Does kindness matter? Diabetes, depression, and self-compassion: a selective review and research agenda
Open accessAbstract
Depression and severe psychological distress are frequently comorbid with diabetes and are associated with reduced adherence to medication and healthy lifestyle regimens, poorer glycemic control, and increased complications. The mixed success of existing treatments for depression in diabetes patients suggests a need for supplementary approaches to this common problem. This article reviews recent evidence for the benefits of self-compassion in chronically ill patients, suggesting its utility as a clinical tool for improving self-care, depression, and glycemic control in diabetes. Possible physical and psychological pathways by which self-compassion may promote better outcomes in diabetes patients are considered, with particular attention given to reductions in negative self-judgment and improved motivation to undertake self-care.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Living with diabetes may increase one's experience of self-criticism.
“Living with diabetes may increase one's experience of self-criticism (Friis et al., 2015) as diabetes is a stigmatised condition.”
From An online acceptance, commitment, and self-compassion based treatment to decrease psychological distress in people with type 2 diabetes: A feasibility randomised-controlled trial (2023) · cites this paper as Friis et al., 2015
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Ryan, R. M., & Deci, E. L. (2000) · American Psychologist · doi:10.1037//0003-066x.55.1.68 · Cited by 27,815 · see citing works
The Development and Validation of a Scale to Measure Self-Compassion
NEFF, K. D. (2003) · Self and Identity · doi:10.1080/15298860309027 · Cited by 6,436 · cited 3× · see citing works
“Neff (13) conceptualizes selfcompassion as being composed of three components, all of which may be relevant to the experience of living with diabetes and managing its daily demands.”
BackgroundMoral Identity and Developmental Theory
Lapsley, D. K. (2015) · Human Development · doi:10.1159/000435926 · Cited by 3,836 · see citing works
Type 2 diabetes as an inflammatory disease
Donath, M. Y., & Shoelson, S. E. (2011) · Nature Reviews Immunology · doi:10.1038/nri2925 · Cited by 3,737 · see citing works
Self-regulation failure: an overview.
Baumeister, R. F., & Heatherton, T. F. (1996) · Psychological Inquiry · doi:10.1207/s15327965pli0701_1 · Cited by 2,266 · see citing works
A pilot study and randomized controlled trial of the mindful self-compassion program
Neff, K. D., & Germer, C. K. (2013) · Journal of Clinical Psychology · doi:10.1002/jclp.21923 · Cited by 2,253 · see citing works
Thayer, J. F., Hansen, A. L., Saus-Rose, E., & Johnsen, B. H. (2009) · Annals of Behavioral Medicine · doi:10.1007/s12160-009-9101-z · Cited by 1,872 · see citing works
Exploring compassion: A meta-analysis of the association between self-compassion and psychopathology
MacBeth, A., & Gumley, A. (2012) · Clinical Psychology Review · doi:10.1016/j.cpr.2012.06.003 · Cited by 1,838 · see citing works
Self-compassion and adaptive psychological functioning.
Neff, K. D., Kirkpatrick, K. L., & Rude, S. S. (2007) · Journal of Research in Personality · doi:10.1016/j.jrp.2006.03.004 · Cited by 1,627 · see citing works
Introducing compassion-focused therapy
Gilbert, P. (2009) · Advances in Psychiatric Treatment · doi:10.1192/apt.bp.107.005264 · Cited by 1,435 · see citing works
Ali, S., Stone, M. A., Peters, J., Davies, M. J., & Khunti, K. K. (2006) · Diabetic Medicine · doi:10.1111/j.1464-5491.2006.01943.x · Cited by 1,281 · see citing works
Neff, K. D., Rude, S. S., & Kirkpatrick, K. L. (2007) · Journal of Research in Personality · doi:10.1016/j.jrp.2006.08.002 · Cited by 1,224 · see citing works
Self‐Compassion, Self‐Esteem, and Well‐Being
Neff, K. D. (2011) · Social and Personality Psychology Compass · doi:10.1111/j.1751-9004.2010.00330.x · Cited by 1,214 · see citing works
Epidemiology and treatment of depression in patients with chronic medical illness
J. Katon, W. (2011) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2011.13.1/wkaton · Cited by 820 · see citing works
Depressive Symptoms and Physical Decline in Community-Dwelling Older Persons
Penninx, B. W. J. H. (1998) · JAMA · doi:10.1001/jama.279.21.1720 · Cited by 809 · see citing works
Self-Compassion Increases Self-Improvement Motivation
Breines, J. G., & Chen, S. (2012) · Personality and Social Psychology Bulletin · doi:10.1177/0146167212445599 · Cited by 652 · see citing works
Functional Neural Plasticity and Associated Changes in Positive Affect After Compassion Training
Klimecki, O. M., Leiberg, S., Lamm, C., & Singer, T. (2013) · Cerebral Cortex · doi:10.1093/cercor/bhs142 · Cited by 634 · see citing works
Compassion training alters altruism and neural responses to suffering.
