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
. 2016 Mar;40(2):194-204.
doi: 10.5993/AJHB.40.2.4.

Barriers to Self-management of Serious Mental Illness and Diabetes

Carol E Blixen  1 , Stephanie Kanuch  2 , Adam T Perzynski  2 , Charles Thomas  2 , Neal V Dawson  3 , Martha Sajatovic  4
Affiliations

Barriers to Self-management of Serious Mental Illness and Diabetes

Carol E Blixen et al. Am J Health Behav. 2016 Mar.

Abstract

Objectives: Individuals with serious mental illness (SMI) (major depressive disorder, bipolar disorder, schizophrenia), and diabetes (DM), face significant challenges in managing their physical and mental health. The objective of this study was to assess perceived barriers to self-management among patients with both SMI and DM in order to inform healthcare delivery practices.

Methods: We conducted 20 in-depth interviews with persons who had diagnoses of both SMI and DM. All interviews were audiotaped, transcribed verbatim, and analyzed using content analysis with an emphasis on dominant themes.

Results: Transcript-based analysis generated 3 major domains of barriers to disease self-management among patients with both DM and SMI: (1) personal level barriers (stress, isolation, stigma); (2) family and community level barriers (lack of support from family and friends); and (3) provider and health care system level barriers (poor relationships and communication with providers, fragmentation of care).

Conclusions: Care approaches that provide social support, help in managing stress, optimize communication with providers, and reduce compartmentalization of medical and psychiatric care are needed to help these vulnerable individuals avoid health complications and premature mortality.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Statement

Dr. Sajatovic has research grants from Pfizer, Merck, Ortho-McNeil Janssen, Janssen, Reuter Foundation, Woodruff Foundation, Reinberger Foundation, National Institute of Health (NIH), and the Centers for Disease Control and Prevention (CDC). Dr. Sajatovic is a consultant for Bracket, Prophase, Otsuka, Pfizer and Amgen, and receives royalties from Springer Press, Johns Hopkins University Press, Oxford Press, UpToDate, and Lexicomp. Her CME activities include American Physician’s Institute and MCM Education. All other authors have no conflict of interest to disclose.

References

    1. Walker ER, McGhee RE, Druss BG. Mortality in mental disorders and global disease burden implications. JAMA Psychiatry. 2015;72(4):334–341. - PMC - PubMed
    1. Miller BJ, Paschall CB, Svendsen DP. Mortality and medical comorbidity among patients with serious mental illness. Psychiatr Serv. 2006;57(10):1482–1487. - PubMed
    1. Dembling BP, Chen DT, Vachon L. Life expectancy and causes of death in a population treated for serious mental illness. Psychiatr Serv. 1999;50(8):1036–1042. - PubMed
    1. Kilbourne AM, McCarthy JF, Welsh D, Blow F. Recognition of co-occurring medical conditions amongpatients with serious mental illness. J Nerv Ment Dis. 2006;194(8):598–602. - PubMed
    1. Lyketsos CG, Dunn G, Kaminsky MJ, Breakey WR. Medical comorbidity in psychiatric inpatients: relation to clinical outcomes and hospital length of stay. Psychosom Med. 2002;43(1):24–30. - PubMed

Publication types