1
|
Yoon YJ. Depressive symptom trajectory of older adults with diabetes: exploring the role of physical activities using latent growth modeling. Aging Ment Health 2024; 28:1041-1049. [PMID: 38353514 DOI: 10.1080/13607863.2024.2313722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 01/25/2024] [Indexed: 06/21/2024]
Abstract
OBJECTIVES The literature highlights the role of physical activities in reducing depression, primarily in clinical samples and international longitudinal studies on older adults with diabetes. Based on Andersen's Behavioral Model, this study aims to describe the trajectory of depressive symptoms in this population and examine whether physical activities are associated with this trajectory. METHODS This study used a longitudinal survey design, utilizing three waves of data from the Health and Retirement Study. The respondents were adults aged 50 or older (N = 4,278) with diabetes. After conducting descriptive analyses, latent growth modeling was performed including unconditional and conditional models. RESULTS The overall trajectory of depressive symptoms in adults with diabetes decreased over a 4-year period. Physical activities were significantly associated with the variance in the intercept of the trajectory (p < .05), but not associated with the variance in the slope (p > .05). Additionally, this study identified factors significantly associated with the variance in the intercept (e.g. age, gender, race, marriage, education, income, self-reported health) or the slope (e.g. race, marriage, education, self-reported health) of the depressive symptom trajectory (p < .05). CONCLUSION The findings underscore the importance of implementing targeted interventions to encourage and promote physical activities among older adults with diabetes, recognizing the potential benefits for managing their mental health.
Collapse
Affiliation(s)
- Young Ji Yoon
- Department of Social Work, Colorado State University Pueblo, Pueblo, USA
| |
Collapse
|
2
|
Ter Braake JG, Fleetwood KJ, Vos RC, Blackbourn L, McGurnaghan SJ, Wild SH, Jackson CA. Cardiovascular risk management among individuals with type 2 diabetes and severe mental illness: a cohort study. Diabetologia 2024; 67:1029-1039. [PMID: 38409440 PMCID: PMC11058755 DOI: 10.1007/s00125-024-06111-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 01/09/2024] [Indexed: 02/28/2024]
Abstract
AIMS/HYPOTHESIS The aim of this study was to compare cardiovascular risk management among people with type 2 diabetes according to severe mental illness (SMI) status. METHODS We used linked electronic data to perform a retrospective cohort study of adults diagnosed with type 2 diabetes in Scotland between 2004 and 2020, ascertaining their history of SMI from hospital admission records. We compared total cholesterol, systolic BP and HbA1c target level achievement 1 year after diabetes diagnosis, and receipt of a statin prescription at diagnosis and 1 year thereafter, by SMI status using logistic regression, adjusting for sociodemographic factors and clinical history. RESULTS We included 291,644 individuals with type 2 diabetes, of whom 1.0% had schizophrenia, 0.5% had bipolar disorder and 3.3% had major depression. People with SMI were less likely to achieve cholesterol targets, although this difference did not reach statistical significance for all disorders. However, people with SMI were more likely to achieve systolic BP targets compared to those without SMI, with effect estimates being largest for schizophrenia (men: adjusted OR 1.72; 95% CI 1.49, 1.98; women: OR 1.64; 95% CI 1.38, 1.96). HbA1c target achievement differed by SMI disorder and sex. Among people without previous CVD, statin prescribing was similar or better in those with vs those without SMI at diabetes diagnosis and 1 year later. In people with prior CVD, SMI was associated with lower odds of statin prescribing at diabetes diagnosis (schizophrenia: OR 0.54; 95% CI 0.43, 0.68, bipolar disorder: OR 0.75; 95% CI 0.56, 1.01, major depression: OR 0.92; 95% CI 0.83, 1.01), with this difference generally persisting 1 year later. CONCLUSIONS/INTERPRETATION We found disparities in cholesterol target achievement and statin prescribing by SMI status. This reinforces the importance of clinical review of statin prescribing for secondary prevention of CVD, particularly among people with SMI.
