Hostname: page-component-68945f75b7-qvshk Total loading time: 0 Render date: 2024-08-06T06:45:40.223Z Has data issue: false hasContentIssue false
  • English
  • Français

Diabetes Mellitus as a Model of Psychosomatic and Somatopsychic Interrelationships

Published online by Cambridge University Press:  10 April 2014

Ludvig I. Wasserman  and
Elena A. Trifonova
Ludvig I. Wasserman*
Affiliation:
V.M. Bekhterev Psychoneurological Research Institute, St.Petersburg, Russia
Elena A. Trifonova
Affiliation:
V.M. Bekhterev Psychoneurological Research Institute, St.Petersburg, Russia
*
Correspondence concerning this article should be addressed to Prof. Ludvig I.Wasserman, Head of Laboratory of Clinical Psychology of V.M. Bekhterev Psychoneurological Research Institute, 193019, St. Petersburg, ul. Bekhtereva 3, Russia. Tel: +7-812- 265-04-44 / 567-71-27. Fax: +7-812- 265-04-44. e-mail: LW@KC5566.spb.edu, wasserman@bekhterev.org
Get access Rights & Permissions [Opens in a new window]

Abstract

The article reviews research on the problem of interrelationship between different physical and psychosocial factors in type 1 diabetes mellitus (DM1). The authors consider methodological principles of health-related quality of life (HRQoL) assessment in DM1 patients and stress the need for an integrated biopsychosocial approach to the management of the disease. DM1 is a chronic metabolic disease with an absolute requirement for insulin replacement therapy. The stress-inducing nature of DM1 is associated with its unexpected and dramatic manifestation in juvenile years, life-threatening nature of severe hypo-/hyperglycaemias and long-term complications, with the burden of diabetes self-management, threat of work disability, employment and career problems etc. These features of DM1 increase the likelihood of the development of anxiety and depressive disorders, which, in turn, may negatively influence the course of diabetes and in particular, diabetes self-care. This necessitates early diagnosis of emotional and behavioral disturbances in DM1 using self-report instruments as well as clinical assessment. Evidence suggests that active problem-focused coping behavior and adequate social support promote adherence to diabetes regimes and may act as a buffer against negative effects of the disease on HRQoL in DM1 patients. The core element in the HRQoL structure is personal disease picture (as opposed by objective clinical picture) – the cognitive-affective-behavioral complex reflecting the patient's personal perception of the disease. Examination of the personal disease picture and attitude towards the ailment in DM1 patients may help to improve understanding of the mechanisms of poor adjustment. Problems in disease adjustment can be detected also by diabetes-specific HRQoL assessment. The measures of HRQoL can be applied as screening instruments useful in increasing the effectiveness of patient-provider interactions and diabetes care.

El artículo revisa la investigación del problema de la interrelación entre diferentes factores físicos y psicosociales en la diabetes melitus tipo 1 (DM1). Los autores consideran los principios de la evaluación de la calidad de vida relacionada con la salud (CVRS) en pacientes de DM1 y ponen de manifiesto la necesidad de un abordaje biopsicosocial integrado del manejo de la enfermedad. La DM1 es una enfermedad metabólica crónica con una necesidad absoluta de terapia de reemplazo de insulina. La naturaleza estresante de la DM1 se asocia con su aparición inesperada y dramática durante los años de juventud, la naturaleza peligrosa de las hipo e hiperglucemias y las complicaciones a largo plazo, con la carga del auto-cuidado de la diabetes, la amenaza de discapacidad laboral, problemas de empleo y carrera, etc. Estas características de la DM1 aumentan la probabilidad de desarrollar trastornos de ansiedad y depresivos que, a su vez, pueden afectar negativamente el curso de la diabetes y, en particular, el auto-cuidado de la diabetes. Esto requiere un diagnóstico temprano de los trastornos emocionales y comportamentales en los enfermos de DM1, empleando instrumentos de auto-informe además de la evaluación clínica. La evidencia sugiere que el comportamiento de afrontamiento activo centrado en los problemas y el apoyo social adecuado promocionan la adherencia a los regímenes diabéticos y pueden amortiguar los efectos negativos de la enfermedad en la CVRS en los pacientes con DM1. El elemento esencial en la estructura de la CVRS es el cuadro clínico personal (en contraste con el cuadro clínico objetivo)—el complejo cognitivo-afectivo-conductual que refleja la percepción personal que tiene el paciente de su enfermedad. El examen del cuadro de enfermedad personal y la actitud hacia la enfermedad en los pacientes con DM1 puede mejorar la comprensión de los mecanismos de desadaptación. Los problemas en la adaptación a la enfermedad también pueden detectarse por medio de la evaluación de la CVRS específica para la diabetes. Las medidas de CVRS pueden aplicarse como instrumentos de criba útiles para incrementar la efectividad de las interacciones paciente-cuidador y del cuidado de la diabetes.

