Screening for and subsequent participation in a trial for depression and anxiety in people with type 2 diabetes treated in primary care: Who do we reach?
This study investigated (factors related to) (a) the response to a screening procedure for depression and anxiety in people with type 2 diabetes in primary care, and (b) participation in a subsequent randomised controlled trial targeting depressive or anxiety symptoms.



People with type 2 diabetes (n=1837) received a screening questionnaire assessing depressive symptoms (PHQ-9) and anxiety symptoms (GAD-7). Eligible persons who scored above the cut-off score (PHQ-9≥7 or GAD-7≥8) were offered to participate in the trial.



In total, 798 people (43%) returned the screening questionnaire. Non-responders were more often female (53% vs 44%, p<0.001), had higher LDL cholesterol levels (Cohen's d=0.17, p=0.001) and a higher albumin/creatinine ratio (Cohen's d=0.08, p=0.01). In total, 130 people (18%) reported elevated depressive or anxiety symptoms. Twenty-seven persons agreed to participate in the trial. Factors related to participation were a high education level, a higher level of diabetes distress and a history of psychological problems.



Using screening as recruitment resulted in a small number of participants in a treatment trial for anxiety and depression. Research is needed to investigate whether screening is also followed by a low uptake of treatment in primary care outside a RCT setting.
Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic disorders (CoRPS), Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands; PoZoB, PO Box 312, 5500 AH Veldhoven, The Netherlands.
Corinne H
CH
Stoop
Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic disorders (CoRPS), Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands. Electronic address: g.m.nefs@tilburguniversity.edu.
Giesje
G
Nefs
Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic disorders (CoRPS), Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands.
Victor J
VJ
Pop
Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic disorders (CoRPS), Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands.
François
F
Pouwer
D000368:Aged; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D017281:Cost of Illness; D003863:Depression / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000523:psychology*; D004522:Educational Status; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010358:Patient Participation; D018579:Patient Selection; D011320:Primary Health Care; D011569:Psychiatric Status Rating Scales; D035842:Research Subjects / Q000523:psychology*; D018401:Sample Size; D013315:Stress, Psychological / Q000175:diagnosis / Q000523:psychology; D011795:Surveys and Questionnaires
Anxiety; Depression; Diabetes; Screening; Trial participation