BackgroundComorbid depression in diabetes has been suggested as one of the possible causes of an inadequate glycemic control. The purpose of this study was to investigate the association between major depression and the glycemic control of type 2 diabetes mellitus (T2DM).MethodsSeventy T2DM patients were evaluated. They underwent a psychiatric examination using the following instruments: Structured Clinical Interview for DSM-IV and Beck Depression Inventory. The diabetes status was assessed in the short-term (glycemia, glycated hemoglobin) clinical control.ResultsThe presence of current depression was observed in 18.6% (13/70). In addition, type 2 diabetes patients who displayed depression evidenced higher levels of glycated hemoglobin (8.6 ± 2.0 vs. 7.5 ± 1.8; p = 0.05) when compared to those who did not exhibit a mood disorder.ConclusionsIn our sample, the presence of depression seems to impact on the short-term control of T2DM. The authors discuss the clinical utility of these findings in the usual treatment of diabetes.

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A presença de depressão no paciente com diabetes mellitus (DM) parece relacionar-se a alterações no curso clínico da doença. O objetivo deste trabalho é realizar uma revisão sistemática sobre a associação entre o DM e depressão. Foi realizada uma pesquisa bibliográfica utilizando as bases de dados MEDLINE e LILACS para identificar artigos relevantes, publicados entre 1990 e 2001, que avaliassem esta associação. Foram analisadas informações referentes à prevalência, ao impacto e ao tratamento da depressão no DM. A prevalência de depressão no DM variou de 0 a 60,5%. Sintomas depressivos relacionaram-se a um pior controle glicêmico, a um aumento e a uma maior gravidade das complicações clínicas, a uma piora da qualidade de vida e ao comprometimento de aspectos sociais, econômicos e educacionais ligados ao DM. O tratamento da depressão está relacionado à melhora dos níveis glicêmicos, podendo contribuir para um melhor controle de diversos aspectos relacionados ao DM. The presence of depression in a patient with diabetes mellitus (DM) seems to be related to changes in the clinical course of the disease. The purpose of this study is to perform a systematic review on the association of DM and depression. A bibliographic search was performed using the MEDLINE and LILACS databases to identify relevant articles, published from 1990 to 2001, which evaluate this relationship. Information concerning prevalence, impact and treatment of depression in DM were analyzed. The prevalence of depression varied from 0 to 60.5%. The presence of depressive symptoms were associated with a poor glycemic control, an increase in the number and severity of clinical complications, a worse quality of life and impairment of social, educational and economic aspects related to DM. The treatment of depression is associated with an improvement in glycemic levels, which may contribute to a better control of several aspects related to DM. (Arq Bras Endocrinol Metab 2003;47/1:19-29)

Summary Bariatric surgery has been recognized as the gold standard treatment for severe obesity. Although postbariatric surgery patients usually achieve and maintain substantial weight loss, a group of individuals may exhibit weight regain. Several factors are proposed to weight regain, including psychiatric comorbidity. The objective of the study is to conduct a systematic review and meta‐analysis of studies investigating the relationship between psychiatric comorbidity and weight regain. A systematic review through PubMed, Web of Science, Cochrane Library, Scopus, and PsycINFO was performed, following Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA). After a stepwise selection, 13 articles were included in the qualitative analysis and 5 were included for a meta‐analysis. Women was majority in most of the studies (87.6%), and a bypass procedure was the bariatric intervention most evaluated (66.8%), followed by gastric banding (32.1%) and sleeve (1.1%). Higher rates of postbariatric surgery eating psychopathology were reported in patients with weight regain. However, the association between general psychopathology and weight regain was not consistent across the studies. In the meta‐analysis, the odds of eating psychopathology in the weight regain group was higher compared with the nonweight regain group (OR = 2.2, 95% CI 1.54‐3.15). Postbariatric surgery eating psychopathology seems to play an important role in weight regain.

The aim of this study was to translate into Portuguese and to assess the reliability of an instrument for the diagnosis of diabetic distal polyneuropathy (DPN). The process for translation and adaptation into Portuguese of the Neuropathy Symptom Score (NSS) and the Neuropathy Disability Score (NDS) was performed following internationally standardized procedures. The instruments were applied by 2 raters in 57 consecutive subjects. Spearman correlation was used to evaluate the reliability and Cronbachs' alpha to evaluate the internal consistency of the items. Both, ECN and ESN, showed a good reliability (r= 0.77, p< 0.0001 and r= 0.76, p< 0.0001, respectively). ESN showed a good internal consistency (alpha= 0.74). The diagnosis of DPN, defined as the combination of the two scores (ECN+ESN) also showed a good reliability (r= 0.63, p< 0.0001). The Portuguese versions of the ESN and the ECN seem to be adequate for the diagnosis of DPN in this population.