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Cited by 324Diabetes Management and EducationAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMental Health Treatment and Access

How to screen for depression and emotional problems in patients with diabetes: comparison of screening characteristics of depression questionnaires, measurement of diabetes-specific emotional problems and standard clinical assessment

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Hermanns, N., Kulzer, B., Krichbaum, M., Kubiak, T., Haak, T.·2006·Diabetologia
DOI 10.1007/s00125-005-0094-2
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Abstract

Aims/hypothesis We compared the screening performance of different measures of depression: the standard clinical assessment (SCA); the Beck Depression Inventory (BDI); the Center of Epidemiological Studies-Depression Scale (CES-D); and the Problem Areas in Diabetes (PAID) questionnaire, which assesses diabetes-specific distress. We also studied the ability of these measures to detect diabetes-related distress.Materials and methods A total of 376 diabetic patients (37.2% type 1; 23.9% type 2 without insulin treatment, 38.8% type 2 with insulin) completed the BDI and CES-D; patients who screened positive participated in a diagnostic interview, the Composite International Diagnostic Interview (CIDI). Also, all patients completed the PAID questionnaire. Results of the SCA that related to depression diagnosis were reviewed to correct for false negative screening results.Results The prevalence of clinical depression was 14.1%, with an additional 18.9% of patients receiving a diagnosis of subclinical depression. Sensitivity for clinical depression in SCA (56%) was moderate, whereas BDI, CES-D and the PAID questionnaire showed satisfactory sensitivity (87, 79 and 81%, respectively). For subclinical depression, the sensitivity of the PAID questionnaire (79%) was sufficient, whereas that of SCA (25%) was poor. All methods showed low sensitivity for the detection of diabetes-specific emotional problems (SCA 19%, CIDI 34%, BDI 60%, CES-D 49%).Conclusions/interpretation The screening performance of SCA for clinical and subclinical depression was modest. Additional screening for depression using the PAID or another depression questionnaire seems reasonable. The ability of depression screening measures to identify diabetes-related distress is modest, suggesting that the PAID questionnaire could be useful when screening diabetic patients for both depression and emotional problems.

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  • Measurement inconsistencies complicate the conceptualisation of depression in diabetes and call into question how depression, especially as measured by depressive symptom scales, differs from diabetes-specific distress.

    “Measurement inconsistencies complicate the conceptualisation of depression in diabetes and call into question how depression, especially as measured by depressive symptom scales, differs from diabetes-specific distress [1, 2].”

    From Differentiating symptoms of depression from diabetes-specific distress: relationships with self-care in type 2 diabetes (2008) · cites this paper as [2]

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Authors
Hermanns, N., Kulzer, B., Krichbaum, M., Kubiak, T., & Haak, T.
Affiliations
  • German Diabetes Center Mergentheim (DE)
  • Forschungsinstitut der Diabetes Akademie Mergentheim (DE)
  • Universität Greifswald (DE)
Corresponding author
Hermanns, N.
ORCID
Venue
Diabetologia
Publisher
Springer Science and Business Media LLC
Published
2006-01-24
Volume
49
Issue
3
Pages
469-477
ISSN
  • 0012-186X (ISSN-L)
  • 1432-0428
DOI
10.1007/s00125-005-0094-2
OpenAlex
W1970667052
Cited by
324
References
51
Citations by year
2026: 4 · 2025: 7 · 2024: 14 · 2023: 26 · 2022: 32 · 2021: 21 · 2020: 12 · 2019: 9 · 2018: 18 · 2017: 13 · 2016: 17 · 2015: 31 · 2014: 15 · 2013: 23 · 2012: 18
FWCI
7.25
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (tdm)
Locations
  • Diabetologia (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
depression screening, diabetes mellitus, diabetes distress, Beck Depression Inventory, CES-D, subthreshold depression, sensitivity, type 1 diabetes, type 2 diabetes, emotional problems
MeSH terms
Mental Disorders, Depression, Emotions, Female, Humans, Male, Mass Screening, Middle Aged, Surveys and Questionnaires, Diabetes Complications

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