Abstract
Depressive disorders are highly prevalent in patients with diabetes. While depressive
disorders themselves require therapy, they also contribute negatively to diabetes-related
medical, social and psychological outcomes, and therefore need to be addressed. Disease
burden is very high for both diabetes and depression, even more so in case of comorbidity.
Comorbid depressive symptoms in patients with diabetes are associated with a reduced
quality of life and adherence to treatment regimes, impaired coping abilities, as
well as increased morbidity and mortality rates, diabetes-related distress, and economic
burden.
The interactions between diabetes and depression are bidirectional. Both diseases
appear to have a variety of shared bio-psychosocial, as well as biological risk factors.
Recent research implies that the interaction between diabetes and depression cannot
be understood as a simple cause-effect relationship but might rather be explained
by being part of a disturbed homeostasis of biological and psychological circuits.
Regular depression screenings should be applied to identify depressive symptoms in
patients with diabetes. To verify positive screening results, treating physicians
have a key role in targeting depression by actively asking patients for depressive
symptoms within the last 14 days. If symptoms are present, further diagnostics, and
the exploration of psychosocial problems are necessary. In case of a depressive disorder,
varieties of effective antidepressant treatments (psychotherapy, psychopharmacological
medications) are available. Physical activation and diabetes education programs can
be offered additionally. The current paper offers insights on epidemiology, symptoms,
interactions, diagnostics, treatments as well as the relationship between physician
and patient.
Bei vielen Patienten mit Diabetes finden sich depressive Störungen – sie gehen mit
einer deutlich reduzierten Lebensqualität, erhöhter Mortalität sowie gesteigerten
krankheitsbezogenen Kosten einher. Oftmals stellen sie bedeutsame Behandlungsbarrieren
für den Diabetes dar. Dieser Beitrag gibt einen Überblick über Epidemiologie und Symptomatik,
Zusammenhänge, Diagnostik, therapeutische Optionen sowie die Bedeutung der Arzt-Patient-Beziehung.
Schlüsselwörter
depressive Störungen - Diabetes - chronische Stress - diabetesbezogene Belastungen
Key words
depressive disorders - diabetes - chronic stress - diabetes-related distress