Weng, H. Y., Fox, A. S., Shackman, A. J., Stodola, D. E., Caldwell, J. Z. K., Olson, M. C., Rogers, G. M., & Davidson, R. J. (2013) · Psychological Science · doi:10.1177/0956797612469537 · Cited by 602 · see citing works
Depression in diabetic patients
Lustman, P. J., & Clouse, R. E. (2005) · Journal of Diabetes and its Complications · doi:10.1016/j.jdiacomp.2004.01.002 · Cited by 600 · see citing works
Depression, Self-Care, and Medication Adherence in Type 2 Diabetes
Gonzalez, J. S., Safren, S. A., Cagliero, E., Wexler, D. J., Delahanty, L., Wittenberg, E., Blais, M. A., Meigs, J. B., & Grant, R. W. (2007) · Diabetes Care · doi:10.2337/dc07-0158 · Cited by 579 · see citing works
Self-Compassion: What It Is, What It Does, and How It Relates to Mindfulness
Neff, K. D., & Dahm, K. A. (2015) · Handbook of Mindfulness and Self-Regulation · doi:10.1007/978-1-4939-2263-5_10 · Cited by 574 · see citing works
Kristiansen, O. P., & Mandrup-Poulsen, T. R. (2005) · Diabetes · doi:10.2337/diabetes.54.suppl_2.s114 · Cited by 525 · see citing works
Self-compassion, self-regulation, and health
Terry, M. L., & Leary, M. R. (2011) · Self and Identity · doi:10.1080/15298868.2011.558404 · Cited by 396 · see citing works
Winkley, K., Landau, S., Eisler, I., & Ismail, K. (2006) · BMJ · doi:10.1136/bmj.38874.652569.55 · Cited by 359 · see citing works
Promoting Self–Compassionate Attitudes Toward Eating Among Restrictive and Guilty Eaters
Adams, C. E., & Leary, M. R. (2007) · Journal of Social and Clinical Psychology · doi:10.1521/jscp.2007.26.10.1120 · Cited by 353 · see citing works
Feltz-Cornelis, C. M. V. D., Nuyen, J., Stoop, C. H., Chan, J. C. N., Jacobson, A. M., Katon, W. J., Snoek, F. J., & Sartorius, N. (2010) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2010.03.011 · Cited by 339 · see citing works
Evolution and depression: issues and implications
GILBERT, P. (2006) · Psychological Medicine · doi:10.1017/s0033291705006112 · Cited by 289 · see citing works
Rockliff, H., Gilbert, P., McEwan, K., Lightman, S. L., & Glover, D. G. (2008) · University of Derby Online Research Archive. (University of Derby) · Cited by 234 · see citing works
A Review of the Evidence for a Neuroendocrine Link Between Stress, Depression and Diabetes Mellitus
Golden, S. H. (2007) · Current Diabetes Reviews · doi:10.2174/157339907782330021 · Cited by 224 · see citing works
Pinto‐Gouveia, J., Duarte, C., Matos, M., & Fráguas, S. (2013) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.1838 · Cited by 198 · see citing works
Magnus, C. M. R., Kowalski, K. C., & McHugh, T.-L. (2009) · Self and Identity · doi:10.1080/15298860903135073 · Cited by 186 · see citing works
Self-compassion as a predictor of interleukin-6 response to acute psychosocial stress
Breines, J. G., Thoma, M. V., Gianferante, D., Hanlin, L., Chen, X., & Rohleder, N. (2014) · Brain, Behavior, and Immunity · doi:10.1016/j.bbi.2013.11.006 · Cited by 181 · see citing works
Who Benefits from Training in Self-Compassionate Self-Regulation? A Study of Smoking Reduction
Kelly, A. C., Zuroff, D. C., Foa, C. L., & Gilbert, P. (2010) · Journal of Social and Clinical Psychology · doi:10.1521/jscp.2010.29.7.727 · Cited by 181 · see citing works
The Role of Self-Compassion in Physical and Psychological Well-Being
Hall, C. W., Row, K. A., Wuensch, K. L., & Godley, K. R. (2013) · The Journal of Psychology · doi:10.1080/00223980.2012.693138 · Cited by 175 · see citing works