Collapse
Affiliation(s)
- Jonne G Ter Braake
- Department of Public Health and Primary Care, Leiden University Medical Centre, The Hague, the Netherlands
| | | | - Rimke C Vos
- Department of Public Health and Primary Care, Leiden University Medical Centre, The Hague, the Netherlands
| | - Luke Blackbourn
- MRC Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
| | | | - Sarah H Wild
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | | |
Collapse
|
3
|
Stenov V, Willaing I, Joensen LE, Knudsen L, Andersen GS, Hansen DL, Cleal B. Which self-reported measures are useful to explore diabetes support needs among adults with diabetes and severe mental illness? Chronic Illn 2024:17423953241241762. [PMID: 38584462 DOI: 10.1177/17423953241241762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
OBJECTIVES To construct and test patient-reported outcome measures (PROMs) for identifying diabetes support needs of adults with co-existing diabetes and severe mental illness (SMI) provided by mental health professionals at psychiatric outpatient clinics. METHODS Design thinking was used to identify, select, and modify PROMs in collaboration with 18 adults with type 1 or type 2 diabetes and SMI and 10 healthcare experts. The PROMs were then tested with 86 adults with diabetes and SMI recruited from eight psychiatric outpatient clinics in Denmark. Data were analysed using systematic text condensation (questionnaire construction) and descriptive statistics (testing). RESULTS Four principles for PROMs were identified: (a) be modified to be relevant for the target group, (b) be concise and simple to complete, (c) have a clear and unambiguous wording, and (d) be designed to measure topics that are perceived as meaningful. Test of the questionnaire contained 49 items in four domains. Missing response rates in the test were 1.2-4.7% in three domains and 4.7-11.6% in a domain addressing potential sources of diabetes support. DISCUSSION PROMs can successfully be constructed in collaboration with this vulnerable population that yield low rates of missing responses.
Collapse
Affiliation(s)
- Vibeke Stenov
- Department of Prevention, Health Promotion and Community Care, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Ingrid Willaing
- Department of Prevention, Health Promotion and Community Care, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Lene Eide Joensen
- Department of Prevention, Health Promotion and Community Care, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
- Section of Health Services Research, Department of Public Health, Copenhagen University, Copenhagen, Denmark
| | - Lenette Knudsen
- Department of Education, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Gregers Stig Andersen
- Clinical Epidemiological Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Dorte Lindqvist Hansen
- Department of Diabetes Care, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Bryan Cleal
- Department of Prevention, Health Promotion and Community Care, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
| |
Collapse
|
4
|
da Silva BB, Lima MHDM, Saidel MGB. Mental health nursing care for people with diabetes mellitus: An integrative review. Rev Lat Am Enfermagem 2023; 31:e4073. [PMID: 38055591 PMCID: PMC10695291 DOI: 10.1590/1518-8345.6827.4073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 09/04/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVE evaluate the evidence available on mental health nursing care for people with diabetes mellitus at different levels of health care. METHOD integrative literature review. The search was conducted in five databases. The sample consisted of 14 studies. The studies were exported to the EndNote manager and their data to a Microsoft Excel spreadsheet. The methodological quality of the studies was evaluated using tools proposed by the Joanna Briggs Institute. Sampling, categorization, evaluation, interpretation of the results, and synthesis of the included studies were carried out by two reviewers independently. The descriptive analysis of the results is presented in three categories. RESULTS self-care guidelines enhanced by the social support network, encompassing physical and psychological tools and strategies; therapeutic communication and psychotherapy strategies, focusing on psychotherapy and therapeutic communication; and self-management interventions, addressing self-care based on behavioral theories. CONCLUSION the synthesis of knowledge revealed that guidelines for self-care enhanced by the social support network, psychotherapy and therapeutic communication strategies, and self-management interventions are positive interventions that contribute to people with mental disorders and diabetes mellitus in the prevention of diseases.
Collapse
Affiliation(s)
- Bianca Brandão da Silva
- Universidade Estadual de Campinas, Faculdade de Enfermagem, Campinas, SP, Brasil
- Becaria de la Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
| | | | - Maria Giovana Borges Saidel
- Universidade Estadual de Campinas, Faculdade de Enfermagem, Campinas, SP, Brasil
- Becaria del Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brasil
| |
Collapse
|
5
|
Camacho-Barcia L, Lucas I, Miranda-Olivos R, Jiménez-Murcia S, Fernández-Aranda F. Applying psycho-behavioural phenotyping in obesity characterization. Rev Endocr Metab Disord 2023; 24:871-883. [PMID: 37261609 PMCID: PMC10492697 DOI: 10.1007/s11154-023-09810-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/14/2023] [Indexed: 06/02/2023]
Abstract
Individual differences in obesity, beyond being explained by metabolic and medical complications, are understood by alterations in eating behaviour which underlie psychological processes. From this psychological perspective, studies have identified several potential characteristic features at the psycho-behavioural level that could additionally explain the maintenance of chronic excess weight or the unsuccessful results of current treatments. To date, despite the growing evidence, the heterogeneity of the psychological evidence associated with obesity has made it challenging to generate consensus on whether these psycho-behavioural phenotypes can be a complement to improve outcomes of existing interventions. For this reason, this narrative review is an overview focused on summarizing studies describing the psycho-behavioural phenotypes associated with obesity. Based on the literature, three psychological constructs have emerged: reward dependence, cognitive control, and mood and emotion. We discuss the clinical implications of stratifying and identifying these psycho-behavioural profiles as potential target for interventions which may ensure a better response to treatment in individuals with obesity. Our conclusions pointed out a considerable overlap between these psycho-behavioural phenotypes suggesting bidirectional interactions between them. These findings endorse the complexity of the psycho-behavioural features associated with obesity and reinforce the need to consider them in order to improve treatment outcomes.
