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. 2021 Aug 28:40:101118.
doi: 10.1016/j.eclinm.2021.101118. eCollection 2021 Oct.

Unraveling the concepts of distress, burnout, and depression in type 1 diabetes: A scoping review

Dona A Kiriella  1 , Sumaiya Islam  1 , Olutobi Oridota  1 , Nancy Sohler  1 , Coralie Dessenne  2 , Carine de Beaufort  3   4 , Guy Fagherazzi  5 , Gloria A Aguayo  5
Affiliations

Unraveling the concepts of distress, burnout, and depression in type 1 diabetes: A scoping review

Dona A Kiriella et al. EClinicalMedicine. .

Abstract

Background: Psychological complications are frequent in type 1 diabetes (T1D) but they might be difficult to distinguish one from the other in clinical practice. Our objective was to study the distinguishing characteristics, overlaps and their use in the literature between three concepts of T1D: depression, diabetes distress (DD) and diabetes burnout (DB).

Methods: A scoping review (PRISMA guidelines) performed in three databases (PubMed/MEDLINE, PsycInfo, Web of Science) with the keywords: T1D, depression, diabetes and burnout, from January 1990 to June 2021. We selected original studies with participants with T1D, which reported depression, DD, or DB. We extracted information about the concepts, their sub-concepts and screening tools.

Findings: Of the 4763 studies identified, 201 studies were included in the study. Seventy-three percent, 57% and 45% of sub-concepts do not overlap in depression, DD, and DB, respectively. We observed overlap between depression (27%)/DD (27%) and between DD (20%)/DB (50%).

Interpretation: A number of sub-concepts distinguish depression and DD. Overlaps between concepts suggest that a more precise definition is still lacking. DB is still a relatively new concept and more research is needed to better understand how it can present itself differently, in order to personalize care in comparison to those having DD.

Keywords: Depression; Diabetes burnout; Diabetes distress; Diagnostic questionnaires; Exhaustion; Fear of hypoglicaemia; Insulin pump; Psychological burden; Selfmanagement; Type 1 diabetes.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
PRISMA Flowchart. Number of records identified, included and excluded with reasons.
Fig. 2
Fig. 2
Cumulative number of studies by year of publication. The blue line shows studies in depression, the green line in diabetes distress and the salmon line in diabetes burnout.
Fig. 3
Fig. 3
Circular bar plot of concepts of depression, diabetes distress and diabetes burnout. Bar length represents the frequency of words or phrases for each concept in percentage among the 201 included studies. Words or phrases found in studies about depression, diabetes distress and diabetes burnout are in blue, green and salmon, respectively. Abbreviation: Detach.from sup.system = Detachment from support system.
Fig. 4
Fig. 4
Areas of overlap among the three concepts One sentence is common for the three concepts “Detachment from support systems”. Overlapping between depression (blue) and diabetes distress (green) is in seven more sub concepts: “Fear”, “Feeling guilty”, “Feeling of failure”, “Lonely”, “Loss of energy”, “Negative mood” and “Poor concentration”. Overlapping between diabetes distress (green) and diabetes burnout (salmon) is in five more sentences/words: “Anger”, “Burned-out”, “Frustration”, “Overwhelmed” and “Powerlessness to manage diabetes”. Twenty-two (73%), 17 (57%) and five sentences (45%) do not overlap in depression, diabetes distress and diabetes burnout, respectively.
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