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A psychological support program for individuals with Type 1 diabetes

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Abstract

We aimed to test the effects of a psychological support program on the psychological distress, mood, and quality of life of well-educated individuals with type 1 diabetes. A newly developed support program was offered to 60 patients with type 1 diabetes on intensive insulin treatment, previously enrolled in group-care educational programs. Thirty-three subjects participated (experimental group, in groups of 8–12 subjects); 22, who postponed their entry, were used as controls. The program consisted of 7 weekly work sessions of 2 hours chaired by a psychologist and covered aspects of daily living with diabetes using role-playing, metaplan, and problem solving. At baseline and approximately 6 months later, all participants completed a battery of questionnaires, and the differences between the experimental and the control group were analyzed by repeated-measurements ANOVA. In response to the psychological support program, subjects in the experimental group reduced their depressive mood (Beck Depression Inventory and depression scales of the Psychological Well-Being Index) and anxiety (Self-rating Anxiety Scale), improved disease-specific quality of life (Symptom and Well-Being scales of the Well-Being Enquiry for Diabetes), increased their internal and decreased their external locus of control. These changes were accompanied by a 0.3% decrease in glycosylated hemoglobin, whereas no significant changes were observed in the control group (ANOVA, P = 0.032). These results underline the importance of psychological aspects in individuals with type 1 diabetes; treating the psychological aspects related to the disease may be as important as medical control in order to improve living with diabetes.

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References

  1. Simson U, Nawarotzky U, Porck W, Friese G, Schottenfeld-Naor Y, Hahn S, Scherbaum WA, Kruse J (2008) Depression, anxiety, quality of life and type D pattern among inpatients suffering from diabetic foot syndrome. Psychother Psychosom Med Psychol 58:44–50

    Article  PubMed  Google Scholar 

  2. Forlani G, Zannoni C, Tarrini G, Melchionda N, Marchesini G (2006) An empowerment-based educational program improves psychological well-being and health-related quality of life in Type 1 diabetes. J Endocrinol Invest 29:405–412

    PubMed  CAS  Google Scholar 

  3. Shaban C, Fosbury JA, Cavan DA, Kerr D, Skinner TC (2009) The relationship between generic and diabetes specific psychological factors and glycaemic control in adults with Type 1 diabetes. Diabetes Res Clin Pract 85:e26–e29

    Article  PubMed  CAS  Google Scholar 

  4. Eiber R, Berlin I, Grimaldi A, Bisserbe JC (1997) Insulin-dependent diabetes and psychiatric pathology: general clinical and epidemiologic review. Encephale 23:351–357

    PubMed  CAS  Google Scholar 

  5. Anderson RJ, Freedland KE, Clouse RE, Lustman PJ (2001) The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care 24:1069–1078

    Article  PubMed  CAS  Google Scholar 

  6. Pouwer F, Geelhoed-Duijvestijn PH, Tack CJ, Bazelmans E, Beekman AJ, Heine RJ, Snoek FJ (2010) Prevalence of comorbid depression is high in out-patients with Type 1 or Type 2 diabetes mellitus. Results from three out-patient clinics in the Netherlands. Diabet Med 27:217–224

    Article  PubMed  CAS  Google Scholar 

  7. Lloyd CE, Dyer PH, Barnett AH (2000) Prevalence of symptoms of depression and anxiety in a diabetes clinic population. Diabet Med 17:198–202

    Article  PubMed  CAS  Google Scholar 

  8. Gendelman N, Snell-Bergeon JK, McFann K, Kinney G, Paul Wadwa R, Bishop F, Rewers M, Maahs DM (2009) Prevalence and correlates of depression in individuals with and without type 1 diabetes. Diabetes Care 32:575–579

    Article  PubMed  Google Scholar 

  9. Hislop AL, Fegan PG, Schlaeppi MJ, Duck M, Yeap BB (2008) Prevalence and associations of psychological distress in young adults with Type 1 diabetes. Diabet Med 25:91–96

    Article  PubMed  CAS  Google Scholar 

  10. Collins MM, Corcoran P, Perry IJ (2009) Anxiety and depression symptoms in patients with diabetes. Diabet Med 26:153–161

