Depression and Diabetes
Depression and Diabetes, edited by Katon, Maj, and Sartorius, is a 180-page book detailing the evidence-based world literature on the interaction between depression and diabetes. The volume is well written and concise and will be a benefit to clinicians (especially primary care providers, psychiatrists, endocrinologists, and nurse specialists in mental health and in diabetes) and trainees (nursing students, medical students, and resident physicians).
The text is divided into 6 chapters covering the broad topics of epidemiology, pathogenesis, medical costs, treatment, management, and sociodemographic/cultural aspects of depression and diabetes with public health implications. The public health importance of diabetes has been well established given the rapid increase in the world population experiencing diabetes. It is estimated that the "rates of depression in people with diabetes are significantly increased and are thought to be at least doubled for those with diabetes compared to those without any chronic disease" (p 2).
The chapter on epidemiology has well-written sections on the known risk factors for depression in people with diabetes and the projected risk factors for development of diabetes when depression is present. There is a discussion about glycemic control and its relationship to depressive symptomatology and a discussion about vascular comorbidity with diabetes and its potential relationship to depression. While this section is concise, the reader is provided an in-depth review of the relevant epidemiology.
The chapter on pathogenesis makes a compelling case for the positive association between depression and increased insulin resistance. The authors describe in detail the depression-diabetes link with the autonomic nervous system; the discussion concerning cardiovascular autonomic neuropathy is especially well written.
Perhaps the most compelling discussion of a public health approach to the treatment and management of depression with diabetes comes from the chapter on medical costs. This chapter should be a must read for nursing and medical students. The author notes that about 6.6% of the world’s population had diabetes in 2010, with a 50% increase expected by 2030 (p 63). The chapter is filled with impressive facts that clearly show the worldwide impact of this devastating disease pair. Importantly, the author makes a strong case for the treatment and management of depression with diabetes as being cost-effective and leading to improved outcomes. This chapter comes before the treatment chapter and provides the framework for a compelling argument to treat. The treatment chapter provides evidence-based data supporting the role of psychotherapies and pharmacotherapies for depression in patients with diabetes.
The chapter on management discusses many of the most common barriers to delivering effective treatment. Of special note is the section discussing attitudes about depression of people living in the People’s Republic of China. The authors elaborate on one barrier that many would not consider: the relationship between depression, cognitive functioning, and glycemic control.
The final chapter, on sociodemographic/cultural and public health implications, explores topics including women, late-life disease, socioeconomic status, migration, and ethnicity. The discussion about rapid modernization and acculturation provides insight into the projections for the increasing prevalence of diabetes over the next 2 decades.
Depression and Diabetes is an outstanding book that provides an impressive amount of information on a major worldwide health problem that requires concerted efforts by the global community of health providers, including health care policy makers. The book is highly recommended and is well worth the short time commitment needed to read it.
Author affiliation: Emory University School of Medicine, Atlanta, Georgia. Potential conflicts of interest: None reported.
doi:10.4088/JCP.11bk06921
© Copyright 2011 Physicians Postgraduate Press, Inc.
