BackgroundDiabetes mellitus (DM) is a chronic illness with impaired health-related quality of life and a high risk of psychiatric disorders. We carried out a systematic review analyzing the relationship between DM and suicide by providing a qualitative data synthesis of the studies.MethodsWe conducted, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic search of the literature in PubMed, Scopus, ISI Web of Science, PsycINFO, Google Scholar, and ScienceDirect. Search terms were “suicid*” combined with the Boolean “AND” operator with “diabetes.”ResultsThe initial search identified 568 citations. A total of 17 research reports met the predefined inclusion criteria and were analyzed. DM was found to be significantly associated with a marked increase in suicidal behaviors and suicidal ideation (SI), especially in patients with depressive symptoms. Insulin therapy, DM of long duration, and unsatisfactory glycemic control were identified as risk factors for SI in Type 1 (T1DM) and Type 2 (T2DM).ConclusionHealth-care professionals need to be aware of the higher suicidal risk in patient subgroups based on the clinical characteristics of DM; thus, patients with these characteristics warrant special attention. In this regard, clinical management should include efforts to manage emotional distress in DM care.

Introduction: It is essential to consider the clinical assessment of psychological aspects in patients with Diabetes Mellitus (DM), in order to prevent potentially adverse self-management care behaviors leading to diabetes-related complications, including declining levels of Quality of Life (QoL) and negative metabolic control.Purpose: In the framework of Structural Equation Modeling (SEM), the specific aim of this study is to evaluate the influence of distressed personality factors as Negative Affectivity (NA) and Social Inhibition (SI) on diabetes-related clinical variables (i.e., QoL and glycemic control).Methods: The total sample consists of a clinical sample, including 159 outpatients with Type 2 Diabetes Mellitus (T2DM), and a control group composed of 102 healthy respondents. All participants completed the following self- rating scales: The Type D Scale (DS14) and the World Health Organization QoL Scale (WHOQOLBREF). Furthermore, the participants of the clinical group were assessed for HbA1c, disease duration, and BMI. The observed covariates were BMI, gender, and disease duration, while HbA1c was considered an observed variable.Results: SEM analysis revealed significant differences between groups in regards to the latent construct of NA and the Environmental dimension of QoL. For the clinical sample, SEM showed that NA had a negative impact on both QoL dimensions and metabolic control.Conclusions: Clinical interventions aiming to improve medication adherence in patients with T2DM should include the psychological evaluation of Type D Personality traits, by focusing especially on its component of NA as a significant risk factor leading to negative health outcomes.

Objective To investigate whether obese patients with binge eating (BE) have higher alexithymic features; to explore the different relationships between psychological features (alexithymia, depression, and anxiety) and BE. Method Three hundred sixty one obese BE‐patients were evaluated for alexithymia, psychological distress, and BE. Alexithymia was measured with the 20‐item Toronto Alexithymia Scale (TAS‐20); BE was assessed with the BE Scale (BES), and depression and anxiety symptoms were evaluated with the Hospital Anxiety and Depression Scale (HADS). Results Patients with BE reported significantly higher TAS‐20 total scores than those without BE (p < .001). The SEM analysis showed that the difficulty in identifying feelings (DIF) and difficulty in describing feelings (DDF) components of alexithymia affected BE along different pathways. DIF was found as a major factor influencing altered eating both directly (p = .20*) and above all through the mediation of psychological distress (p = .19***), whereas DDF affected BE only through psychological distress at a lesser extent (p = .09**). Discussion Alexithymic difficulties in affective awareness may play an important role in the onset and maintenance of BE, especially when patients experienced anxiety and depression symptoms. Clinicians involved in the management of obesity should address the combination of alexithymic traits and emotional distress by planning effective client‐focused interventions.

Purpose Alexithymia, a personality trait characterized by difficulties in emotional processing, has been associated with unhealthy behaviors and chronic medical conditions. This study aimed to further develop our understanding of this complex relationship by investigating whether alexithymia increases the risk of metabolic syndrome (MetS) in participants with obesity or overweight through the mediating role of binge eating (BE). Methods A consecutive sample of 238 treatment-seeking patients with obesity or overweight were recruited. Alexithymia (TAS-20), binge eating symptoms (BES), body mass index (BMI), and depression and anxiety symptoms (HADS) were concurrently assessed. Results Almost half of the participants met the criteria for MetS (44.12%). Compared to patients without MetS, those with MetS were older, had a longer duration of overweight, and had a higher BMI (p < 0.01). Individual with MetS also had higher HADS, BES, and TAS-20 scores, particularly difficulty identifying and describing feelings. The structural equation modeling (SEM) analysis revealed that BES levels exerted a significant direct effect on MetS (p < 0.01), and that TAS-20 levels exerted a significant direct effect on BES (p < 0.01), anxiety (p < 0.001) and depression (p < 0.001). Moreover, psychological distress (anxiety, p = 0.01, and depression, p = .05) indirectly affected MetS through the mediating effect of BES, and TAS-20 (p = 0.01) indirectly affected MetS through the mediating effect of HADS and BES. Finally, age had a significant direct effect on MetS (p < 0.001). Conclusion Our findings indicate that alexithymia is a concurrent causative factor to the development of MetS through the mediating role of BE and psychological distress. Level of evidence Level III, case–control analytic study.