Collapse
Affiliation(s)
- Lucía Camacho-Barcia
- Clinical Psychology Unit, University Hospital of Bellvitge, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviours Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain
| | - Ignacio Lucas
- Clinical Psychology Unit, University Hospital of Bellvitge, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviours Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain
| | - Romina Miranda-Olivos
- Clinical Psychology Unit, University Hospital of Bellvitge, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviours Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Clinical Psychology Unit, University Hospital of Bellvitge, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviours Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Fernando Fernández-Aranda
- Clinical Psychology Unit, University Hospital of Bellvitge, Barcelona, Spain.
- Psychoneurobiology of Eating and Addictive Behaviours Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain.
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
| |
Collapse
|
6
|
Lerbæk B, Jørgensen R, McCloughen A. "It's Not Important"-The Social Constructing of Poor Physical Health as 'Normal' among People with Schizophrenia: Integrated Findings from an Ethnographic Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6133. [PMID: 37372721 DOI: 10.3390/ijerph20126133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/07/2023] [Accepted: 06/10/2023] [Indexed: 06/29/2023]
Abstract
People with schizophrenia have shortened life expectancy partly due to physical ill health. Management of coexisting mental and physical health issues is complex, and knowledge in the field is lacking. This study investigated how physical health was managed among people with schizophrenia, by integrating findings from three separate analyses conducted in an ethnographic study. Qualitative data generation methods were used; 505 h of field work were undertaken among nine participants with schizophrenia and 27 mental healthcare professionals were interviewed using a semi-structured interview approach. Three separate analyses were conducted using thematic and discourse analysis. Progressive focusing was used to integrate findings. Across the mental health care contexts that were part of this research, managing physical health was characterised by a lack of recognition of the seriousness of physical health issues as part of everyday life among people with schizophrenia. Poor physical health was accounted for as being "not of importance" by both mental health care professionals and the participants experiencing physical health issues. The integrated findings offer new insights about the social co-construction of poor physical health as something normal. At the individual level, this shared understanding by people with schizophrenia and healthcare professionals contributed to sustaining inexpedient management strategies of "modifying" behaviour or "retreating" from everyday life when physical health issues were experienced.
Collapse
Affiliation(s)
- Birgitte Lerbæk
- Unit for Psychiatric Research, Psychiatry, Aalborg University Hospital, 9000 Aalborg, Denmark
| | - Rikke Jørgensen
- Unit for Psychiatric Research, Psychiatry, Aalborg University Hospital, 9000 Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark
| | - Andrea McCloughen
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| |
Collapse
|
7
|
Rønne ST, Joensen LE, Zabell V, Arnfred SM, Brown JVE, Jørgensen R. Schizophrenia and type 2 diabetes: Perceptions and understandings of illness management in everyday life. Int J Ment Health Nurs 2023; 32:893-903. [PMID: 36825444 DOI: 10.1111/inm.13135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 01/20/2023] [Accepted: 02/12/2023] [Indexed: 02/25/2023]
Abstract
People with schizophrenia and type 2 diabetes face complex challenges in daily life and the management of both illnesses is burdensome. This qualitative interview study aimed to explore perceptions and understandings of the day-to-day management of schizophrenia and type 2 diabetes. Fourteen semi-structured interviews were conducted between January 2020 and October 2021 in the participants' respective mental health clinics, in their homes or by phone. Thematic analysis led to four themes representing participants' self-management strategies and perceived challenges. The first theme showed that participants use self-learned strategies for managing schizophrenia. In contrast, they perceived type 2 diabetes self-management as governed by a set of rules and guidelines given by health professionals. The second theme showed that both psychotic and negative symptoms present challenges to diabetes management. Theme 3 illustrated that participants consider their type 2 diabetes to be a very serious illness. They worried about potential long-term consequences and expressed wishes and motivation to improve their lifestyle. The final theme showed that participants discuss challenges related to their schizophrenia with family and friends but not type 2 diabetes. In conclusion, this study highlights the importance of considering individual challenges and everyday routines when supporting this population. It underlines the need for future research to further explore the complexity of managing the illnesses and to understand the needs for treatment and support.
