Diabetes Distress and Depression Are Not the Same Thing: Implications for Screening in Outpatient Clinics
DOI:
https://doi.org/10.5281/zenodo.22258322Keywords:
Diabetes distress, Depression, Screening, Diabetes Distress Scale, Regimen-related distressAbstract
Diabetes distress and depression are frequently treated as the same problem measured two ways, and the evidence does not
support that. Distress affects 18 to 35 per cent of people with diabetes and is common enough that in one specialty clinic more
patients endorsed it than endorsed depression. The two overlap incompletely: roughly a third to a half of people screening positive
for depression report no diabetes-related distress. More importantly, they behave differently against glycaemic outcomes. In 235
adults with type 1 diabetes, distress was related to HbA1c on both the Diabetes Distress Scale and the Problem Areas in Diabetes
scale, while depression, anxiety and overall well-being were not, and only the regimen-related subscale remained independently
associated. A separate type 1 cohort found the same pattern, with regimen distress and low empowerment related to HbA1c while
major depressive disorder and depressive symptoms were not. This review sets out what the two instruments measure and what
follows for screening.
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