Wren, A. A., Somers, T. J., Wright, M. A., Goetz, M. C., Leary, M. R., Fras, A. M., Huh, B. K., Rogers, L. L., & Keefe, F. J. (2012) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2011.04.014 · Cited by 173 · see citing works
Terry, M. L., Leary, M. R., & Mehta, S. (2013) · Self and Identity · doi:10.1080/15298868.2012.667913 · Cited by 165 · see citing works
Self-compassion and reactions to serious illness: The case of HIV
Brion, J. M., Leary, M. R., & Drabkin, A. S. (2013) · Journal of Health Psychology · doi:10.1177/1359105312467391 · Cited by 148 · see citing works
Adverse Effects of Depression on Glycemic Control and Health Outcomes in People with Diabetes
Pouwer, F., Nefs, G., & Nouwen, A. (2013) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2013.05.002 · Cited by 132 · see citing works
Self-Compassionate Reactions to Health Threats
Terry, M. L., Leary, M. R., Mehta, S., & Henderson, K. (2013) · Personality and Social Psychology Bulletin · doi:10.1177/0146167213488213 · Cited by 124 · see citing works
Egede, L. E., & Osborn, C. Y. (2010) · The Science of Diabetes Self-Management and Care · doi:10.1177/0145721710361389 · Cited by 122 · see citing works
Depression in diabetes mellitus: a comprehensive review.
Andreoulakis, E., Hyphantis, T. N., Kandylis, D., & Iacovides, A. (2012) · Europe PMC (PubMed Central) · Cited by 116 · see citing works
Psychological counselling in problematic diabetes: does it help?
Snoek, F. J., & Skinner, T. C. (2002) · Diabetic Medicine · doi:10.1046/j.1464-5491.2002.00678.x · Cited by 106 · see citing works
Pizzi, C., Manzoli, L., Mancini, S., Bedetti, G., Fontana, F., & Costa, G. M. (2010) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2010.04.038 · Cited by 88 · see citing works
Barnard, K. D., & Lloyd, C. E. (2012) · Springer eBooks · doi:10.1007/978-0-85729-573-6 · Cited by 34 · see citing works
Screening and Correlates of Depression and HbA1Cin United Arab Emirates (UAE) Women With Diabetes
Hawamdeh, S., Almakhzoomy, I. K., & Hayajneh, Y. A. (2013) · Perspectives In Psychiatric Care · doi:10.1111/ppc.12013 · Cited by 11 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Self-Compassion, Physical Health, and Health Behaviour: A Meta-Analysis
Phillips, W. J., & Hine, D. W. (2021) · Health Psychology Review · doi:10.1080/17437199.2019.1705872 · Cited by 224 · see citing works
“…reviews have synthesised observed associations between self-compassion and health behaviour (Biber & Ellis, 2017; Braun, Park, & Gorin, 2016; Friis et al., 2015; Mantzios & Egan, 2017; Rahimi-Ardabili et al., 2018; Sirois & Hirsch, 2019; Sirois et al., 2015), none of them were comprehensive.”
BackgroundSelf-compassion and adherence in five medical samples: the role of stress.
Sirois, F. M., & Hirsch, J. K. (2019) · Mindfulness · doi:10.1007/s12671-018-0945-9 · Cited by 79 · see citing works
A multidimensional approach to perfectionism and self-compassion
Linnett, R. J., & Kibowski, F. (2019) · Self and Identity · doi:10.1080/15298868.2019.1669695 · Cited by 44 · see citing works
Adapting and validating a measure of diabetes-specific self-compassion
Tanenbaum, M. L., Adams, R. N., Gonzalez, J. S., Hanes, S. J., & Hood, K. K. (2017) · Journal of Diabetes and its Complications · doi:10.1016/j.jdiacomp.2017.10.009 · Cited by 33 · see citing works
“The pathway put forth in the literature is that SC serves to buffer against negative emotions such as depression or distress, which in turn may lead to improved diabetes selfmanagement, which can then lead to better health outcomes such as glycemic control (36).”
