Depression and diabetes.

Diabetes, a condition that places responsibility for management firmly on the individual, has a serious impact on daily life, and can have psychosocial and emotional consequences. Psychologic problems such as depressive symptomatology are much more common in those with diabetes than in those without this disease. Symptoms may recur more frequently and be longer-lasting, and diabetes self-care may be compromised. Recent studies have suggested that women with diabetes may be more likely to suffer from depression compared with their male counterparts, and there are strong links with poor metabolic control and diabetes complications. Despite the availability of appropriate screening tools, less than half of those with depression are identified and treated. However, when individuals are referred for psychologic treatment, various therapies (both pharmacologic and nonpharmacologic) have been found to be successful. Two case studies within this article highlight the effectiveness of these different approaches, and indicate that an individualized patient-focused approach is useful.