Keywords

diabetes mellituspsychosocial factorsdisease adjustmenthealth-related quality of lifepsychological assessmentdiabetes melitusfactores psicosocialesadaptación a la enfermedadcalidad de vida relacionada con la saludevaluación psicológica
Type
Articles
Information
The Spanish Journal of Psychology , Volume 9 , Issue 1 , May 2006 , pp. 75 - 85
Copyright
Copyright © Cambridge University Press 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alexander, F. (1950). Psychosomatic medicine: Its principles and applications. New York: Norton.Google Scholar
Anderson, R.J. (1985). Is the problem of compliance all in our heads? Diabetes Education, 11, 31–34.CrossRefGoogle Scholar
Anderson, R.J., Freedland, K.E., Clouse, R.E., & Lustman, P.J. (2001). The prevalence of comorbid depression in adults with diabetes. A meta-analysis. Diabetes Care, 24, 1069–1078.CrossRefGoogle ScholarPubMed
Barrett, E.J. (2004). Diabetes epidemic is a worldwide threat. Clinical Diabetes, 22, 47–48.CrossRefGoogle Scholar
Beck, A.T., Ward, C.H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.CrossRefGoogle ScholarPubMed
Black, S.A., Markides, K.S., & Ray, L.A. (2003). Depression predicts increased incidence of adverse health outcomes in older Mexican Americans with Type 2 diabetes. Diabetes Care, 26, 2822–2828.CrossRefGoogle ScholarPubMed
Bott, U., Mühlhauser, I., Overmann, H., & Berger, M. (1998). Validation of a Diabetes-Specific Quality-of-Life Scale for patients with Type 1 diabetes. Diabetes Care, 21, 757–769.CrossRefGoogle ScholarPubMed
Boyer, J.G., & Earp, J.A. (1997). The development of an instrument for assessing the quality of life of people with diabetes. Diabetes-39. Medical Care, 35, 440–453.CrossRefGoogle ScholarPubMed
Bradley, C., Todd, C., Gorton, T., Symonds, E., Martin, A., & Plowright, R. (1999). The development of an individualized questionnaire measure of perceived impact of diabetes on quality of life: The ADDQoL. Quality of Life Research, 8, 79–91.CrossRefGoogle ScholarPubMed
Brands, A.M., Biessels, G.J., de Haan, E.H., Kappelle, L.J., & Kessels, R.P. (2005). The effects of type 1 diabetes on cognitive performance. A meta-analysis. Diabetes Care, 28, 726–735.CrossRefGoogle ScholarPubMed
Brown, S.A. (1992). Meta-analysis of diabetes patient education research: Variations in intervention effects across studies. Research in Nursing & Health, 15, 409–419.CrossRefGoogle ScholarPubMed
Carver, S.C., Scheier, F.M., & Weintrub, J.K. (1989). Assessing coping strategies: A theoretical based approach. Journal of Personality and Social Psychology, 56, 267–283.CrossRefGoogle ScholarPubMed
Ciechanowski, P.S., Katon, W.J., & Russo, J.E. (2000). Depression and diabetes: Impact of depressive symptoms on adherence, function, and costs. Archives of Internal Medicine, 160, 3278–3285.CrossRefGoogle ScholarPubMed
Clouse, R.E., Lustman, P.J., Freedland, K.E., Griffith, L.S., McGill, J.B., & Carney, R.M. (2003). Depression and coronary heart disease in women with diabetes. Psychosomatic Medicine, 65, 376–383.CrossRefGoogle ScholarPubMed
Cohen, S., & Hoberman, H.M. (1983). Positive events and social supports as buffers of life change stress. Journal of Applied Social Psychology, 13, 99–125.CrossRefGoogle Scholar