Collapse
Affiliation(s)
- Sabrina Trappaud Rønne
- Research Unit of Psychotherapy and Psychopathology, Region Sjaelland, Slagelse, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Lene Eide Joensen
- Health Promotion Research, Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Vicki Zabell
- Research Unit of Psychotherapy and Psychopathology, Region Sjaelland, Slagelse, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Sidse Marie Arnfred
- Research Unit of Psychotherapy and Psychopathology, Region Sjaelland, Slagelse, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Rikke Jørgensen
- Unit for Psychiatric Research, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| |
Collapse
|
8
|
Zabell V, Arnfred SM, Høgsgaard D, Gaede PH, Rønne ST, Jørgensen R. User accounts on received diabetes and mental health care in a Danish setting - An interview study. Int J Ment Health Nurs 2022; 31:1446-1456. [PMID: 35974659 PMCID: PMC9804252 DOI: 10.1111/inm.13045] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/10/2022] [Indexed: 01/05/2023]
Abstract
People with coexisting type 1 and 2 diabetes and mental illness have a higher mortality rate compared to the general population, among other reasons due to unregulated diabetes. One explanation might be the complexity of managing both conditions. In this interview study, we explored the accounts of delivered diabetes and mental health care of 16 individuals living with coexisting diabetes and mental illness in Denmark. A thematic analysis by Braun and Clarke was applied in the analysis. Some of the participants described the care for diabetes and mental illness to be inextricably linked to each other. Therefore, health care providers ought to focus and knowledge of both conditions as essential components in the care provided. The participants accounted for support needs in other settings beyond diabetes and mental health outpatient clinics, such as the family doctor, residential institutions, and community care. However, the inefficient collaboration between these health care settings is one of the barriers to supporting the participants' self-management.
Collapse
Affiliation(s)
- Vicki Zabell
- Research Unit for Psychotherapy & Psychopathology, Mental Health Service West, Copenhagen University Hospital - Psychiatry Region Zealand, Slagelse, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Sidse Marie Arnfred
- Research Unit for Psychotherapy & Psychopathology, Mental Health Service West, Copenhagen University Hospital - Psychiatry Region Zealand, Slagelse, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Ditte Høgsgaard
- Primary & eHealth care, Soroe, Denmark.,Faculty of Public Health, University of Southern Denmark, Odense, Denmark
| | - Peter Haulund Gaede
- Faculty of Public Health, University of Southern Denmark, Odense, Denmark.,Departments of 5Internal Medicine Cardiology and Endocrinology, Slagelse Hospital, Slagelse, Denmark
| | - Sabrina Trappaud Rønne
- Research Unit for Psychotherapy & Psychopathology, Mental Health Service West, Copenhagen University Hospital - Psychiatry Region Zealand, Slagelse, Denmark.,Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Rikke Jørgensen
- Unit for Psychiatric Research, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| |
Collapse
|
9
|
Nadal IP, Cliffton C, Tolani E, Achilleos S, Winkley K, Chamley M, Gaughran F, Kottegoda R, Gallo F, Ismail K. Eliciting the mechanisms of action of care navigators in the management of type 2 diabetes in people with severe mental illness: A qualitative study. Diabet Med 2022; 39:e14894. [PMID: 35635552 PMCID: PMC9543493 DOI: 10.1111/dme.14894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 05/17/2022] [Accepted: 05/25/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND People with severe mental illness and type 2 diabetes have a reduced life expectancy compared to the general population. One factor that contributes to this is the inability to provide optimal management, as the two conditions are typically managed by separate physical and mental health systems. The role of care navigators in coordinating diabetes care in people with severe mental illness may provide a solution to better management. AIM To explore the views of clinicians and people with severe mental illness and type 2 diabetes on an integrated health service model with a focus on the care navigator to identify potential mechanisms of action. DESIGN Qualitative one-to-one semi-structured interviews and part of a wider pilot intervention study. SETTING Community Mental Health Unit in South London. METHOD Topic guides explored the perspectives and experiences of both clinicians and people with severe mental illness and diabetes. Data analysis was conducted using Thematic Analysis. RESULTS From the analysis of 19 participants, five main themes emerged regarding the care navigator role: administrative service; signposting to local services; adhering to lifestyle changes and medication; engaging in social activities; further skills and training needed. The key findings from this study emphasise the benefits that the role of a care navigator has in helping people with severe mental illness to better manage their diabetes i.e. through diet, exercise medication and attending essential health check-ups. CONCLUSION This study illustrates that having a care navigator in place empowers those with severe mental illness to improve the management of their diabetes. Future research should focus on the extent to which care navigators are effective in improving specific outcomes.
