There is consensus that when treating diabetes, treatment of mental illness should be a priority for patients (El-Mallakh, 2006; Goldney et al., 2004; Russel et al., 2009). suggest that prompt treatment of depression may prevent the progression of mood to suicidality and may reduce the burden of long-term diabetes related complications.
They found there was support of depression as a result of diabetes, as well as depression as a precursor to diabetes, and suggest the relationship may be bidirectional. (2009) in their review of the literature found that there is emerging data that suggest the association between diabetes and depression is in fact bidirectional, and that it cannot be conclusively said whether the higher rate of depression in diabetic patients is due to an increased rate of depression in patients with diabetes, or an increased rate of diabetes in patients with depression.
Several studies describe the link between depression and non-adherence to diabetic treatment. (2000) conducted a limited study which showed that individuals with medium to high severity depressive symptoms were less likely to adhere to a dietary treatment of diabetes and that high severity depressive symptoms were associated with a greater percentage of interruptions in the use of oral hypoglycemic therapy. (2010) also found that patients with diabetes and persistent or worsening depressive symptoms over a five year period showed significantly worse adherence to dietary and exercise regimens than patients without depression.
Egede and Ellis (2010a) agree that the coexistence of diabetes and depression is associated with decreased adherence to treatment, however in a subsequent study (2010b) they found that measures of metabolic control did not differ significantly between depressed and non-depressed patients. (2007) in a study of male veterans found that participants were most likely to have poor adherence to their diabetic medication regimen as compared to their mental health medication regimen. (2005) state that recognizing cognitive deficits in patients may be important in the development of specialized education programs for individuals with mental illness.
Patients with comorbid psychiatric disorders which influence some aspects of their self-reports of quality of life may be misunderstood by clinicians who use this information to guide therapeutic decisions (Jacobson et al., 1997).
For patients with schizophrenia, El-Mallakh (2007) found that the social and economic consequences of their mental illness interfered with the ability to access the resources for associated with significantly increased health costs (Egede & Ellis, 2010; Katon, 2008; and Unutzer et al., 2009).