Connell, C.M., Davis, W.K., Gallant, M.P., & Sharpe, P.A. (1994). Impact of social support, social cognitive variables, and perceived threat on depression among adults with diabetes. Health Psychology, 13, 263–273.CrossRefGoogle ScholarPubMed
de Groot, M., Anderson, R.J., Freedland, K.E., Clouse, R.E., & Lustman, P.J. (2001). Association of depression and diabetes complications: a meta-analysis. Psychosomatic Medicine, 63, 619–630.CrossRefGoogle ScholarPubMed
Delamater, A.M., Jacobson, A.M., Anderson, B., Cox, D., Fisher, L., Lustman, P., Rubin, R., & Wysocki, T. (2001). Psychosocial Therapies Working Group: Psychosocial therapies in diabetes: Report of the Psychosocial Therapies Working Group. Diabetes Care, 24, 1286–1292.CrossRefGoogle Scholar
Derogatis, L.R. (1983). SCL-90-R Administration, Scoring, Procedures Manual II for the Revised Version (2nd ed). Towson, MD: Clinical Psychometric Research.Google Scholar
Dunbar, F. (1948). Psychosomatic diagnosis. New York: Harper & Row.Google Scholar
Dunn, S.R., & Turtle, J.R. (1981). The myth of the diabetic personality. Diabetes Care, 4, 640–646.CrossRefGoogle ScholarPubMed
Eaton, W.W., Armenian, H., Gallo, J., Pratt, L., & Ford, D.E. (1996). Depression and risk for onset of Type II diabetes. A prospective population-based study. Diabetes Care, 19, 1097–1102.CrossRefGoogle ScholarPubMed
Endler, N.S., & Parker, J.D.A. (1990). Coping Inventory for Stressful Situations (CISS): Manual. Toronto, Canada: Multi-Health Systems.Google Scholar
Folkman, S., & Lazarus, R. (1988). Manual for the Ways of Coping Questionnaire. Redwood City, CA: Mind Garden.Google Scholar
Glasgow, R.E., & Anderson, R.M. (1999). In diabetes care, moving from compliance to adherence is not enough. Something entirely different is needed. Diabetes Care, 22, 2090–2092.CrossRefGoogle Scholar
Glasgow, R.E., Ruggiero, L., Eakin, E.G., Dryfoos, J., & Chobanian, L. (1997). Quality of life and associated characteristics in a large national sample of adults with diabetes. Diabetes Care, 20, 562–567.CrossRefGoogle Scholar
Glasgow, R.E., Toobert, D.J., & Gillette, C.D. (2001). Psychosocial barriers to diabetes self-management and quality of life. Diabetes Spectrum, 14, 33–41.CrossRefGoogle Scholar
Goldston, D.B., Kovacs, M., Obrosky, D.S., & Iyengar, S. (1995). A longitudinal study of life events and metabolic control among youths with insulin-dependent diabetes mellitus. Health Psychology, 14, 409–414.CrossRefGoogle ScholarPubMed
Griffith, L.S., Field B.J., & Lustman, P.J. (1990). Life stress and social support in diabetes: Association with glycaemic control. International Journal of Psychiatry in Medicine, 20, 365–372.CrossRefGoogle Scholar
Grigsby, A.B., Anderson, R.J., Freedland, K.E., Clouse, R.E., & Lustman, P.J. (2002). Prevalence of anxiety in adults with diabetes: A systematic review. Journal of Psychosomatic Research, 53, 1053–1060.CrossRefGoogle ScholarPubMed
Hampson, S.E., Skinner, T.C., Hart, J., Storey, L., Gage, H., Foxcroft, D., Kimber, A., Shaw, K., & Walker, J. (2001). Effects of educational and psychosocial interventions for adolescents with diabetes mellitus: A systematic review. Health Technology Assessment, 5, 71–79.CrossRefGoogle ScholarPubMed
Harris, M.A., & Lustman, P.J. (1998). The psychologist in diabetes care. Clinical Diabetes, 16, 91–93.Google Scholar
