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Screening for Depression in People with Diabetes in Primary Care

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Screening for Depression and Other Psychological Problems in Diabetes

Abstract

This chapter considers the question of screening for depression in people with diabetes in primary care. Criteria for assessing the validity of screening are reviewed, together with national and international recommendations and selected research studies, with particular emphasis on relevance to primary care. A specific screening strategy currently being implemented in primary care in the UK is outlined. The need for rigorous evaluation of screening initiatives is highlighted, and a key conclusion is that case-finding alone is unlikely to be effective in terms of improving patient outcomes unless considered and applied in the context of overall case management.

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References

  1. Pearse IH. Periodic overhaul of the uncomplaining. J R Coll Gen Pract. 1970;20:146–52.

    PubMed  CAS  Google Scholar 

  2. Last JM. The iceberg “completing the clinical picture” in general practice. Lancet. 1963;ii:28–31.

    Article  Google Scholar 

  3. Wilson JMG, Junger G. Principles and practice of screening for disease. Public Health Papers, 34. Geneva: World Health Organisation; 1968.

    Google Scholar 

  4. National Screening Committee. The UK National Screening Committee’s criteria for appraising the validity, effectiveness and appropriateness of a screening programme. London: HMSO; 2003.

    Google Scholar 

  5. Goyder EC, McNally PG, Drucquer M, Spiers N, Botha JL. Shifting of care for diabetes from secondary to primary care, 1990–1995: review of general practices. BMJ. 1998;316:1505–6.

    Article  PubMed  CAS  Google Scholar 

  6. Khunti K, Ganguli S. Who looks after people with diabetes: primary or secondary care? J R Soc Med. 2000;93:183–6.

    PubMed  CAS  Google Scholar 

  7. Rubin RR, Ciechanowski P, Egede LE, Lin EHB, Lustman PJ. Recognizing and treating depression in patients with diabetes. Curr Diab Rep. 2004;4:119–25.

    Article  PubMed  Google Scholar 

  8. Pouwer F, Beekman ATF, Lubach C, Snoek FJ. Nurses’ recognition and registration of depression, anxiety and diabetes-specific emotional problems in outpatients with diabetes mellitus. Patient Educ Couns. 2006;60:235–40.

    Article  PubMed  Google Scholar 

  9. Ali S, Taub NA, Stone MA, Davies MJ, Skinner TC, Khunti K. Ethnic differences in the prevalence and recognition of depression in a primary care population with and without type 2 diabetes. Diabetologia. 2010;53 Suppl 1:S21.

    Google Scholar 

  10. Anderson RJ, Freedland KE, Clouse RE, Lustman PJ. The prevalence of co-morbid depression in adults with diabetes. Diabetes Care. 2001;24:1069–78.

    Article  PubMed  CAS  Google Scholar 

  11. Ali S, Stone MA, Peters JL, Davies MJ, Khunti K. The prevalence of co-morbid depression in adults with type 2 diabetes: a systematic review and meta-analysis. Diabet Med. 2006;23:1165–73.

    Article  PubMed  CAS  Google Scholar 

  12. Pouwer F, Geelhoed-Duijvestijn PHLM, Tack CJ, Bazelmans E, Beekman A-J, Heine RJ, et al. Prevalence of depression is high in out-patients with type 1 or type 2 diabetes mellitus. Results from three out-patient clinics in the Netherlands. Diabet Med. 2010;27:217–24.

    Article  PubMed  CAS  Google Scholar 

  13. Pouwer F, Beekman ATF, Nijpels G, Dekker JM, Snoek FJ, Kostense PJ, et al. Rates and risks for co-morbid depression in patients with type 2 diabetes mellitus: results from a community-based study. Diabetologia. 2003;46:1124–6.

    Article  Google Scholar 

  14. Lustman PJ, Anderson RJ, Freedland KE, De Groot M, Carney R, Clouse RE. Depression and poor glycaemic control: a meta-analytic review of the literature. Diabetes Care. 2000;23:934–42.

    Article  PubMed  CAS  Google Scholar 

  15. National Institute for Health and Clinical Excellence. Clinical guideline 90. Depression. The treatment and management of depression in adults. London: National Institute for Health and Clinical Excellence; 2009.

    Google Scholar 

  16. Bot M, Pouwer F, Ormel J, Slaets JP, de Jonge P. Predictors of incident major depression in diabetic outpatients with subthreshold depression. Diabet Med. 2010;27:1295–301.

    Article  PubMed  Google Scholar 

  17. Improving Access to Psychological Therapies (IAPT). Information available at: http://www.iapt.nhs.uk/about-iapt/. Last accessed Jan 2012.

  18. National Institute for Clinical Excellence. Type 1 diabetes: diagnosis and management of type 1 diabetes in children, young people and adults. London: National Institute for Clinical Excellence; 2004.

    Google Scholar 

  19. National Collaborating Centre for Chronic Conditions. Type 2 diabetes: national clinical guideline for management in primary and secondary care (update). London: Royal College of Physicians; 2008.