BackgroundMorrison, A., Zaccardi, F., Chatterjee, S., Brady, E. M., Doherty, Y., Robertson, N., Hadjiconstantinou, M., Daniels, L. J., Hall, A. P., Khunti, K. K., et al. (2019) · Experimental and Clinical Endocrinology & Diabetes · doi:10.1055/a-0897-3772 · Cited by 33 · see citing works
Lutz, J. G., Berry, M. P., Napadow, V., Germer, C. K., Pollak, S. M., Gardiner, P. M., Edwards, R. R., Desbordes, G., & Schuman‐Olivier, Z. (2020) · Psychiatry Research Neuroimaging · doi:10.1016/j.pscychresns.2020.111155 · Cited by 33 · see citing works
Browne, J. L., Holmes‐Truscott, E., Ventura, A. D., Hendrieckx, C., Pouwer, F., & Speight, J. (2017) · BMJ Open · doi:10.1136/bmjopen-2016-012926 · Cited by 30 · see citing works
Ventura, A. D., Nefs, G., Browne, J. L., Friis, A. M., Pouwer, F., & Speight, J. (2018) · Mindfulness · doi:10.1007/s12671-018-1067-0 · Cited by 25 · see citing works
“A second known study (Friis et al. 2015a, b) drew similar conclusions.”
BackgroundResultInfluentialBean, C. N., Dineen, T. E., & Jung, M. E. (2020) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2020.09.001 · Cited by 24 · see citing works
Kılıç, A., Hudson, J. L., Scott, W., McCracken, L. M., & Hughes, L. D. (2022) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2022.110728 · Cited by 27 · see citing works
Charzyńska, E., Kocur, D. J., Działach, S., & Brenner, R. E. (2020) · Mindfulness · doi:10.1007/s12671-020-01450-2 · Cited by 20 · see citing works
Gunn, S., Henson, J. J., Robertson, N., Maltby, J., Brady, E. M., Henderson, S., Hadjiconstantinou, M., Hall, A. P., Rowlands, A. V., Yates, T. E., et al. (2022) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2022-002927 · Cited by 17 · see citing works
“10 11 Associations with sleep Self-compassion is argued to directly and indirectly affect physiological pathways related to psychological stress and pathophysiology of T2D, 19 and higher self-compassion has been linked with lower inflammatory marker levels (interleukin-6).”
InfluentialStrachan, S. M., Bean, C. N., & Jung, M. E. (2018) · Health & Social Care in the Community · doi:10.1111/hsc.12628 · Cited by 15 · see citing works
The role of self-compassion in diabetes management: A rapid review
Sandham, C., & Deacon, E. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1123157 · Cited by 14 · see citing works
“It is important to investigate this variable as when an individual with diabetes is experiencing this distress/depression, they are more likely to engage in self-judgement and self-criticism when they experience poor glucose control, which often leads to their taking fewer actions to manage their diabetes, further exa…”
BackgroundShea, S., Lionis, C. D., Kite, C., Atkinson, L., Lagojda, L., Chaggar, S. S., Kyrou, I., & Randeva, H. S. (2023) · Livers · doi:10.3390/livers3030031 · Cited by 10 · see citing works
“As such, further investigation is suggested into the use of self-compassion as an intervention for increasing self-care motivation and reducing self-criticism [41].”
BackgroundKılıç, A., Hudson, J., Scott, W., McCracken, L. M., Hackett, R. A., & Hughes, L. D. (2023) · Internet Interventions · doi:10.1016/j.invent.2023.100658 · Cited by 6 · see citing works
“Living with diabetes may increase one's experience of self-criticism (Friis et al., 2015) as diabetes is a stigmatised condition.”
BackgroundXu, J., Yang, J., Lu, Y., Yang, J., Gu, C., Zhu, J., & Yang, L. (2025) · Diabetes Metabolic Syndrome and Obesity · doi:10.2147/dmso.s556917 · Cited by 2 · see citing works
“19 The significance of self-compassion is well-documented; however, there is a scarcity of research in China that specifically investigates the key predictors and their relative importance in determining self-compassion levels among community-dwelling older adults with type 2 diabetes.”
