HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Thoolen, B. J. Articles by Rutten, G. E. Search for Related Content PubMed PubMed Citation Articles by Thoolen, B. J. Articles by Rutten, G. E. Social Bookmarking                What's this?

Psychological Outcomes of Patients With Screen-Detected Type 2 Diabetes

The influence of time since diagnosis and treatment intensity

¹ Department of Clinical and Health Psychology, Utrecht University, Utrecht, the Netherlands
² NIVEL: Netherlands Institute for Health Services Research, Utrecht, the Netherlands
³ Julius Center for Health Sciences and Primary Care, Utrecht, the Netherlands

Address correspondence and reprint requests to Bart J. Thoolen, Department of Clinical and Health Psychology, Utrecht University, P.O. Box 80.140, 3508 TC Utrecht, Netherlands. E-mail: b.j.thoolen{at}fss.uu.nl

OBJECTIVE—The objective of this study was to investigate how time since diagnosis and treatment intensity influence psychological outcomes in patients with screen-detected type 2 diabetes.

RESEARCH DESIGN AND METHODS—A 2 x 2 factorial cross-sectional design was used to examine psychological outcomes in 196 patients with screen-detected diabetes diagnosed 3–33 months previously who were receiving usual care or intensive multifactorial pharmacological treatment. Outcomes included anxiety, depression, diabetes-related distress, perceived seriousness and vulnerability, self-efficacy, and self-care. Multivariate analysis was used to examine variations in outcomes based on time since diagnosis (<1 vs. 2–3 years) and treatment intensity.

RESULTS—Most patients reported little distress, low perceived seriousness and vulnerability, high self-efficacy, and low self-care, but outcomes varied considerably across conditions. Time effects were found for perceived vulnerability, which increases significantly with time since diagnosis. Time x treatment interactions were found for anxiety, diabetes-related distress, and self-efficacy; notably, intensively treated patients showed more distress and less self-efficacy in the 1st year, and usual-care patients reported more distress and less self-efficacy 2–3 years after diagnosis.

CONCLUSIONS—Screen-detected patients generally do not experience much difficulty with their condition in the first few years, but early and intensive treatment can influence patients’ psychological outcomes, leading to relatively more anxiety and less self-efficacy in the 1st year after diagnosis but not necessarily improving self-care. This suggests that intensive treatments confront patients with their diabetes earlier on whereas milder treatments may delay confrontation. This finding should be taken into account in the development and timing of psychological interventions for patients with newly diagnosed diabetes.

Abbreviations: ADDITION, Anglo-Danish-Dutch Study of Intensive Treatment and Complication Prevention in Type 2 Diabetic Patients Identified by Screening in Primary Care • HADS, Hospital Anxiety and Depression Scale • PAID, Problem Areas in Diabetes

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?