    Google Scholar 

  20. American Diabetes Association. Standards of medical care in diabetes – 2011. Diabetes Care. 2011;34(1):S11–61.

    Article  Google Scholar 

  21. International Diabetes Federation Clinical Guideline Task Force. Global guideline for type 2 diabetes. Brussels: International Diabetes Federation; 2005.

    Google Scholar 

  22. Lustman PJ, Freeland KE, Griffith LS, Clouse RE. Fluoxetine for depression in diabetes. A randomised double-blind placebo-controlled trial. Diabetes Care. 2000;23:618–23.

    Article  PubMed  CAS  Google Scholar 

  23. Lustman PJ, Griffith LS, Freedland KE, Kissel SS, Clouse RE. Cognitive behaviour therapy for depression in type 2. Diabetes mellitus a randomized, controlled trial. Ann Intern Med. 1998;129:613–21.

    PubMed  CAS  Google Scholar 

  24. Gilbody S, Sheldon T, House A. Screening and case-finding instruments for depression: a meta-analysis. CMAJ. 2008;178:997–1003.

    Article  PubMed  Google Scholar 

  25. Pouwer F, Tack CJ, Geelhoed-Duijvestijn PH, Bazelmans E, Beekman AT, Heine RJ, et al. Limited effect of screening for depression with written feedback in outpatients with diabetes mellitus: a randomised controlled trial. Diabetologia. 2011;54:741–8.

    Article  PubMed  CAS  Google Scholar 

  26. Wittkampf KA, van Zwieten M, Smits FTh, Schene AH, Huyser J, van Weert HC. Patients’ view on screening for depression in general practice. Fam Pract. 2008;25:438–44.

    Article  PubMed  CAS  Google Scholar 

  27. Thombs BD, de Jonge P, Coyne JC, Whooley MA, Frasure-Smith N, Mitchell AJ, et al. Depression screening and patient outcomes in cardiovascular care. A systematic review. JAMA. 2008;300:2161–71.

    Article  PubMed  CAS  Google Scholar 

  28. Kendrick T, Dowrick C, McBride A, Howe A, Clarke P, Maisey S, et al. Management of depression in UK general practice in relation to scores on depression severity questionnaires: analysis of medical record data. BMJ. 2009;338:b750.

    Article  PubMed  Google Scholar 

  29. Pouwer F, Snoek FJ, van der Ploeg HM, Adèr HJ, Heine RJ. Monitoring of psychological well-being in outpatients with diabetes. Effects on mood, HbA1c, and the patient’s evaluation of diabetes care: a randomized controlled trial. Diabetes Care. 2001;24:1929–35.

    Article  PubMed  CAS  Google Scholar 

  30. Katon WJ, Von Korff M, Lin EHB, Simon G, Ludman E, Russo J, et al. The pathways study. A randomized trial of collaborative care in patients with diabetes and depression. Arch Gen Psychiatry. 2004;61:1042–9.

    Article  PubMed  Google Scholar 

  31. Pouwer F. Should we screen for emotional distress in type 2 diabetes mellitus? Nat Rev Endocrinol. 2009;5:665–71.

    Article  PubMed  Google Scholar 

  32. Doran T, Fullwood C, Gravelle H. Pay for performance programs in family practices in the United Kingdom. N Engl J Med. 2006;335:375–84.

    Article  Google Scholar 

  33. National Institute for Health and Clinical Excellence. Information available at: http://www.nice.org.uk/aboutnice/qof/qof.jsp. Last accessed Jan 2012.

  34. British Medical Association. Information available at: http://www.bma.org.uk/images/focusqofpaymentsoct2011/_v4_tcm41-209913.pdf. Last accessed Jan 2012.

  35. Arroll B, Khin N, Kerse N. Screening for depression in primary care with two verbally asked questions: cross sectional study. BMJ. 2003;327:1144–6.

    Article  PubMed  Google Scholar 

  36. Information Commissioners. Information available from: http://signposting.ic.nhs.uk/?k=QOF/. Last accessed Jan 2012.

  37. Doran T, Fullwood C, Reeves D, Gravelle H, Roland M. Exclusion of patients from pay-for-performance targets by English physicians. N Engl J Med. 2008;359:274–84.

    Article  PubMed  CAS  Google Scholar 

  38. Maisey S, Steel N, Marsh R, Gillam S, Fleetcroft R, Howe A. Effects of payment for performance in primary care: qualitative interview study. J Health Serv Res Policy. 2008;13:133–9.

    Article  PubMed  Google Scholar 

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Correspondence to Margaret A. Stone B.A. (Hons), Ph.D. .

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© 2013 Springer-Verlag London

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Stone, M.A., Gill, P.S. (2013). Screening for Depression in People with Diabetes in Primary Care. In: Lloyd, C., Pouwer, F., Hermanns, N. (eds) Screening for Depression and Other Psychological Problems in Diabetes. Springer, London. https://doi.org/10.1007/978-0-85729-751-8_8

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  • DOI: https://doi.org/10.1007/978-0-85729-751-8_8

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  • Publisher Name: Springer, London

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