Sadeghi, M., Sina, S. M. S., Marefat, F., & Meysam, A. (2017) · DOAJ (DOAJ: Directory of Open Access Journals) · Cited by 2 · see citing works
Applying Self-Compassion: Does Self-Compassion Influence Other-Focused Care in Healthcare?
Cha, J. E., & Consedine, N. S. (2025) · Springer eBooks · doi:10.1007/978-3-031-89095-6_23 · Cited by 1 · see citing works
Cahyani, D., Winarsunu, T., & Yuniardi, M. S. (2020) · UMM Institutional Repository (University of Maine at Machias) · doi:10.25215/0801.054 · Cited by 1 · see citing works
Adjustment to Chronic Diabetes: A Review and Analytical Study
Pourhosein, R. (2021) · Nursing & Healthcare International Journal · doi:10.23880/nhij-16000242 · Cited by 1 · see citing works
A multidimensional approach to perfectionism and self-compassionPreprint
Linnett, R. J., & Kibowski, F. (2018) · doi:10.31234/osf.io/bcu37 · Cited by 1 · see citing works
Modic, M. B. (2017) · Journal for Nurses in Professional Development · doi:10.1097/nnd.0000000000000382
Prevalence of depression among patients with type 2 diabetes mellitus: a cross-sectional study
Parihar, S., & Singh, R. (2019) · International Journal of Advances in Medicine · doi:10.18203/2349-3933.ijam20193668
Kelly, J. D. A., & Kelly, A. M. (2017) · Springer eBooks · doi:10.1007/978-3-319-61220-1_8
Compassion: From Neuroscience to New Horizons and Innovative, Inclusive Research Agendas
Waddington, K., Manley, J. Y., Edginton, T., & Kanov, J. (2024) · Frontiers research topics · doi:10.3389/978-2-8325-4230-9
Sahu, H. S., & Rajyalakshmi, S. V. (2024) · Student s Journal of Health Research Africa · doi:10.51168/sjhrafrica.v5i6.1192
Self-compassion and reasons individuals stop eating: An exploratory investigation
Hussain, M., Dunsmore, N., Ung, L., & Mantzios, M. (2024) · Nutrition and Health · doi:10.1177/02601060241266387
“Similarly, self-compassion was also implied to promote positive outcomes for patients with diabetes by improving self-regulation of diet (Friis et al., 2015).”
A CROSS-SECTIONAL STUDY: PREVALENCE OF DEPRESSION AMONG DIABETIC PATIENTS
Fazal, K., Kumar, P. M., & Yasmin, E. (2024) · Student s Journal of Health Research Africa · doi:10.51168/sjhrafrica.v5i12.1466
Exploring the Role of Promoting Kindness in Enhancing Community Health: A Qualitative Study
Amogain, F. Z., Gholami, F., Mansourian, M., Rahmanzadeh, E., Ebrahimian, A., & Alavi, F. (2025) · Middle East Journal of Rehabilitation and Health Studies · doi:10.5812/mejrh-164556
Ebadi, M., Azmodeh, M., Eghbali, A., & Chalabianloo, G. (2025) · Journal of Rafsanjan University of Medical Sciences · doi:10.61882/jrums.24.6.555
Yeung, N. C. Y., Lee, E. K. P., Alice Pik Shan, K. O. N. G., & Leung, M. K. W. (2026) · Patient Education and Counseling · doi:10.1016/j.pec.2026.109781
- Authors
- Friis, A. M., Consedine, N. S., & Johnson, M. H.
- Affiliations
- University of Auckland (NZ)
- Corresponding author
- Consedine, Nathan S.
- ORCID
- Consedine, Nathan S.
- Venue
- Diabetes Spectrum
- Publisher
- American Diabetes Association
- Published
- 2015-11-01
- Volume
- 28
- Issue
- 4
- Pages
- 252-257
- ISSN
- 1040-9165 (ISSN-L)
- 1944-7353
- PMC
- PMC4647176
- OpenAlex
- W2172969561
- Cited by
- 33
- References
- 45
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 4 · 2023: 3 · 2022: 2 · 2021: 1 · 2020: 5 · 2019: 4 · 2018: 4 · 2017: 5
- FWCI
- 3.73
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Spectrum (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- self-compassion, diabetes mellitus, depression, comorbidities, glycemic control, medication adherence, self-care, motivation, psychological distress, chronic disease
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 ›
Are you an author, or do you see a problem with this page? Request a review