Screening for depression and diabetes-related distress in a diabetes outpatient clinic
Version of Record online: 13 DEC 2012
© 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK
Volume 30, Issue 1, pages 88–94, January 2013
How to Cite
Fleer, J., Tovote, K. A., Keers, J. C., Links, T. P., Sanderman, R., Coyne, J. C. and Schroevers, M. J. (2013), Screening for depression and diabetes-related distress in a diabetes outpatient clinic. Diabetic Medicine, 30: 88–94. doi: 10.1111/dme.12001
- Issue online: 13 DEC 2012
- Version of Record online: 13 DEC 2012
- Accepted manuscript online: 25 AUG 2012 09:51AM EST
- Accepted 17 August 2012
Aims To investigate: (1) the willingness of patients with diabetes to participate in a screening programme; (2) the extent to which patients with diabetes who screen positive endorse need for psychosocial care; (3) the rate of referral to psychosocial care during screening vs. usual care.
Methods Four hundred and ninety-nine patients with diabetes were invited to complete the Center for Epidemiologic Studies Depression and the Problem Areas in Diabetes questionnaires. Patients screening positive on either instrument were invited for an interview. One year after screening was withdrawn, rates of referral to psychosocial care were assessed from physician reports of patient referrals.
Results In total, 349/499 (70%) patients with diabetes completed the questionnaire. Patients who did not take up the screening were younger, smoked more often and had higher HbA1c values. ‘No-shows’ for clinical appointments accounted for 74% of non-participation. Of the 104 (30% of 349) patients screening positive, 45 accepted an invitation for an interview. Finally, 36/104 (35%) would like a referral for psychological care. Seven per cent of patients were referred to psychological care during screening compared with 1% when screening was withdrawn.
Conclusions Results raise questions as to whether screening is the most efficient way to identify patients with psychological problems. Many patients did not take up the screening, especially those with low adherence to diabetes care in general. Furthermore, few patients screening positive wanted to be referred. Screening should be evaluated in the context of consideration of alternative ways to identify at-risk patients, including providing resources to deal with patients with already known adjustment and adherence problems.