Aims To investigate the use of a short questionnaire to measure psychologic
al symptoms in a busy clinic setting, and to examine the prevalence of thes
e symptoms in adults with diabetes. The perceived need for psychological tr
eatment services was also measured.
Methods Adults (> 18 years) with either Type 1 or Type 2 diabetes were invi
ted to complete a short demographic form and the Hospital Anxiety and Depre
ssion Scale (HADS) whilst waiting for their routine diabetes outpatients ap
pointment. Complication status was measured via patients' medical records.
Glycaemic control (HbA(1c)) was also recorded.
Results A high response rate (96%) was achieved. Prevalence rates of psycho
logical symptoms were high (overall 28% of study participants reported mode
rate-severe levels of depression or anxiety or both). Men were somewhat mor
e likely to report moderate-severe depressive symptoms, whereas women repor
ted more moderate-severe anxiety. A significant association between depress
ion and poor glycaemic control was observed in the men, but not in the wome
n. Regression analysis demonstrated that the interaction between sex and gl
ycaemic control, HbA(1c) and sex were all significantly associated with dep
ression and anxiety (R-2 = 0.16 and 0.19, respectively). One-third of subje
cts reported that at the moment they would be interested in receiving couns
elling or psychotherapy if it was currently available at the diabetes clini
c.
Conclusions This study has shown that the HADS is an appropriate questionna
ire to use in a clinic setting in adults with diabetes. There may be a stro
nger association between glycaemic control and psychological symptomatology
in men than in women. There remains a significant proportion of individual
s with diabetes who require psychological support, which, if available, mig
ht help improve glycaemic control and thus overall wellbeing.