INTERPRET-DD: The International Prevalence and Treatment of Diabetes and Depression Study.

Principal Investigator: Professor Cathy Lloyd (OU)
Co-investigators: Professor Norman Sartorius (Association for the Improvement of Mental Health Programmes); Professor Arie Nouwen (Middlesex University)
Focus Countries: Argentina, Bangladesh, China, Croatia, Germany, Egypt, India, Italy, Kenya, Mexico, Pakistan, Poland, Russia, Serbia, Uganda, Ukraine
Dates: 2013-present

It is now well-known that the prevalence of both diabetes and mental health problems are increasing rapidly, with a greater risk for depression in people with diabetes compared to those without. Comorbid diabetes and depression are linked to increased mortality as well as a greater risk for developing other conditions. In addition, there are extra challenges given that emotional distress may be present in people with diabetes due to difficulties with the sometimes overwhelming requirements of self-management.
Funded by the Association for the Improvement of Mental Health Programmes, the INTERPRET-DD study has been set up to investigate the prevalence of recognised and unrecognised depression (using a standardised clinical interview) in 14 different countries. Diabetes-related emotional distress, the impact on diabetic control and complications, and the care pathways that are initiated to treat co-morbid diabetes and depression are also being examined.
The research collected data from participants with type 2 diabetes treated in out-patient settings aged 18–65 years, using psychiatric assessment to diagnose major depressive disorder (MDD). The participants also completed health questions, wellbeing scales and composite stress scores.

What did the study find?

Overall, 10.6% of participants were diagnosed with current MDD and 17.0% reported moderate to severe levels of depressive symptomatology. Analysis demonstrated that those with MDD were more likely to be female, less likely to be physically active, more likely to have diabetes complications at baseline and have higher composite stress scores.
The study has shown that as well as physiological variables, psychosocial factors also pay an important role in the development of depressive symptoms, including stressful life events and diabetes-related distress. All of this has implications for practice, with the study investigators recommending a more holistic approach to diabetes care, which recognises the complex interplay of physiological and psychosocial factors.