Collapse
Affiliation(s)
- Iliatha Papachristou Nadal
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- Department of Non‐Communicable Disease Epidemiology, Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineLondonUK
| | - Catherine Cliffton
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Esther Tolani
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Stavria Achilleos
- Lewisham and Greenwich NHS TrustUniversity Lewisham HospitalLondonUK
| | - Kirsty Winkley
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Mark Chamley
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Fiona Gaughran
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Ruvan Kottegoda
- Lewisham and Greenwich NHS TrustUniversity Lewisham HospitalLondonUK
| | - Fidel Gallo
- South London and Maudsley NHS Foundation TrustLondonUK
| | - Khalida Ismail
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| |
Collapse
|
10
|
Burahmah J, Zheng D, Leslie RD. Adult-onset type 1 diabetes: A changing perspective. Eur J Intern Med 2022; 104:7-12. [PMID: 35718648 DOI: 10.1016/j.ejim.2022.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 04/27/2022] [Accepted: 06/03/2022] [Indexed: 11/19/2022]
Abstract
Type 1 diabetes most commonly presents in adulthood, contrary to the widely held view that it is a disease of childhood. Furthermore, a substantial proportion of cases of adult-onset type 1 diabetes does not require insulin therapy at clinical onset. Recent studies have emphasised the evidence that adult-onset type 1 diabetes is prevalent but often misclassified initially as type 2 diabetes (1, 2). In this review, we discuss that recent literature, highlighting the similarities and differences between adult-onset and childhood-onset type 1 diabetes, exploring recent debates surrounding its epidemiology and genetics, as well as expanding on important issues of diagnostic criteria for individuals presenting with adult-onset diabetes and the subsequent management once identified as having an autoimmune basis. In addition, this review looks at the psychosocial challenges faced by T1D patients and their possible management.
Collapse
Affiliation(s)
- J Burahmah
- Blizard Institute, Queen Mary, London, UK
| | - D Zheng
- Blizard Institute, Queen Mary, London, UK
| | - R D Leslie
- Blizard Institute, Queen Mary, London, UK.
| |
Collapse
|
11
|
Knudsen L, Hansen DL, Joensen LE, Wibaek R, Benros ME, Jørgensen ME, Andersen GS. Need for improved diabetes support among people with psychiatric disorders and diabetes treated in psychiatric outpatient clinics: results from a Danish cross-sectional study. BMJ Open Diabetes Res Care 2022; 10:10/1/e002366. [PMID: 35078855 PMCID: PMC8796247 DOI: 10.1136/bmjdrc-2021-002366] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 01/04/2022] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION People with psychiatric disorders have increased risk of premature death partly due to diabetes. This study aims to explore the quality of diabetes care, diabetes management, diabetes support and well-being of people with psychiatric disorders and diabetes. RESEARCH DESIGN AND METHODS A total of 107 participants aged ≥18 years with diabetes and psychiatric disorders treated at psychiatric outpatient clinics in Denmark were recruited from August 2018 to June 2019. This descriptive cross-sectional study includes data from medical records on quality of diabetes care (eg, level and annual examination of hemoglobin A1c (HbA1c)) and questionnaires on diabetes management (measured on items from the Summary of Diabetes Self-Care Activities Scale and diabetes distress based on Problem Areas in Diabetes Scale (PAID-5)), diabetes support (no, some or high support from eight potential support persons and experience of care actions measured on items from Patient Assessment of Chronic Illness Care) and well-being (WHO 5-Item Scale and self-rated general health). RESULTS The mean age was 52 years, 56% were men, the mean body mass index was 31.9 kg/m2, the median HbA1c was 53 mmol/mol (7.0%) and the mean blood pressure was 131/83 mm Hg. The proportion with annual measurements of HbA1c was 93%, blood pressure 80%, cholesterol 93%, foot examination 77% and eye examination 75%. Fifty-one per cent had high diabetes distress (PAID-5 score ≥8). Diabetologists and general practitioners (39% and 37%) were the health professionals most frequently reported to provide high diabetes support. CONCLUSIONS This study highlights a need for improved diabetes support in people with psychiatric disorders and diabetes. Although a high proportion received appropriate diabetes care, we found high levels of diabetes distress, moderate levels of optimal self-management behaviors, low well-being and low diabetes support from psychiatric health professionals, while one-third of the population found it relevant to receive diabetes support from psychiatric health professionals.
