No abstract

Psychological adjustment to any chronic disease, such as diabetes mellitus, concerns self-view rearrangement toward self-integrity and self-regulation. Both distance between self and disease paired with positive and negative new identities may contribute to adaptation to diabetes. The present investigation aimed to detect main trends on self-management in patients with both diabetes types within a self-regulatory framework. Sample consisted of 121 adult patients with both diabetes types. Answer to question about having diabetes or being a diabetic was combined with self-benefices or self-damages concerning diabetes in a 2 × 2 combination. Psychological adjustment to diabetes, anxiety and depression were evaluated among subgroups. Almost 16% of patients had any benefit with diabetes and a better psychological adjustment than patients reporting losses. Type 1 diabetes answered more "being diabetic" and type 2 "having diabetes". Education was positively associated with profits with diabetes. Patients referring "to have diabetes" and profits had the best diabetes psychological adjustment. Distance between self and diabetes does not seem to relate to psychological adjustment. Type 1 diabetes patients are likely to identify more with their disease comparing with type 2 diabetes, independently from gains or losses associated with diabetes. Better psychological adjustment related to more education and positivity highlights future interest on working with gains in diabetes patient education, fostering patient self-growth, self-integration and resilience.

Findings suggest that Interpersonal Psychotherapy is a useful tool to treat major depression in type 2 diabetes patients. A significant number of type 2 diabetes patients with major depression do not achieve depression remission irrespective of the type of treatment. Further clinical research should focus on addictive effects of psychotherapy and psychopharmacology in the treatment of depressed patients with chronic somatic diseases.