Clinical Depression Versus Distress Among Patients With Type 2 Diabetes Not just a question of semantics

OBJECTIVE — We sought to determine differences between structured interviews, symptom questionnaires, and distress measures for assessment of depression in patients with diabetes. RESEARCHDESIGNANDMETHODS — We assessed 506 diabetic patients for major depressive disorder (MDD) by a structured interview (Composite International Diagnostic In-terview [CIDI]), a questionnaire for depressive symptoms (Center for Epidemiological Studies Depression Scale [CESD]), and on the Diabetes Distress Scale. Demographic characteristics, two biological variables (A1C and non-HDL cholesterol), and four behavioral management measures (kilocalories, calories of saturated fat, number of fruit and vegetable servings, and minutes of physical activity) were assessed. Comparisons were made between those with and without depression on the CIDI and the CESD. RESULTS — Findings showed that 22 % of patients reached CESD16, and 9.9 % met a CIDI diagnosis of MDD. Of those above CESD cut points, 70 % were not clinically depressed, and 34% of those who were clinically depressed did not reach CESD scores 16. Those scoring 16, compared with those16 on the CESD, had higher A1C, kilocalories, and calories of saturated fat and lower physical activity. No differences were found using the CIDI. Diabetes distress wa