Collapse
Affiliation(s)
- Lenette Knudsen
- Education, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | | | - Lene Eide Joensen
- Diabetes Management Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Rasmus Wibaek
- Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Michael Eriksen Benros
- Biological and Precision Psychiatry, Copenhagen Research Centre for Mental Health, Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Marit Eika Jørgensen
- Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark
- Center for Health Research in Greenland, University of Southern Denmark Faculty of Health Sciences, Odense, Denmark
| | | |
Collapse
|
12
|
Lerbaek B, Jørgensen R, Buus N, Lauritsen MB, Aagaard J, Nordgaard J, McCloughen A. "Modifying" or "Retreating"- Self-management of physical health among a group of people with schizophrenia. An ethnographic study from Denmark. Int J Ment Health Nurs 2021; 30:1575-1587. [PMID: 34263516 DOI: 10.1111/inm.12907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 06/07/2021] [Accepted: 06/18/2021] [Indexed: 11/30/2022]
Abstract
The aim of this ethnographic study was to explore how a group of nine Danish people with schizophrenia managed physical health issues as they naturally occurred in everyday life. Qualitative methods were used to generate of data. Thematic analysis led to the description of two typical strategies used by participants to manage debilitating physical health issues in everyday life. Modifying everyday life to manage discomfort was a strategy employed to manage potential or actual discomfort associated with ongoing poor physical health, while retreating from everyday life to recover was a strategy used by participants who experienced recurring discrete episodes of poor physical health characterized by fast deterioration. Both management strategies were inexpedient as they failed to produce any positive progress in terms of the participants regaining health. The social context of participants' everyday life was characterized by a lack of interactions with others about their prevailing and ongoing physical health issues. Repeated use of these inexpedient strategies to manage physical health caused potential worsening rather than improvements to physical health. There is a need for future research that explores aspects of beneficial management of physical health issues among people with severe mental illness. Relevant foci of such research include enhancing self-management of physical health, active help-seeking behaviours, and opportunities to engage in interactions with others about physical health issues.
Collapse
Affiliation(s)
- Birgitte Lerbaek
- Clinic for Internal and Emergency Medicine, Aalborg University Hospital, Aalborg, Denmark.,Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.,Clinic Psychiatry South, Psychiatry, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Rikke Jørgensen
- Unit for Psychiatric Research, Psychiatry, Aalborg University Hospital, Aalborg, Denmark
| | - Niels Buus
- Relationships Australia NSW, Macquarie Park, New South Wales, Australia.,Faculty of Health, Department of Regional Health Research, University of Southern Denmark, Syddanmark, Denmark.,Faculty of Medicine and Health, Sydney Nursing School, University of Sydney, Sydney, New South Wales, Australia
| | - Marlene Briciet Lauritsen
- Psychiatry, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | | | - Julie Nordgaard
- Mental Health Center Amager, Copenhagen, Denmark.,University of Copenhagen, Copenhagen, Denmark
| | - Andrea McCloughen
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
13
|
Holt RIG, DeVries JH, Hess-Fischl A, Hirsch IB, Kirkman MS, Klupa T, Ludwig B, Nørgaard K, Pettus J, Renard E, Skyler JS, Snoek FJ, Weinstock RS, Peters AL. The management of type 1 diabetes in adults. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia 2021; 64:2609-2652. [PMID: 34590174 PMCID: PMC8481000 DOI: 10.1007/s00125-021-05568-3] [Citation(s) in RCA: 120] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) convened a writing group to develop a consensus statement on the management of type 1 diabetes in adults. The writing group has considered the rapid development of new treatments and technologies and addressed the following topics: diagnosis, aims of management, schedule of care, diabetes self-management education and support, glucose monitoring, insulin therapy, hypoglycaemia, behavioural considerations, psychosocial care, diabetic ketoacidosis, pancreas and islet transplantation, adjunctive therapies, special populations, inpatient management and future perspectives. Although we discuss the schedule for follow-up examinations and testing, we have not included the evaluation and treatment of the chronic microvascular and macrovascular complications of diabetes as these are well-reviewed and discussed elsewhere. The writing group was aware of both national and international guidance on type 1 diabetes and did not seek to replicate this but rather aimed to highlight the major areas that healthcare professionals should consider when managing adults with type 1 diabetes. Though evidence-based where possible, the recommendations in the report represent the consensus opinion of the authors. Graphical abstract.
Collapse
Affiliation(s)
- Richard I G Holt
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.
- Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
| | - J Hans DeVries
- Amsterdam UMC, Internal Medicine, University of Amsterdam, Amsterdam, the Netherlands
- Profil Institute for Metabolic Research, Neuss, Germany
| | - Amy Hess-Fischl
- Kovler Diabetes Center, University of Chicago, Chicago, IL, USA
| | - Irl B Hirsch
- UW Medicine Diabetes Institute, Seattle, WA, USA
| | - M Sue Kirkman
- University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Tomasz Klupa
- Department of Metabolic Diseases, Center for Advanced Technologies in Diabetes, Jagiellonian University Medical College, Kraków, Poland
| | - Barbara Ludwig
- University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Kirsten Nørgaard
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
- University of Copenhagen, Copenhagen, Denmark
| | | | - Eric Renard
- Montpellier University Hospital, Montpellier, France
- Institute of Functional Genomics, University of Montpellier, CNRS, Inserm, Montpellier, France
| | - Jay S Skyler
- University of Miami Miller School of Medicine, Miami, FL, USA
| | - Frank J Snoek
- Amsterdam UMC, Medical Psychology, Vrije Universiteit, Amsterdam, the Netherlands
| | | | - Anne L Peters
- Keck School of Medicine of USC, Los Angeles, CA, USA
| |
Collapse
|
14
|
The Effectiveness of Pay-for-Performance Program of Diabetes Care for Psychiatric Patients: A Regional Psychiatric Hospital Experience. Healthcare (Basel) 2021; 9:healthcare9111565. [PMID: 34828611 PMCID: PMC8624475 DOI: 10.3390/healthcare9111565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/13/2021] [Accepted: 11/15/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The Pay-for-performance (P4P) program of diabetes care has demonstrated successful outcomes in patients with type 2 diabetes. However, the effectiveness of this multidisciplinary care model for psychiatric patients has never been evaluated. The objective of this study is to examine the effectiveness of P4P program of diabetes for psychiatric patients with diabetes. METHODS This study utilized a retrospective cohort design to examine the effectiveness of P4P program of diabetes care for psychiatric patients with diabetes. The participants' HbA1c (hemoglobin A1c) data of the fourth quarter in 2018 were used as baseline value, while P4P program was not applied yet. HbA1c data of every quarter in 2019 were collected. Generalized estimating equations (GEE) was used to analyze the change of HbA1c level. RESULTS The HbA1c level increased slightly in the first quarter, and then decreased gradually since the second quarter. The HbA1c level was significantly lower in the fourth quarter after P4P program intervention (p < 0.05). CONCLUSION P4P program of diabetes care is also effective on psychiatric patients with diabetes, and this multidisciplinary care model could be encouraged and promoted for psychiatric patients with diabetes.
Collapse
|
15
|
Holt RIG, DeVries JH, Hess-Fischl A, Hirsch IB, Kirkman MS, Klupa T, Ludwig B, Nørgaard K, Pettus J, Renard E, Skyler JS, Snoek FJ, Weinstock RS, Peters AL. The Management of Type 1 Diabetes in Adults. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care 2021; 44:2589-2625. [PMID: 34593612 DOI: 10.2337/dci21-0043] [Citation(s) in RCA: 202] [Impact Index Per Article: 67.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 08/25/2021] [Indexed: 02/03/2023]
Abstract
The American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) convened a writing group to develop a consensus statement on the management of type 1 diabetes in adults. The writing group has considered the rapid development of new treatments and technologies and addressed the following topics: diagnosis, aims of management, schedule of care, diabetes self-management education and support, glucose monitoring, insulin therapy, hypoglycemia, behavioral considerations, psychosocial care, diabetic ketoacidosis, pancreas and islet transplantation, adjunctive therapies, special populations, inpatient management, and future perspectives. Although we discuss the schedule for follow-up examinations and testing, we have not included the evaluation and treatment of the chronic microvascular and macrovascular complications of diabetes as these are well-reviewed and discussed elsewhere. The writing group was aware of both national and international guidance on type 1 diabetes and did not seek to replicate this but rather aimed to highlight the major areas that health care professionals should consider when managing adults with type 1 diabetes. Though evidence-based where possible, the recommendations in the report represent the consensus opinion of the authors.
