Assessment of the spectrum of depression and bipolarity in patients with type 1 diabetes

Abstract

Aims:The aim of the study was to check the prevalence of unipolarity (depression), bipolarity, as well as the quality of sleep and temperament traits in patients with type 1 diabetes (T1DM) who are provided with optimal conditions of diabetes care and to identify possible risk factors connected with affective traits. Materials and Methods: Out of the 107 T1DM patients, 78 (54 females, 24 males) were included for the analysis (HbA1c [%] 7.11 � 1.0, BMI [kg/m 2 ] 25.3 � 5.6; Years of disease duration [N] 13.7 � 8.3). The patients filled in a set of questionnaires during their regular visit to the outpatient clinic. Three patients from the whole group were on intensive insulin therapy with Multiple Daily Injections (MDI) and Self-Monitoring of Blood Glucose (SMBG), all the rest were on various types of personal insulin pumps (years on insulin pump [N] 9.1 � 4.5). All the patients were on regular diabetologist care, with regular visits in a Centre for Advanced Technologies in Diabetes (at least every 6 months). Results:In QIDS-S (full explanation and abbreviation 26 patients (33.8%) were screened positive for depression, in PHQ (full explanation and ab 57.7% of the patients (45 patients) had symptoms of depression (age was negatively correlated with PHQ score [r = −0.26; p = 0.023]). In CES-D 16 (20%) of the patients assessed their present affect as depressed. None of the analysed clinical variables correlated with depression scores. In the Mood Disorder Questionnaire (MDQ), 16 patients reported having symptoms of bipolarity (20.5% vs. 79.5%). Hypomania Checklist (HCL) analysis indicated 10 patients with bipolar traits (>14) (14.9% vs. 85.1%).None of the analysed clinical variables correlated with HCL results. 11.5% of patients were indicated to be of morning type. Morningness was more often seen in younger patients (r = 0.39; p = 0.001). As many as 46.6% declared that they had poor sleep quality. The temperament traits analysis correlated with clinical parameters: Cyclothymic temperament trait was negatively correlated with age (r = −0.30; p = 0.007) and positively with HbA1c level (r = 0.30; p = 0.025).Hyperthymic temperament was positively correlated with (BMI r = 0.28; p = 0.016).

Comorbity of eating disorders and depression in T1DM patients: challenges and tasks for dietetician - a pilot study

“…According to the main study protocol the inclusion criteria were a: T1DM for at least a year, having regular diabetes visits (every 3 months, including late complications check every year) age over 18, expressing informed consent to participate in the study by Cyranka et al [20]. Due to the later expansion of the main study to include eating disorders, only 27 patients were included in the pilot study (55.5% of the group were women) -the included persons filled in the forms correctly (there were no missing data) and regularly visited a diabetologist (at least once every 6 months).…”

“…In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity [21]. The PHQ-9 assesses several factors that center around the criteria used to professionally diagnose depression according to the current Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and include: Feeling depressed or irritable; Loss of interest or pleasure in doing things; Overeating or loss of appetite; Sleep problems (sleeping too much or having trouble falling or staying asleep); Moving or talking slowly or vice versa, talking fast or restless; You feel like a failure or that you have disappointed your family or yourself; Difficulty concentrating, for example when watching TV or reading a news app; Thinking it would be better if you died or wishing you could hurt yourself in some way [20,23].…”

“…Center for Epidemiological Studies Depression Questionnaire (CES-D) is a tool that not only can evaluate whether a person is depressed, but also the severity of the depressive symptoms where ≤ 16 is not depressed to mild depression, 17-23 is moderate, and ≥ 24 is severe [24,25]. The tool collects a patient's rating of how often they have experienced depression-related symptoms, such as restless sleep, poor appetite and feelings of loneliness, over the past week [20,26].…”

“…Mood Disorder Questionnaire (MDQ) is a selfadministered screening instrument for bipolar disorder composed of three parts: the first part is identify previous hypomanic or manic episodes; the second part regard the simultaneous occur-rence of symptoms; and the third part assesment influence of the above symptoms [20,27,28]. Polish Version of MDQ was performed by Kiejna et al 2010 [29].…”

“…Published studies have focused on the younger population of T1DM patients. The research from our unit of the university hospital covered the adult population, but first focused on the aspects of unipolarity (depression) and bipolarity and the identification of possible risk factors related to affective features [20]. During the study, a decision was made to extend the study to include aspects of ED as a pilot assessment of whether such problems apply to our population.…”