (DAWN2). Effect size (ES) tests were used to quantify differences between the two samples adjusted for diabetes type, age, gender, treatment, treatment duration, diabetes complications and co-morbidities to achieve comparability of the two samples.

Results: compared to the DAWN2-UK sample, people with diabetes and SMI reported poorer quality of life (WHOQOL ES -0.3 (CI -0.5,-0.1), p<0.001), mental well-being (ES -13.4 (CI -17.3,-9.5), p<0.001), and increased diabetes distress (PAID5 ES 1.6 (CI 0.9,2.3), p<0.001). While people with diabetes and SMI reported a negative impact from diabetes, their SMI had a greater impact on their lives than diabetes (mental illness impact profile 2.6±1.1 vs diabetes impact profile 3.4±1.0, p<0.001). People with SMI reported being less engaged in self-management than the DAWN2-UK population (SDSCA-6; ES -0.4 (CI -0.7,-0.1), p=0.01).

Conclusions: the psychosocial impact of diabetes is greater for people with SMI. To reduce inequalities in diabetes outcomes, people with SMI and diabetes require tailored support for diabetes management that considers the additional challenges associated of living with a severe mental illness.
1464-5491
Holt, Richard I.G.
d54202e1-fcf6-4a17-a320-9f32d7024393
Peyrot-Stuckey, Heather
1e1f6588-ce9c-48d4-8eee-7c60a4f2ab09
Böhning, Dankmar
1df635d4-e3dc-44d0-b61d-5fd11f6434e1
Taylor, Jo
f48a60e0-f7bd-4a6a-bfb7-866c6e1a2334
Siddiqi, Najma
4bff7b9b-91c0-4b72-96f5-ede207e7f361
Holt, Richard I.G.
d54202e1-fcf6-4a17-a320-9f32d7024393
Peyrot-Stuckey, Heather
1e1f6588-ce9c-48d4-8eee-7c60a4f2ab09
Böhning, Dankmar
1df635d4-e3dc-44d0-b61d-5fd11f6434e1
Taylor, Jo
f48a60e0-f7bd-4a6a-bfb7-866c6e1a2334
Siddiqi, Najma
4bff7b9b-91c0-4b72-96f5-ede207e7f361

Holt, Richard I.G., Peyrot-Stuckey, Heather, Böhning, Dankmar, Taylor, Jo and Siddiqi, Najma (2025) The Diabetes Attitudes Wishes and Needs (DAWN)-SMI study: a cross-sectional comparison of the psychosocial impact of diabetes in adults with and without severe mental illness. Diabetic Medicine. (In Press)

Record type: Article

Abstract

Aims: people with severe mental illness (SMI) are 2-3 times more likely to have diabetes than the general population. Little is known about the impact of living with diabetes for people with SMI. This study investigates psychosocial problems, and diabetes self-management for people with SMI and diabetes.

Methods: we compared cross-sectional survey data collected from 258 adults with diabetes and SMI in England with 500 adults with diabetes from the UK sample of the second Diabetes Attitudes, Wishes and Needs study (DAWN2). Effect size (ES) tests were used to quantify differences between the two samples adjusted for diabetes type, age, gender, treatment, treatment duration, diabetes complications and co-morbidities to achieve comparability of the two samples.

Results: compared to the DAWN2-UK sample, people with diabetes and SMI reported poorer quality of life (WHOQOL ES -0.3 (CI -0.5,-0.1), p<0.001), mental well-being (ES -13.4 (CI -17.3,-9.5), p<0.001), and increased diabetes distress (PAID5 ES 1.6 (CI 0.9,2.3), p<0.001). While people with diabetes and SMI reported a negative impact from diabetes, their SMI had a greater impact on their lives than diabetes (mental illness impact profile 2.6±1.1 vs diabetes impact profile 3.4±1.0, p<0.001). People with SMI reported being less engaged in self-management than the DAWN2-UK population (SDSCA-6; ES -0.4 (CI -0.7,-0.1), p=0.01).

Conclusions: the psychosocial impact of diabetes is greater for people with SMI. To reduce inequalities in diabetes outcomes, people with SMI and diabetes require tailored support for diabetes management that considers the additional challenges associated of living with a severe mental illness.

Text
The psychosocial impact of having diabetes alongside severe mental illness - Accepted Manuscript
Restricted to Repository staff only until 6 August 2026.
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Accepted/In Press date: 6 August 2025

Identifiers

Local EPrints ID: 504996
URI: http://eprints.soton.ac.uk/id/eprint/504996
ISSN: 1464-5491
PURE UUID: b50c71aa-9a06-407c-b27a-30e6ab0518b4
ORCID for Richard I.G. Holt: ORCID iD orcid.org/0000-0001-8911-6744
ORCID for Dankmar Böhning: ORCID iD orcid.org/0000-0003-0638-7106

Catalogue record

Date deposited: 23 Sep 2025 17:08
Last modified: 24 Sep 2025 01:46

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Contributors

Author: Heather Peyrot-Stuckey
Author: Jo Taylor
Author: Najma Siddiqi

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