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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Psychiatric disorder and sub-threshold psychological distress were more common in 113 young men and women with insulin-dependent diabetes living in a defined area than in comparable general population samples. Twelve per cent of men and 19% of women were classified by the PSE as psychiatric 'cases'. Forty per cent of women and 47% of men reported at least one major social problem; effects of diabetes on everyday activities were common. There were associations between medical and social variables. The clinical implications are discussed.
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PMID:Psychiatric morbidity in young adults with insulin-dependent diabetes mellitus. 194 52

This study examined the relationship between symptoms of psychiatric morbidity and health problems among a nationally representative, cross-sectional sample of 2107 black adults from the National Survey of Black Americans. Subjects experiencing a high level of psychiatric symptomatology had a significantly higher number of health problems and reported a lower level of satisfaction with their overall health than blacks with low levels of psychiatric symptoms or those who never experienced emotional problems. Individuals with the highest level of psychiatric symptomatology were more likely to have been physician-diagnosed as having ulcers, hypertension, diabetes, kidney problems, nervous-emotional problems, and circulatory system difficulties. These relationships persisted after controlling for age, gender, socioeconomic factors, and traditional risk factors for health problems, such as smoking and alcohol use. Although generally consistent with previous research on predominantly white samples, these specific findings underscore the complexities involved in drawing inferences from associations between psychiatric symptomatology and health problems observed in cross-sectional surveys. Prospective psychiatric epidemiologic studies, utilizing better measures of psychological distress and objective health outcome measures, are needed to clarify the relationship between psychiatric difficulties and health problems among black Americans.
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PMID:Psychiatric morbidity and health problems among black Americans: a national survey. 269 55

The self-reported physical and mental health of 315 persons caring for a spouse who had been diagnosed with Alzheimer's disease or a related disorder was compared with general population norms for existing data bases controlling for age and gender. Results suggest that across all indicators of mental health, spouse caregivers are more depressed, express higher levels of negative affect, are more likely to use psychotropic drugs, and have more symptoms of psychological distress than the general population. In terms of physical health, caregivers report higher than expected rates of diabetes, arthritis, ulcers, and anemia, yet they use medical services at rates which are similar or lower than those reported by the general population. Since no simultaneous control group was studied, these results suggest, but do not prove, the presence of differences between caregivers and non-caregivers.
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PMID:Caregiving spouses. Physical and mental health in perspective. 275 54

The aim of the study was to assess psychological contributors or correlates of sexual dysfunction in diabetic men. The study was conducted on 40 diabetic men and 40 age-matched healthy volunteers. The subjects underwent a psychosexual interview with their sexual partners and had a comprehensive medical evaluation to rule out the confounding effects of other illnesses or medications. Psychiatric, psychological and marital information was obtained with the Schedule for Affective Disorders and Schizophrenia (SADS-L), the SCL-90-R, the Derogatis Sexual Function Inventory, the Locke-Wallace Marital Adjustment test and the Dyadic Adjustment Inventory. Compared to controls, diabetic patients had significantly lower levels of erotic drive, sexual arousal, enjoyment and satisfaction. Problems in these areas coexisted with alterations in sexual attitudes and body image but were not related to group differences in marital adjustment as reported separately by the patients and their partners. There was no evidence that psychological distress or psychiatric disorders are associated with diabetes or with its effects on sexual function.
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PMID:Diabetes, psychological function and male sexuality. 763 74

This study was carried out to determine whether levels of physical activity of patients with various chronic diseases are associated with subsequent functioning and well-being. It was an observational 2-year longitudinal design. The setting was offices of medical and mental health practices within health maintenance organizations, large multispecialty groups, and solo practices or small single-specialty group practices in three U.S. cities. Included in the study were 1758 adult patients with one or more of the following: diabetes, hypertension, congestive heart failure, recent myocardial infarction, depressive symptoms, or current depressive disorder. Outcome measures included physical, role, and functioning; energy/fatigue; pain intensity; sleep problems; depressed affect, anxiety, positive affect, and overall psychological distress/well-being; health distress; and current health perceptions. Cross-sectional (base-line), 2-year endpoint, and change score relationships were evaluated between baseline levels of physical activity and each outcome, controlling for chronic conditions, comorbidity, smoking, alcohol use, overweight, self-reported adherence, and other patient and study characteristics. Higher baseline levels of exercise were uniquely associated with better functioning and well-being at baseline and 2 years later for some measures. The magnitude of the differences varied by disease group, but tended to be between 0.17 and 0.39 of the baseline SD. Greater levels of exercise are associated with feeling and functioning better for patients with chronic conditions over a 2-year period, suggesting that this is a fruitful area for further study using controlled interventions.
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PMID:Long-term functioning and well-being outcomes associated with physical activity and exercise in patients with chronic conditions in the Medical Outcomes Study. 772 85

Psychological status, including depressive symptoms, anxiety, and mastery, was measured in a community-based sample of 3,076 persons aged 55 to 85 with various chronic diseases. Strong, linear associations were found between the number of chronic diseases and depressive symptoms and anxiety, indicating that psychological distress among elderly people is more apparent in the presence of (more) diseases. Furthermore, in contrast to general assumptions that mastery is a relatively stable state, our results indicate that mastery is affected by having chronic diseases. The 8 groups of chronically ill patients (with cardiac disease, peripheral atherosclerosis, stroke, diabetes, lung disease, osteoarthritis, rheumatoid arthritis, or cancer) did differ in their associations with psychological distress. Psychological distress is most frequently experienced by patients with osteoarthritis, rheumatoid arthritis, and stroke, whereas diabetic and cardiac patients appear to be the least psychologically distressed. Differences in disease characteristics, such as functional incapacitation and illness controllability, may partly explain these observed psychological differences across diseases.
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PMID:Psychological status among elderly people with chronic diseases: does type of disease play a part? 880 61

