Diabetes wellness experts, psychiatrists and neuroscientists have agreed that it is important to measure depression and disease-related stress in people whose wellness is affected by diabetes. Further, they also conclude that genetic changes in the way your body handles mood-regulating serotonin affect your levels of distress.
The large study has produced many reports in the hope that doctors will be able to quickly identify people in need of psychiatric guidance or counselling, or practical help, to manage their diabetes. 184 patients participated in the study, 75% with Type 2 diabetes, 25% with Type 1 diabetes, with each person completing a PAID questionnaire to assess their disease-related distress, agreeing to serotonin genotyping, and being interviewed to assess their depression history.
Most recently, the study published a paper in Psychosomatics, showing that your blood sugar control correlates with your level of disease-related distress. One of the study’s researchers, Professor Lesley Campbell, senior clinical researcher at the Garvan Institute of Medical Research and Director of Diabetes Services at St. Vincent’s Hospital, said ‘Our Psychosomatics paper clearly showed that diabetes-related distress predicts the level of chronic blood glucose control, and we saw a high level of distress in people related to their disease.’
She added, ‘When people are distressed, it interferes with their ability to look after themselves – and most clinicians are at sea as to how to handle that. They talk about non-compliant patients, but they don’t figure the distress of the patient as part of the story. Although this study looks specifically at diabetes, it is also a paradigm for other chronic disease distress management, including coronary heart disease and stroke.’
In another paper, published by the study last year in Psychiatry Research, Professor Kay Wilhelm, a Liaison Psychiatrist and Research Director of Faces in the Street, the Urban Mental Health and Wellbeing Institute at St. Vincent’s Hospital, noted, ‘we wanted to see if there were reliable ways of predicting stress, anxiety and depression to give doctors a practical way of helping people.’ They found that people with a specific variant of a serotonin genotype were more excitable and less able to control their emotions in a crisis.
Dr Wilhelm said, ‘It’s interesting to note that a person’s genetic make-up predicts their ability to cope with stress, and that in turn determines their level of distress. While depression and distress both affect a person’s ability to cope with diabetes, distress is easier to measure with the PAID questionnaire and much more accurately predicts disease management.’
He added, ‘We’re now working on an algorithm to identify people at risk and personalise their treatment options – using PAID as well as a measure of depression and anxiety. Ideally, we’d like to see patients complete a questionnaire in the waiting room. That would allow the treating clinician to see immediately whether or not they have a high distress score – and then give appropriate advice.’
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