The influence of diabetes on a clinician-rated assessment of depression in adults with type 1 diabetes.
The purpose of the study was to examine the role of diabetes and diabetes-related distress within clinician-administered depression interviews of adults with type 1 diabetes.



This mixed-methods study coded responses to a structured clinical interview of depressive symptom severity administered to adults with type 1 diabetes (n = 34; 65% female; 56% white, 38% African American, 27% Hispanic). Pearson correlations and t tests assessed relationships between interview-based and self-reported ratings of diabetes-related distress and depression.



Among participants endorsing depressive symptoms in the interview, 73% mentioned diabetes as a contributing factor. Themes emerged relating to (1) a link between diabetes symptoms and distress, including problems with appetite, sleep, concentration, and social relationships; (2) overlapping symptoms between diabetes and depression; and (3) the perceived interconnectedness of mood and blood glucose levels. Clinician-assessed depression ratings were strongly associated with self-reported ratings of depression and self-reported diabetes-related distress. Interview-based diabetes-related distress was significantly associated with self-reported diabetes-related distress. Those with a diagnosis of major depressive disorder (44%) reported more diabetes-related distress.



Results suggest that diabetes may influence the evaluation of depression, even in standardized clinical interviews administered by trained professionals, the gold standard of assessment. Findings highlight a need for improved conceptualization and measurement of distress in individuals with diabetes to distinguish between symptoms caused by illness burden and those indicating a psychiatric disorder.
The Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York (Ms Tanenbaum, Dr Gonzalez)
Molly L
ML
Tanenbaum
The Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York (Ms Tanenbaum, Dr Gonzalez)|The Diabetes Research Center, Albert Einstein College of Medicine, Bronx, New York (Dr Gonzalez)
Jeffrey S
JS
Gonzalez
D000328:Adult; D000339:Affect; D001066:Appetite; D001786:Blood Glucose; D003863:Depression / Q000150:complications / Q000175:diagnosis*; D003865:Major Depressive Disorder / Q000150:complications / Q000175:diagnosis; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000523:psychology*; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012890:Sleep; D013315:Stress, Psychological
D001786:Blood Glucose