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Duration of depressive episodes, recovery periods shorten with recurrence in type 2 diabetes
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Adults with type 2 diabetes who experience recurring depressive disorders may have a lifetime exposure of several years, with decreasing length of depressive episodes and recovery periods, study data show.
Depression should be effectively diagnosed and treated in people with type 2 diabetes to minimize the risk for future episodes, according to the researchers.
Mary de Groot, PhD, associate professor of medicine at the Diabetes Research Translational Research Center at Indiana University in Indianapolis, and colleagues evaluated 50 adults with type 2 diabetes and major depressive disorder enrolled in a 12-week behavioral intervention to determine the course of depressive disorders. The structured clinical interview for DSM-IV-TR was used to interview participants to assess history of depressive disorders at baseline, after intervention and at 3-month follow-up.
The first episode of any depressive disorder was experienced at a mean age of 41.7 years for a mean of 2.3 lifetime depressive episodes; exposure to any depressive disorder was a mean of 71.1 months. The lifetime exposure to all major depressive episodes was a combined 43.1 months, according to the researchers.
Among participants who experienced at least two episodes, the second episode was substantially shorter than the first (P = .048 for time > 5 months); the same was true for the third episode vs. the first in participants who experienced at least three episodes (P = .007 for time > 3 months). No significant differences were found for the lengths of the second and third episodes, the researchers wrote.
No significant differences were found for survival curves for the time to first remission or length of episode for participants diagnosed with diabetes before a depressive disorder episode compared with those who experienced a depressive disorder before a diabetes diagnosis.
“The findings from this study confirm that depression is persistent for our patients with type 2 daibetes,” de Groot told Endocrine Today. “Patients with depression will benefit from learning about the range of medication and non-medication treatment approaches (eg, talk therapy, exercise) that can be used individually or in combination to effectively treat depression with the added benefit of supporting glycemic control. Future research is needed to confirm these findings in large samples of patients with type 1 and type 2 diabetes.” – by Amber Cox
For more information:
Mary de Grott , PhD, can be reached at mdegroot@iu.edu.
Disclosure: The researchers report no relevant financial disclosures.
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Cathy E. Lloyd
Mary de Groot and colleagues have reported findings from their secondary data analysis, examining the course of depression in people with type 2 diabetes. As has been described before, people with type 2 diabetes have significantly poorer mental health compared with people without diabetes. De Groot’s report goes one step further (albeit in a small sample and with no control group) and shows that the duration of episodes of depression (measured by a structured clinical interview — the gold standard for identifying depression and other mental disorders) is much higher in people with type 2 diabetes. More importantly, this study shows that when individuals with comorbid diabetes and depression are treated with cognitive behavioral therapy each subsequent episode of depression and the recovery time is shorter. These findings have important implications for practice, not only in terms of improving the life quality of people with comorbid diabetes and depression, but also in order to reduce the risk for other complications, which require further intervention. As de Groot and colleagues assert, depression can be effectively treated using a number of strategies, but in order to identify those individuals in need of treatment and care, frequent assessment and regular monitoring are essential.
Disclosure: Lloyd reports receiving a grant from the Association for the Improvement of Mental Health Programmes.
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