Depression and Diabetes

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Abstract
IDENTIFICATION and effective treatment of comorbid depression increasingly is considered an essential component of high-quality clinical care of patients with chronic medical illness in the specialty medical setting. This is in response to a number of studies in specialty settings demonstrating the high prevalence of depression in the medically ill1,2 and the major adverse impact of affective illness on symptom burden, functional impairment, and self-management of illness.3-9 For example, it has been shown that, compared with nondepressed medically ill patients, those who are depressed are more likely to experience a higher burden of disease-specific symptoms10 and social and vocational impairment when controlling for severity of medical illness.9 Other researchers have shown that depression is associated with poorer adherence to medication and self-care regimens (eg, diet, exercise, and quitting smoking),11-14 potentially leading to worse medical outcomes. These factors and the propensity for depressed medical patients to utilize more health care lead to higher direct and indirect health care costs.15-17