    Article  PubMed  CAS  Google Scholar 

  11. Lin EH, Rutter CM, Katon W, Heckbert SR, Ciechanowski P, Oliver MM, Ludman EJ, Young BA, Williams LH, McCulloch DK, Von Korff M (2010) Depression and advanced complications of diabetes: a prospective cohort study. Diabetes Care 33:264–269

    Article  PubMed  Google Scholar 

  12. Shaban MC, Fosbury J, Kerr D, Cavan DA (2006) The prevalence of depression and anxiety in adults with Type 1 diabetes. Diabet Med 23:1381–1384

    Article  PubMed  CAS  Google Scholar 

  13. Hart HE, Bilo HJ, Redekop WK, Stolk RP, Assink JH, Meyboom-de Jong B (2003) Quality of life of patients with type I diabetes mellitus. Qual Life Res 12:1089–1097

    Article  PubMed  CAS  Google Scholar 

  14. Hart HE, Redekop WK, Bilo HJ, Meyboom-de Jong B, Berg M (2007) Health related quality of life in patients with type I diabetes mellitus: generic and disease-specific measurement. Indian J Med Res 125:203–216

    PubMed  Google Scholar 

  15. Peyrot M (2002) Recognizing emotional response to diabetes. In: Anderson BJ, Rubin RR (eds) Practical psychology for diabetes clinicians, 2nd edn. American Diabetes Association, Alexandria, VA, pp 211–218

    Google Scholar 

  16. Simson U, Nawarotzky U, Friese G, Porck W, Schottenfeld-Naor Y, Hahn S, Scherbaum WA, Kruse J (2008) Psychotherapy intervention to reduce depressive symptoms in patients with diabetic foot syndrome. Diabet Med 25:206–212

    Article  PubMed  CAS  Google Scholar 

  17. Zhang X, Norris SL, Chowdhury FM, Gregg EW, Zhang P (2007) The effects of interventions on health-related quality of life among persons with diabetes: a systematic review. Med Care 45:820–834

    Article  PubMed  Google Scholar 

  18. Amsberg S, Anderbro T, Wredling R, Lisspers J, Lins PE, Adamson U, Johansson UB (2009) A cognitive behavior therapy-based intervention among poorly controlled adult type 1 diabetes patients–a randomized controlled trial. Patient Educ Couns 77:72–80

    Article  PubMed  Google Scholar 

  19. Wild D, von Maltzahn R, Brohan E, Christensen T, Clauson P, Gonder-Frederick L (2007) A critical review of the literature on fear of hypoglycemia in diabetes: Implications for diabetes management and patient education. Patient Educ Couns 68:10–15

    Article  PubMed  Google Scholar 

  20. Dupuy HJ (1984) The psychological general well-being (PGWB) inventory. In: Wenger NK (ed) Assessment of quality of life in clinical trials of cardiovascular therapies. Le Jacq Publications, New York, pp 170–183

    Google Scholar 

  21. Grossi E, Mosconi P, Groth N, Niero M, Apolone G (2002) Il Questionario psychological general well-being. Versione Italiana. Edizioni “Mario Negri”, Milano

  22. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571

    Article  PubMed  CAS  Google Scholar 

  23. Shaw BF, Vallis TM, McCabe MP (1985) The assessment of the severity and symptom patterns in depression. In: Beckham EE, Leber WR (eds) Handbook of depression. The Dorsey Press, Homewood, IL, pp 372–407

    Google Scholar 

  24. Beck AT (1978) Depression Inventory. Centre for cognitive therapy, Philadelphia

    Google Scholar 

  25. Baggio A, Ferrari R, Partinico M, Vidotto G, Visentin M (1997) Il Beck Depression Inventory per la valutazione della depressione nel dolore cronico. Il contributo degli “item” somatici. Int J Pain Ther 7:4–11

    Google Scholar 

  26. Zung WW (1971) A rating instrument for anxiety disorders. Psychosomatics 12:371–379

    PubMed  CAS  Google Scholar 

  27. Conti L (2000) Repertorio delle Scale di Valutazione in Psichiatria. SEE-Edizioni Medico-Scientifiche, Firenze

    Google Scholar 

  28. Mannucci E, Ricca V, Bardini G, Rotella CM (1996) Well-being enquiry for diabetics: a new measure of diabetes-related quality of life. Diab Nutr Metab 9:89–102

