Glucose and cholesterol stabilization in patients with type 2 diabetes mellitus with depressive and anxiety symptoms by problem-solving therapy in primary care centers in Mexico City

• Published in: Primary health care research & development Vol. 19; no. 1; pp. 33 - 41
• Main Authors: Villamil-Salcedo, Valerio, Vargas-Terrez, Blanca E., Caraveo-Anduaga, Jorge, González-Olvera, Jorge, Díaz-Anzaldúa, Adriana, Cortés-Sotres, José, Pérez-Ávila, Magdalena
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.01.2018
• Subjects: Anxiety; Anxiety Disorders - complications; Anxiety Disorders - psychology; Anxiety Disorders - therapy; Blood Glucose - metabolism; Cholesterol - blood; Chronic illnesses; Collaboration; Depressive Disorder - complications; Depressive Disorder - psychology; Depressive Disorder - therapy; Diabetes; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - psychology; Expenditures; Female; Humans; Longitudinal Studies; Male; Mental depression; Mental disorders; Mental health; Metabolism; Mexico; Middle Aged; Patients; Primary care; Primary Health Care - methods; Problem Solving; Psychiatric Status Rating Scales; Psychiatry; Psychotherapy; Psychotherapy - methods; Quantitative psychology; R&D; Research & development; Students; Treatment Outcome; Mexico; primary healthcare; cholesterol; diabetes mellitus; depression; glucose metabolism disorders
• ISSN: 1463-4236; 1477-1128; 1477-1128
• DOI: 10.1017/S1463423617000512

Aim The aim of this study was to determine if the problem-solving therapy (PST) helps control metabolic variables in patients with type 2 diabetes mellitus (T2DM) who show depressive and anxiety symptoms. T2DM is a chronic-degenerative multifactorial disease. It is considered one of the main public health problems in the world, and it represents an important social and economic burden. It is frequently associated with major depression and anxiety disorders, which are related with high glycated hemoglobin (HbA1c) concentrations and poor metabolic control. We initially included 123 patients diagnosed with T2DM from five primary care centers (PCC) in Mexico City. HbA1c, central glucose, and lipid profile were measured in each patient. In addition, the Kessler psychological distress scale (K-10), the Beck Depression Inventory, and the Beck Anxiety Inventory were applied at the beginning and, to those who continued, at the end of the PST, as well as four months later. Findings In total, 36 patients completed the PST and the follow-up. There was a significant decrease in depressive and anxiety symptoms (P<0.001), as well as in total cholesterol (P=0.002), HbA1c (P=0.05), and low-density lipoprotein (LDL) (P=0.022). The PST helps reduce depressive and anxiety symptoms and may help stabilize glucose and cholesterol up to four months. Further studies on this area are recommended. If our findings are confirmed, the PST could help improve the quality of life of thousands of individuals with psychiatric-metabolic co-morbidity who only visit PCC.