Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2011 Apr;54(4):741-8.
doi: 10.1007/s00125-010-2033-0. Epub 2011 Jan 11.

Limited effect of screening for depression with written feedback in outpatients with diabetes mellitus: a randomised controlled trial

F Pouwer  1 , C J Tack, P H L M Geelhoed-Duijvestijn, E Bazelmans, A T Beekman, R J Heine, F J Snoek
Affiliations
Randomized Controlled Trial

Limited effect of screening for depression with written feedback in outpatients with diabetes mellitus: a randomised controlled trial

F Pouwer et al. Diabetologia. 2011 Apr.

Abstract

Aims/hypothesis: The aim of this study was to test the effectiveness of a screening procedure for depression (SCR) vs care as usual (CAU) in outpatients with diabetes. The primary outcome measured was depression score and the secondary outcomes were mental healthcare consumption, diabetes-distress and HbA(1c).

Materials and methods: In a multicentre parallel randomised controlled trial, 223 outpatients with diabetes, who had an elevated depression score, were randomly assigned to SCR (n = 116) or CAU (n = 107), using computer generated numbers. SCR-patients were invited for a Composite International Diagnostic Interview (CIDI) to diagnose depression and/or anxiety (interviewers were not blinded for group assignment). As part of the intervention, patients and their physicians were informed of the outcome of the CIDI in a letter and provided with treatment advice. At baseline and 6 month follow-up, depression and diabetes-distress were measured using the Centre for Epidemiologic Studies Depression Scale (CES-D) and the Problem Areas in Diabetes survey (PAID). HbA(1c) levels were obtained from medical charts.

Results: Mean CES-D depression scores decreased from baseline to 6 months in both groups (24 ± 8 to 21 ± 8 [CAU] and 26 ± 7 to 22 ± 10 [SCR] respectively [p < 0.001]), with no significant differences between groups. Neither diabetes-distress nor HbA(1c) changed significantly within and between groups. The percentage of patients receiving mental healthcare increased in the SCR group from 20% to 28%, compared with 15% to 18% in the CAU group.

Conclusions/interpretation: Depression screening with written feedback to patient and physician does not improve depression scores and has a limited impact on mental healthcare utilisation, compared with CAU. It appears that more intensive depression management is required to improve depression outcomes in patients with diabetes.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Screening for depression in outpatients with diabetes study: patient enrolment
See this image and copyright information in PMC

References

    1. Barnard KD, Skinner TC, Peveler R. The prevalence of co-morbid depression in adults with type 1 diabetes: systematic literature review. Diabet Med. 2006;23:445–448. doi: 10.1111/j.1464-5491.2006.01814.x. - DOI - PubMed
    1. Ali S, Stone MA, Peters JL, Davies MJ, Khunti K. The prevalence of co-morbid depression in adults with type 2 diabetes: a systematic review and meta-analysis. Diabet Med. 2006;23:1165–1173. doi: 10.1111/j.1464-5491.2006.01943.x. - DOI - PubMed
    1. Schram M, Baan CA, Pouwer F. Depression and quality of life in patients with diabetes: a systematic review from the European Depression in Diabetes (EDID) Research Consortium. Curr Diab Rev. 2009;5:112–119. doi: 10.2174/157339909788166828. - DOI - PMC - PubMed
    1. Lustman PJ, Anderson RJ, Freedland KE, de Groot M, Carney RM, Clouse RE. Depression and poor glycemic control: a meta-analytic review of the literature. Diab Care. 2000;23:934–942. doi: 10.2337/diacare.23.7.934. - DOI - PubMed
    1. Ismail K, Winkley K, Stahl D, Chalder T, Edmonds M. A cohort study of people with diabetes and their first foot ulcer: the role of depression on mortality. Diab Care. 2007;30:1473–1479. doi: 10.2337/dc06-2313. - DOI - PubMed

Publication types