Comorbid major depressive disorder (MDD) occurs frequently in diabetes mellitus and is associated with high symptom burden, disability and costs. Effective treatments are available but persons with diabetes with comorbid MDD are generally under-detected. A survey showed that comorbid MDD should be identified in a systematic way, such as by screening.
Aim
To identify and describe possible strategies to screen for MDD in persons with diabetes.
Method
After a survey exploring patients’ needs, a description of best practice is provided based on a review of the literature and clinical experience.
Results
Valid instruments for screening are the Center for Epidemiological Studies-Depression Scale (CES-D), the Beck Depression Inventory (BDI), and the Patient Health Questionnaire (PHQ-9). Research shows that screening and informing patients and physicians about comorbid MDD in diabetes is inadequate and more intensive treatment as follow-up is needed to change treatment and outcomes. Screening should identify patients willing and able to follow treatment if comorbid MDD is detected and should be followed by a stepwise approach to tailor treatment to patient need and ability.
Conclusion
Screening is best performed in a clinical setting, not by mail, and may be achieved by healthcare professionals using a collaborative care model.
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