Hathaway, S.R., & McKinley, J.C. (1951, 1967 Rev.). The Minnesota Multiphasic Personality Inventory manual. New York. Psychological Corporation.Google Scholar
Hauser, S.T., Jacobson, A.M., Lavori, P., Wolfsdorf, J.I., Herskowitz, R.D., Milley, J.E., Bliss, R., Wertlieb, D., & Stein, J. (1990). Adherence among children and adolescents with insulindependent diabetes mellitus over a 4-year follow-up. II: Immediate and long term linkages with the family milieu. Journal of Pediatric Psychology, 15, 527–542.CrossRefGoogle Scholar
Heisler, M., Bouknight, R.R., Hayward, R.A., Smith, D.M., & Kerr, E.A. (2002). The relative importance of physician communication, participatory decision making, and patient understanding in diabetes self-management. Journal of General Internal Medicine, 17, 243–252.CrossRefGoogle ScholarPubMed
Herpertz, S., Albus, C., Lohff, S., Michalski, K., Masrour, M., Lichtblau, K., Kohle, K., Mann, K., & Senf, W. (2000). Comorbidity of diabetes mellitus and eating disorders. A comparison of psychological features of eating disordered and non-eating disordered patients with diabetes mellitus [Article in German]. Psychotherapie, Psychosomatik, medizinische Psychologie, 50, 161–168.CrossRefGoogle ScholarPubMed
Jacobson, A.M., Barofsky, I., Cleary, P., & Rand, L. (1988). Reliability and validity of a diabetes quality-of-life measure for the diabetes control and complications trial (DCCT). Diabetes Care, 11, 725–732.Google Scholar
Jacobson, A.M., de Groot, M., & Samson, J.A. (1997). The effects of psychiatric disorders and symptoms on quality of life in patients with Type I and Type II diabetes mellitus. Quality of Life Research, 6, 11–20.CrossRefGoogle ScholarPubMed
Jackson, J.L., & Kroenke, K. (1999). Difficult patient encounters in the ambulatory clinic: clinical predictors and outcomes. Archives of Internal Medicine, 159, 1069–1075.CrossRefGoogle ScholarPubMed
Katon, W.J. (2003). Clinical and health services relationships between major depression, depressive symptoms, and general medical illness. Biological Psychiatry, 54, 216–226.CrossRefGoogle ScholarPubMed
Kohen, D., Burgess, A. P., Catalan, J., & Lant, A. (1998). The role of anxiety and depression in quality of life and symptom reporting in people with diabetes mellitus. Quality of Life Research, 7, 197–204.CrossRefGoogle ScholarPubMed
Korkina, M.V., & Elfimova, E.V. (2004). Psichogennosomatogennye vzaimootnosheniya pri sacharnom diabete [Psychogenic and somatic interactions in diabetes mellitus]. Zh Nevrol Psikhiatr Im SS Korsakova, 104(11), 25–28.Google Scholar
Lipowski, Z.J. (1983). Psychosocial reactions to physical illness. Canadian Medical Association Journal, 128, 1069–1072.Google ScholarPubMed
Lloyd, C.E., & Orchard, T.J. (1999). Physical and psychological well-being in adults with Type 1 diabetes. Diabetes Research and Clinical Practice, 44, 9–19.CrossRefGoogle ScholarPubMed
Luria, R.A. (1977). Vnutrennyaya kartina bolezni i iatrogennye zabolevaniya [Subjective illness picture and iatrogenic diseases] (4th ed.). Moscow: Meditzina.Google Scholar
Lustman, P.J. (1988). Anxiety disorders in adults with diabetes mellitus. Psychiatric Clinics of North America, 11, 419–432.CrossRefGoogle ScholarPubMed
