OBJECTIVES Patients with type 1 and type 2 diabetes mellitus (DM) are 2 times as predisposed to developing mood disorders, such as major depressive disorder (MDD), compared with patients without diabetes. Management of comorbid MDD and DM remains a challenge because patients often suffer from poor medication compliance, lifestyle factors and refractory depression. Integration of psychiatric care into diabetes education clinics (DECs) has been suggested as an effective method of managing the comorbid conditions. As this strategy is being implemented into clinical care, its effectiveness in practice warrants further research. METHODS A retrospective chart review of 24 patients (10 men and 14 women) followed by an integrated psychiatry-DEC in Newmarket, Ontario, Canada, between April 2016 and July 2019 was performed. Depressive symptom severity at each appointment was assessed with the Patient Health Questionnaire-9 (PHQ-9) depression rating scale. RESULTS There was no significant change in PHQ-9 depression rating scale scoring between the first and most recent appointments (paired t test, p=0.356); however, patients who had improved PHQ-9 scoring were more likely to have more clinic visits (analysis of variance, p=0.0271). A significant negative correlation was found between both number of visits (Pearson coefficient, -0.56; p=0.005) and overall time the patients were followed by DEC (Pearson coefficient, -0.42; p=0.040) and PHQ-9 score changes between the first and most recent appointments. PHQ-9 change between individual appointments also displayed a positive correlation with time between appointments (Pearson coefficient, 0.26; p=0.027). CONCLUSIONS Regular follow up in a psychiatry-DEC service might be beneficial in managing MDD symptom severity for comorbid MDD and DM.

中文翻译：

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抑郁症管理在综合精神病学 - 糖尿病教育诊所对共病抑郁症和糖尿病的疗效

目标 与没有糖尿病的患者相比，1 型和 2 型糖尿病 (DM) 患者易患情绪障碍，如重度抑郁症 (MDD)。合并 MDD 和 DM 的管理仍然是一个挑战，因为患者经常患有药物依从性差、生活方式因素和难治性抑郁症。已建议将精神科护理整合到糖尿病教育诊所 (DEC) 中作为管理合并症的有效方法。由于该策略正在实施到临床护理中，因此其在实践中的有效性值得进一步研究。方法 在 2016 年 4 月至 2019 年 7 月期间，对 24 名患者（10 名男性和 14 名女性）进行了回顾性图表审查，随后在加拿大安大略省纽马克特进行了综合精神病学-DEC。使用患者健康问卷 9 (PHQ-9) 抑郁评分量表评估每次就诊时的抑郁症状严重程度。结果 PHQ-9 抑郁量表评分在第一次和最近一次约会之间没有显着变化（配对 t 检验，p=0.356）；然而，PHQ-9 评分提高的患者更可能有更多的就诊次数（方差分析，p=0.0271）。就诊次数（Pearson 系数，-0.56；p=0.005）和患者随访 DEC（Pearson 系数，-0.42；p=0.040）和 PHQ-9 评分变化的总时间之间发现显着负相关。第一次和最近的约会。PHQ-9 个人约会之间的变化也与约会之间的时间呈正相关（Pearson 系数，0.26；p=0.027）。