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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
Open accessAbstract
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 [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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Metadata
- 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.
- Venue
- Diabetologia
- Published
- 2006-01-24
- Volume
- 49
- Issue
- 3
- Pages
- 469-477
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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