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

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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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Background
General Life and Diabetes-Related Stressors in Early Adolescents With Type 1 Diabetes
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Psychometric Properties of the Problem Areas in Diabetes (PAID) Instrument in Singapore
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A cross‐sectional study of glycaemic control, complications and psychosocial functioning among 18‐ to 35‐year‐old adults with Type 1 diabetes
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On the Role of Spirituality and Religiosity in Type 2 Diabetes Mellitus Management—A Systematic Review
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Diabetes distress in young adults with early‐onset Type 1 diabetes and its prospective relationship with HbA1cand health status
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Adherence to Insulin, Emotional Distress, and Trust in Physician Among Patients with Diabetes: A Cross-Sectional Study
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Cut Points for Identifying Clinically Significant Diabetes Distress in Adolescents With Type 1 Diabetes Using the PAID-T: Results From Diabetes MILES Youth–Australia
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How Do the Challenges of Emerging Adulthood Inform our Understanding of Diabetes Distress? An Integrative Review
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Time With Diabetes Distress and Glycemia-Specific Distress: New Patient-Reported Outcome Measures for the Psychosocial Burden of Diabetes Using Ecological Momentary Assessment in an Observational Study
Ehrmann, D., SCHMITT, A. J., Priesterroth, L., Kulzer, B., Haak, T., & Hermanns, N. (2022) · Diabetes Care · doi:10.2337/dc21-2339 · Cited by 40
Self-citation
Disentangling Clinical Depression from Diabetes-Specific Distress: Making Sense of the Mess We’ve Made
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Clinical Depression Versus Distress Among Patients With Type 2 Diabetes: Not Just a Question of Semantics
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Validation of Six Short and Ultra-short Screening Instruments for Depression for People Living with HIV in Ontario: Results from the Ontario HIV Treatment Network Cohort Study
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WHO‐5 and BDI‐II are acceptable screening instruments for depression in people with diabetes
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Psychological Insulin Resistance in Type 2 Diabetes Patients Regarding Oral Antidiabetes Treatment, Subcutaneous Insulin Injections, or Inhaled Insulin
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Effects of Mindfulness on Psychological Distress and HbA1c in People with Diabetes
Pearson, S., Wills, K. E., Woods, M., & Warnecke, E. (2018) · Mindfulness · doi:10.1007/s12671-018-0908-1 · Cited by 38
Diabetes distress: the psychological burden of living with diabetes
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Identifying disease-specific distress in patients with inflammatory bowel disease
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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: Hermanns, N.
Kulzer, B.
Krichbaum, M.
Kubiak, T.
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: bronze
doi.org
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
Health Sciences › Medicine › Psychiatry and Mental health › 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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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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