    Google Scholar 

  29. Wallston KA, Wallston BS, DeVellis R (1978) Development of the multidimensional health locus of control (MHLC) scales. Health Educ Monogr 6:160–170

    Article  PubMed  CAS  Google Scholar 

  30. Trento M, Passera P, Miselli V, Bajardi M, Borgo E, Tomelini M, Tomalino M, Cavallo F, Porta M (2006) Evaluation of the locus of control in patients with Type 2 diabetes after long-term management by group care. Diabetes Metab 32:77–81

    Article  PubMed  CAS  Google Scholar 

  31. Li C, Ford ES, Strine TW, Mokdad AH (2008) Prevalence of depression among U.S. adults with diabetes: findings from the 2006 behavioral risk factor surveillance system. Diabetes Care 31:105–107

    Article  PubMed  Google Scholar 

  32. Lustman PJ, Singh PK, Clouse RE (2002) Recognizing and managing depression in patients with diabetes. In: Anderson BJ, Rubin RR (eds) Practical psychology for diabetes clinicians, 2nd edn. American Diabetes Association, Alexandria, VA, pp 219–228

    Google Scholar 

  33. Lustman PJ, Griffith LS, Gavard JA, Clouse RE (1992) Depression in adults with diabetes. Diabetes Care 15:1631–1639

    Article  PubMed  CAS  Google Scholar 

  34. Lustman PJ, Clouse RE, Griffith LS, Carney RM, Freedland KE (1997) Screening for depression in diabetes using the Beck depression inventory. Psychosomatic Med 59:24–31

    CAS  Google Scholar 

  35. Manini R, Forlani G, Moscatiello S, Zannoni C, Marzocchi R, Marchesini G (2007) Insulin glargine improves glycemic control and health-related quality of life in Type 1 diabetes. Nutr Metab Cardiovasc Dis 17:493–498

    Article  PubMed  CAS  Google Scholar 

  36. El Achhab Y, Nejjari C, Chikri M, Lyoussi B (2008) Disease-specific health-related quality of life instruments among adults diabetic: a systematic review. Diabetes Res Clin Pract 80:171–184

    Article  PubMed  Google Scholar 

  37. Trento M, Tomelini M, Basile M, Borgo E, Passera P, Miselli V, Tomalino M, Cavallo F, Porta M (2008) The locus of control in patients with Type 1 and Type 2 diabetes managed by individual and group care. Diabet Med 25:86–90

    Article  PubMed  CAS  Google Scholar 

  38. Peyrot M, Rubin RR (1994) Structure and correlates of diabetes-specific locus of control. Diabetes Care 17:994–1001

    Article  PubMed  CAS  Google Scholar 

  39. Lloyd CE, Pambianco G, Orchard TJ (2010) Does diabetes-related distress explain the presence of depressive symptoms and/or poor self-care in individuals with Type 1 diabetes? Diabet Med 27:234–237

    Article  PubMed  CAS  Google Scholar 

  40. Anderson JA, Wright ER, Kooreman HE, Mohr WK, Russell LA (2003) The dawn project: a model for responding to the needs of children with emotional and behavioral challenges and their families. Community Ment Health J 39:63–74

    Article  PubMed  Google Scholar 

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Conflict of interest

Nothing to declare in relation to the matter of the present study.

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Authors and Affiliations

  1. Unit of Metabolic Diseases and Clinical Dietetics, “Alma Mater Studiorum” University, S. Orsola-Malpighi Hospital, Via Massarenti, 9, I-40138, Bologna, Italy

    Gabriele Forlani, Chiara Nuccitelli, Chiara Caselli, Simona Moscatiello, Arianna Mazzotti, Elena Centis & Giulio Marchesini

Authors
  1. Gabriele Forlani
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  2. Chiara Nuccitelli
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  3. Chiara Caselli
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  4. Simona Moscatiello
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  5. Arianna Mazzotti
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  6. Elena Centis
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  7. Giulio Marchesini
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Corresponding author

Correspondence to Giulio Marchesini.

Additional information

The psychological support program described in this article received the Italian DAWN award 2010 “Premio Roberto Sivieri”, supported by Novo Nordisk.

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Forlani, G., Nuccitelli, C., Caselli, C. et al. A psychological support program for individuals with Type 1 diabetes. Acta Diabetol 50, 209–216 (2013). https://doi.org/10.1007/s00592-011-0269-x

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