Collapse
Affiliation(s)
- Richard I G Holt
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, U.K. .,Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, U.K
| | - J Hans DeVries
- Amsterdam UMC, Internal Medicine, University of Amsterdam, Amsterdam, the Netherlands.,Profil Institute for Metabolic Research, Neuss, Germany
| | | | | | - M Sue Kirkman
- University of North Carolina School of Medicine, Chapel Hill, NC
| | - Tomasz Klupa
- Department of Metabolic Diseases, Center for Advanced Technologies in Diabetes, Jagiellonian University Medical College, Kraków, Poland
| | - Barbara Ludwig
- University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Kirsten Nørgaard
- Steno Diabetes Center Copenhagen, Gentofte, Denmark.,University of Copenhagen, Copenhagen, Denmark
| | | | - Eric Renard
- Montpellier University Hospital, Montpellier, France.,Institute of Functional Genomics, University of Montpellier, CNRS, Inserm, Montpellier, France
| | - Jay S Skyler
- University of Miami Miller School of Medicine, Miami, FL
| | - Frank J Snoek
- Amsterdam UMC, Medical Psychology, Vrije Universiteit, Amsterdam, the Netherlands
| | | | | |
Collapse
|
16
|
Balogun-Katung A, Carswell C, Brown JVE, Coventry P, Ajjan R, Alderson S, Bellass S, Boehnke JR, Holt R, Jacobs R, Kellar I, Kitchen C, Lister J, Peckham E, Shiers D, Siddiqi N, Wright J, Young B, Taylor J. Exploring the facilitators, barriers, and strategies for self-management in adults living with severe mental illness, with and without long-term conditions: A qualitative evidence synthesis. PLoS One 2021; 16:e0258937. [PMID: 34699536 PMCID: PMC8547651 DOI: 10.1371/journal.pone.0258937] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 10/10/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND People living with severe mental illness (SMI) have a reduced life expectancy by around 15-20 years, in part due to higher rates of long-term conditions (LTCs) such as diabetes and heart disease. Evidence suggests that people with SMI experience difficulties managing their physical health. Little is known, however, about the barriers, facilitators and strategies for self-management of LTCs for people with SMI. AIM To systematically review and synthesise the qualitative evidence exploring facilitators, barriers and strategies for self-management of physical health in adults with SMI, both with and without long-term conditions. METHODS CINAHL, Conference Proceedings Citation Index- Science, HMIC, Medline, NICE Evidence and PsycInfo were searched to identify qualitative studies that explored barriers, facilitators and strategies for self-management in adults with SMI (with or without co-morbid LTCs). Articles were screened independently by two independent reviewers. Eligible studies were purposively sampled for synthesis according to the richness and relevance of data, and thematically synthesised. RESULTS Seventy-four articles met the inclusion criteria for the review; 25 articles, reporting findings from 21 studies, were included in the synthesis. Seven studies focused on co-morbid LTC self-management for people with SMI, with the remaining articles exploring self-management in general. Six analytic themes and 28 sub-themes were identified from the synthesis. The themes included: the burden of SMI; living with co-morbidities; beliefs and attitudes about self-management; support from others for self-management; social and environmental factors; and routine, structure and planning. CONCLUSIONS The synthesis identified a range of barriers and facilitators to self-management, including the burden of living with SMI, social support, attitudes towards self-management and access to resources. To adequately support people with SMI with co-morbid LTCs, healthcare professionals need to account for how barriers and facilitators to self-management are influenced by SMI, and meet the unique needs of this population.
Collapse
Affiliation(s)
- Abisola Balogun-Katung
- Department of Health Sciences, University of York, York, United Kingdom
- Hull York Medical School, York, United Kingdom
| | - Claire Carswell
- Department of Health Sciences, University of York, York, United Kingdom
| | | | - Peter Coventry
- Department of Health Sciences, University of York, York, United Kingdom
| | - Ramzi Ajjan
- School of Medicine, University of Leeds, Leeds, United Kingdom
| | - Sarah Alderson
- Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - Sue Bellass
- Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - Jan R. Boehnke
- Department of Health Sciences, University of York, York, United Kingdom
- School of Health Sciences, University of Dundee, Dundee, United Kingdom
| | - Richard Holt
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Rowena Jacobs
- Centre for Health Economics, University of York, York, United Kingdom
| | - Ian Kellar
- School of Psychology, University of Leeds, Leeds, United Kingdom
| | - Charlotte Kitchen
- Department of Health Sciences, University of York, York, United Kingdom
| | - Jennie Lister
- Department of Health Sciences, University of York, York, United Kingdom
| | - Emily Peckham
- Department of Health Sciences, University of York, York, United Kingdom
| | - David Shiers
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - Najma Siddiqi
- Department of Health Sciences, University of York, York, United Kingdom
- Hull York Medical School, York, United Kingdom
| | - Judy Wright
- Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - Ben Young
- Department of Health Sciences, University of York, York, United Kingdom
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Jo Taylor
- Department of Health Sciences, University of York, York, United Kingdom
| | | |
Collapse
|
17
|
Vallis M, Tang T, Klein G. Mental Health in Diabetes: Never a Better Time. Can J Diabetes 2021; 44:453-454. [PMID: 32792100 PMCID: PMC7417161 DOI: 10.1016/j.jcjd.2020.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Michael Vallis
- Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Tricia Tang
- Department of Medicine, University of British Columbia Vancouver, British Columbia, Canada
| | - Gerri Klein
- Department of Medicine, University of British Columbia Vancouver, British Columbia, Canada
| |
Collapse
|
18
|
Romain AJ, Bernard P, Piché F, Kern L, Ouellet-Plamondon C, Abdel-Baki A, Roy MA. Mens sana in corpore sano : l’intérêt de l’activité physique auprès des jeunes ayant eu un premier épisode psychotique. SANTE MENTALE AU QUEBEC 2021. [DOI: 10.7202/1088185ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|