The effects of psychiatric disorders and symptoms on quality of life in patients with Type I and Type II diabetes mellitus
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The purpose of this study was to evaluate the influence of psychiatric symptoms and illness status on the health-related quality of life (HRQOL) of outpatients with Type I and Type II diabetes mellitus. Using a two-stage design, all patients were assessed by two measures of quality of life (Diabetes Quality of Life Measure; Medical Outcome Study Health Survey) and a psychiatric symptoms checklist (SCL-90-R). Patients scoring 63 or greater on the global severity index of the SCL-90-R and 30% below this cutoff were then evaluated using the Structured Clinical Interview for the DSM-III-R (SCID). Quality of life in both Type I and Type II diabetes was influenced by the level of current psychiatric symptoms and presence of co-morbid psychiatric disorder, after controlling for number of diabetic complications (e.g. effect of lifetime psychiatric illness on diabetes-related HRQOL; F=46.8; df=3, 135; p < 0.005). These effects were found consistently across specific domains. Both recent and past psychiatric disorders influenced HRQOL. Separate analyses comparing patients with and without depression showed similar effects. No interaction effects between diabetes type, number of complications, and psychiatric status were found in analyses. Finally, increased severity of psychiatric symptoms was correlated with decreased HRQOL in patients without current, recent, or past psychiatric diagnosis. This study shows the consistent, independent contribution of psychiatric symptoms and illness to the HRQOL of patients with a co-existing medical illness. Thus, psychiatric interventions addressing common conditions, such as depression, could improve the HRQOL of patients without changing medical status.
- Welch G. Assessment of quality of life following renal failure. In: McGee H, Bradley C, eds. Quality of Life Following Renal Failure. Switzerland: Harwood, 1994.
- Coons SJ, Kaplan RM. Assessing health-related quality of life: Application to drug therapy. Clin Therap 1992; 14:850-858.
- Guyatt G, Feeny D, Patrick D. Measuring health-related quality of life. Ann Int Med 1993; 118:622-629.
- Joyce C. Requirements for assessment of individual quality of life. In: McGee H, Bradley C, eds. Quality of Life Following Renal Failure. Switzerland: Harwood, 1994.
- Patrick D, Deyo R. Generic and disease-specific measures in assessing health status and quality of life. Med Care 1989; 27(Suppl): 217-232.
- Parkerson G, Connis R, Broadhead W, et al. Disease specific versus generic measurement of health-related quality of life in IDDM patients. Med Care 1993; 31:629-639.
- Stewart AL, Greenfield S, Hays RD, et al. Functional status and well-being of patients with chronic conditions. JAMA 1989; 262:907-913.
- Barrett JE, Barrett JA, Oxman TE, Gerber PD. The prevalence of psychiatric disorders in a primary care practice. Arch Gen Psychiatry 1988; 45:1100-1106.
- Wells KB, Golding JM, Burnam MA. Psychiatric disorder in a sample of the general population with and without chronic medical conditions. Am J Psychiatry 1988; 145:976-981.
- Blumenthal MD, Dielman TE. Depressive symptomatology and role function in a general population. Arch Gen Psychiatry 1975; 32:985-991.
- Wells KB, Stewart A, Hays RD, et al. The functioning and well-being of depressed patients. JAMA 1989; 262:914- 919.
- McHorney CA, Ware JE, Raczek AE. The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 1993; 31:247.
- DCCT Research Group, Reliability and validity of a diabetes quality-of-life measure for the diabetes control and complications trial (DCCT). Diabetes Care 1988; 11:725-732.
- Jacobson AM, de Groot M, Samson J. The evaluation of two measures of quality of life in patients with Type I and Type II diabetes. Diabetes Care 1994; 17:268-274.
- DCCT Research Group. The effect of intensive treatment of diabetes on the quality of life of intensively treated IDDM patients. Diabetes Care 1996; 19: 195-203.
- Gafvels C, Lithner F, Borjeson B. Living with diabetes: relationship to gender, duration, and complications. A survey in northern Sweden. Diabetic Med 1993; 768-773.
- Eiser G, Flynn M, Green E, et al. Quality of life in young adults with Type I diabetes in relation to demographic and disease variables. Diabetic Med 1992; 375-378.
- Hanestad B. Self-reported quality of life and the effect of different clinical and demographic characteristics in people with Type I diabetes. Diabetes Res Clin Prac 1993; 19:139-149.
- Mayou R, Bryant B, Turner R. Quality of life in non-insulin dependent diabetes and a comparison with insulindependent diabetes. J Psychosomatic Res 1990; 1-11.
- Rodin G. Quality of life in adults with IDDM. Psychother Psychosom 1990; 54:132-139.
- Wolf F, Jacober S, Wolf L, et al. Quality of life activities associated with adherence to insulin infusion therapy in the treatment of IDDM. J Clin Epidemiol 1989; 42:1129- 1136.
- Young-Hyman D, Peyrot M, Jacobson A, Schlundt D. Impact of intensive treatment on diabetes related attitudes and behaviors in the DCCT. Diabetes1994; 43(Suppl): 7A.
- Samson J, Jacobson AM, de Groot M. Psychiatric illness in diabetes mellitus. Under review.
- McHorney CA, Ware JE, Rogers W, et al. The validity and relative precision of the MOS short-and long-form health status scales and Dartmouth COOP charts: results from the Medical Outcomes Study. Med Care 1992; 30:MS253.
- McHorney CA, Ware JE, Lu R, Sherbourne DC. The MOS 36-Item Short-form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care 1994; 32:40-66.
- Jacobson AM and the DCCT Research Group. The Diabetes Quality of Life Measure. In: Bradley CS, ed. Handbook of Psychology and Diabetes. London: Harwood Academic Publishers, 1994.
- Derogatis LR. SCL90R administration, scoring and procedures manual - II for the R(evised) Version. Towson, MD: Clinical Psychometric Research, 1983.
- Spitzer RL, Williams JBW, Gibbon M, First MB. The structured clinical interview for the DSM-III-R (SCID): I. History, rationale, and description. Arch Gen Psychiatry 1992; 49: 624-629.
- Williams JBW, Gibbon M, First MB, et al.The structured clinical interview for the DSM-III-R (SCID): II. Multi-site Psychiatric disorders and QOL Quality of Life Research. Vol 6. 1997 19test-retest reliability. Arch Gen Psychiatry1992; 49: 630-637.
- Lloyd C, Matthews K, Wing R, Orchard T. Psychological factors and complications of diabetes. Diabetes Care 1992; 15: 166-172.
- Huber D, Henrich G, Herschbach P. Measuring the quality of life: A comparison between physically and mentally chronically ill patients and healthy persons. Pharmacopsychiat 1988; 21:453-455.
- Weissman M, Klerman G. The chronic depressive in the community: unrecognized and poorly treated. Gen Hosp Psychiatry 1977; 11:201-207.
- Beck AT. Cognitive Therapy and the Emotional Disorders. New York, NY: International Universities Press, Inc, 1976.
- O'Connor P, Jacobson AM. Functional status measurement in elderly diabetic patients. In: Froom J, ed. Diabetes Mellitus in the Elderly. Philadelphia, PA: WB Saunders, 1990.
- The effects of psychiatric disorders and symptoms on quality of life in patients with Type I and Type II diabetes mellitus
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