Prevalence and correlates of depressive disorders in people with Type 2 diabetes: results from the International Prevalence and Treatment of Diabetes and Depression (INTERPRET‐DD) study, a collaborative study carried out in 14 countries

Aims To assess the prevalence and management of depressive disorders in people with Type 2 diabetes in different countries. Methods People with diabetes aged 18–65 years and treated in outpatient settings were recruited in 14 countries and underwent a psychiatric interview. Participants completed the Patient Health Questionnaire and the Problem Areas in Diabetes scale. Demographic and medical record data were collected. Results A total of 2783 people with Type 2 diabetes (45.3% men, mean duration of diabetes 8.8 years) participated. Overall, 10.6% were diagnosed with current major depressive disorder and 17.0% reported moderate to severe levels of depressive symptomatology (Patient Health Questionnaire scores >9). Multivariable analyses showed that, after controlling for country, current major depressive disorder was significantly associated with gender (women) (PPPPP<0.0001). The proportion of those with either current major depressive disorder or moderate to severe levels of depressive symptomatology who had a diagnosis or any treatment for their depression recorded in their medical records was extremely low and non-existent in many countries (0–29.6%). Conclusions Our international study, the largest of this type ever undertaken, shows that people with diabetes frequently have depressive disorders and also significant levels of depressive symptoms. Our findings indicate that the identification and appropriate care for psychological and psychiatric problems is not the norm and suggest a lack of the comprehensive approach to diabetes management that is needed to improve clinical outcomes

The INTERPRET-DD study of diabetes and depression: a protocol

Aim People with diabetes are at an increased risk of developing depression and other psychological disorders. However little is known about the prevalence, correlates, or care pathways in countries other than the UK and the US. A new study, the International Prevalence and Treatment of Diabetes and Depression (INTERPRET-DD) Study aims to address this dearth of knowledge and identify optimal pathways to care across the globe. Method INTERPRET-DD is a two-year longitudinal study, taking place in 16 countries’ diabetes out-patients facilities, investigating the recognition and management of depressive disorders in people with type 2 diabetes. Clinical interviews are used to diagnose depression, with clinical and other data obtained from medical records and through patient interviews. Pathways to care and the impact of treatment for previously unrecognised depression on clinical outcomes and emotional well-being are being investigated. Results Initial evidence indicates a range of pathways to care exist, with few of these based on available recommendations for treatment. Pilot data indicates that the instruments we are using to measure both symptoms and clinical diagnosis of depression are acceptable in our study population and easy to use. Conclusions Our study will increase the understanding of the impact of co-morbid diabetes and depression and identify the most appropriate (country specific) pathways via which patients receive their care. It addresses an important public health problem and lead to recommendations for best practice relevant to the different participating centres with regard to the identification and treatment of people with co-morbid diabetes and depression