Recently, a new diabetes-specific questionnaire, the Diabetes Health Profile (DHP), has been developed to identify psychosocial dysfunctioning of insulin-requiring (NIDDM) and insulin-dependent diabetes mellitus (IDDM) patients. The DHP comprises three dimensions: psychological distress (PSY: 14 items), barriers to activity (BAR: 12 items) and disinhibited eating (EAT: five items). This study investigates the psychometric properties of the DHP in Dutch non-insulin-dependent diabetes mellitus (NIDDM) patients referred for insulin therapy. In addition, the relationship between patient characteristics and the DHP outcome was examined. The factor structure found was similar but not identical to former studies, but construct validity was supported by high correlations of our factor structure and the original factor outcome and Cronbach's alpha. The three factors explained 32% of the variance, supporting earlier findings. It was shown that Cronbach's alpha was satisfactory (0.72, 0.72 and 0.79). Convergent validity showed strong and significant correlations between the PSY/BAR dimensions and predicted corresponding scales of the RAND-36. However, the PSY/BAR dimensions also showed, although less strong, significant correlations with the non-corresponding RAND-36 scales. The EAT dimension showed only correlations with two of the RAND-36 dimensions, thus measuring a different trait. Regression analysis showed that older patients had less problems with items of the EAT dimension and that no difference was found between men and women, supporting earlier findings. The hyperglycaemic complaint "fatigue' gave a significantly lower score (more problems) on the PSY and BAR dimensions. Younger age, the presence of hypertension and retinopathy resulted in a significantly lower score on the EAT dimension. DHP outcome was not significantly influenced by duration of diabetes, HbA1c (indicator of glycemic control), serum total cholesterol, body mass index, chronic diabetes complications and co-morbidity. Overall, the psychometric properties were good considering the small and diverse sample, suggesting that the DHP is promising for use in NIDDM patients, although more study is necessary in a larger sample.
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PMID:The validity and reliability of the Diabetes Health Profile (DHP) in NIDDM patients referred for insulin therapy. 884 Aug 23

Examined the initial impact and subsequent adjustment to the diagnosis of insulin-dependent diabetes mellitus (IDDM). Children between 1 and 14 years of age and their families were assessed several weeks after diagnosis and again a year later using standardized measures of child behavior, parental mental health, and family functioning. Immediately after diagnosis, the children and both parents exhibited mild symptoms of psychological distress but these had largely resolved at 12-month follow-up. The impact of IDDM diagnosis on family functioning varied with informant, SES, and the age of the child, with an overall tendency for families to become less flexible over the year. Findings suggest that most children and their parents exhibit satisfactory individual adjustment after a period of initial stress but family functioning is affected in complex ways. Serial follow-up of the cohort is planned to establish whether the current findings are predictive of longer term outcome.
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PMID:Psychosocial and family functioning in children with insulin-dependent diabetes at diagnosis and one year later. 893 98

The association between physical and psychological disorders has been demonstrated repeatedly. There are a number of explanations for this association, each of them pointing to specific diseases and operationalizations of mental distress. In this article, the relationship between various somatic diseases and a number of indices for psychological distress was investigated. Within one study population, patients with different somatic diseases were identified, and their experience with mental distress, their requests for help from their GP during consultations, and their GPs' diagnoses were registered and compared with the total study population: It appears that relationships could be demonstrated between experience of distress and presentation of psychological symptoms during consultations, on the one hand, and common physical disorders, on the other. Patients with neurological diseases (Parkinson's, epilepsy, multiple sclerosis) and gastric ulcers showed the same relationships, but were also more frequently diagnosed by the GP as having psychological disorders. Patients with a number of other serious somatic diseases, such as diabetes, cancer, and arthritis, did not distinguish themselves in a positive way on one of indices for psychological distress.
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PMID:Somatic disease and psychological disorder. 913 Jan 83

Self-completion instruments assessing subjective health are increasingly being used to measure patient outcome. However, there is very little evidence as yet of existing instruments' responsiveness to change. This paper describes a study to evaluate the responsiveness to change of a self-completion instrument for the measurement of clinical outcome in patients with diabetes. A prospective follow-up study of 48 patients with non-insulin-dependent diabetes commencing insulin therapy was carried out, with assessments at baseline (i.e. pre-intervention), 6 weeks and 3 months post-intervention. The outcome measures used were the changes in scores on the self-completion instrument for symptom level, physical function, energy, depression, psychological distress and barriers to activity, HbA1c, non-fasting serum cholesterol and the body mass index (BMI). There were significant improvements in HbA1c and non-fasting serum cholesterol and worsening of the BMI, as expected. The self-completion instrument detected significant improvements in patient-reported symptoms within 6 weeks of the intervention (p < 0.01) and in energy levels (p < 0.05). There is evidence from this study of the self-completion instrument's ability to respond to change and it has potential for use in evaluative studies.
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PMID:A new self-completion outcome measure for diabetes: is it responsive to change? 929 Mar 7


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