The practical importance of depression diagnosis in type 2 diabetes mellitus patients
Background. Nowadays diabetes mellitus (DM) and depression are widespread and socially significant diseases. A lot of studies and works are dedicated to this diseases, although modern view on the etiology of DM and depression remain unspecified. Depression occurrence is two to three times higher in people with diabetes mellitus, the majority of the cases remain underdiagnosed. Purpose of the study was to demonstrate practical use of the scales for depression diagnosing in Ukrainian patients with type 2 DM and to show the links between depression and DM, point out the importance of identifying depression in diabetic patients and to determine the possible ways to manage both diseases. Possible common pathophysiological mechanisms as stress and inflammation were explained, while screening for depression in diabetic patients was emphasized. Materials and methods. One-hundred and ninety patients with type 2 DM were randomized. The depression was diagnosed using adapted scales PHQ-9, PAID, WHO, MINI-6, Hamilton Scale, processed data from patients Medical History for the last 15 years, anamnesis, physical examination, glycated hemoglobin (HbA1c) and lipid profile measuring, and obligatory advice of psychiatrist, endocrinologist and surgery of diabetic foot care. All collected data and results were analyzed and if necessary, sedative pills, antidepressants, anxiolytics and psychotherapy were prescribed. Results. Out of all screened patients (n = 230), 190 persons were randomized. Depression revealed during the interview was assessed as a current (within 2 weeks) diagnosis MDD in accordance with the criteria given in the International Classification of Diseases (ICD) 10. If previous MDD, lifetime episodes of depression were detected and documented in medical history, the diagnosis of recurrent depression was established. The information about anxiety, suicidality (current or previously) was obligatory as well. Psychiatrist decided about treatment with sedative pills, antidepressants, anxiolytics and psychotherapy. Conclusions. The synergistic effect of anxiety and depression on the state of diabetes mellitus increases the risk of developing micro- and macrovascular complications, causing hyperglycemia in patients, and predetermines the search for new methods for solving this problem.