Lustman, P.J., Anderson, R.J., Freedland, K.E., de Groot, M., Carney, R.M., & Clouse, R.E. (2000). Depression and poor glycaemic control: A meta-analytic review of the literature. Diabetes Care, 23, 434–442.CrossRefGoogle ScholarPubMed
Lustman, P.J., & Clouse, R.E. (2002). Treatment of depression in diabetes: Impact on mood and medical outcome. Journal of Psychosomatic Research, 53, 917–924.CrossRefGoogle ScholarPubMed
Lustman, P.J., Clouse, R.E., Ciechanowski, P.S., Hirsch, I.B., & Freedland, K.E. (2005). Depression-related hyperglycaemia in Type 1 diabetes: A mediational approach. Psychosomatic Medicine, 67, 195–199.CrossRefGoogle ScholarPubMed
Lustman, P.J., Griffith, L.S., & Clouse, R.E. (1988). Depression in adults with diabetes. Results of 5-year follow-up study. Diabetes Care, 11, 605–612.CrossRefGoogle Scholar
Meadows, K., Steen, N., McColl, E., Eccles, M., Shiels, C., Hewison, J., & Hutchinson, A. (1996). The Diabetes Health Profile (DHP): A new instrument for assessing the psychosocial profile of insulin requiring patients—development and psychometric evaluation. Quality of Life Research, 5, 242–254.CrossRefGoogle ScholarPubMed
Mollema, E.D., Snoek, F.J., Ader, H.J., Heine, R.J., & van der Ploeg, H.M. (2001). Insulin-treated diabetes patients with fear of self-injecting or fear of self-testing. Psychological comorbidity and general well-being. Journal of Psychosomatic Research, 51, 665–672.CrossRefGoogle ScholarPubMed
Mooy, J.M., de Vries, H., Grootenhuis, P.A., Bouter, L.M., & Heine, R.J. (2000). Major stressful life events in relation to prevalence of undetected type 2 diabetes: The Hoorn Study. Diabetes Care, 23, 197–201.CrossRefGoogle ScholarPubMed
Nikolaeva, V.V. (1987). Vliyanie chronicheskoy bolezni na psichiku [The influence of chronic disease on the psyche]. Moscow: Izdatelstvo MGU (Moscow State University).Google Scholar
Northam, E.A., Anderson, P.J., Werther, G.A., Warne, G.L., & Andrewes, D. (1999). Predictors of change in the neuropsychological profiles of children with Type 1 diabetes 2 years after disease onset. Diabetes Care, 22, 1438–1444.CrossRefGoogle ScholarPubMed
Peyrot, M., & McMurry, J.F. Jr. (1992). Stress buffering and glycaemic control. The role of coping style. Diabetes Care, 15, 842–846.CrossRefGoogle Scholar
Polonsky, W.H. (2000). Understanding and assessing diabetesspecific quality of life. Diabetes Spectrum, 13, 36–41.Google Scholar
Polonsky, W.H., Anderson, B.J., Lohrer, P.A., Welch, G., Jacobson, A.M., & Schwartz, C. (1995). Assessment of diabetes-specific distress. Diabetes Care, 18, 754–760.CrossRefGoogle Scholar
Polonsky, W.H., Davis, C.L., Jacobson, A.M., & Anderson, B.J. (1992). Correlates of hypoglycaemic fear in type I and type II diabetes mellitus. Health Psychology, 11, 199–202.CrossRefGoogle ScholarPubMed
Rose, M., Fliege, H., Hildebrandt, M., Schirop, T., & Klapp, B.F. (2002). The network of psychological variables in patients with diabetes and their importance for quality of life and metabolic control. Diabetes Care, 25, 35–42.CrossRefGoogle Scholar
Rubin, R.J., Altman, W.M., & Mendelson, D.N. (1994). Health care expenditures for people with diabetes mellitus. Journal of Clinical Endocrinology and Metababolism, 78, 809A–809F.CrossRefGoogle ScholarPubMed
Rubin, R.R., & Peyrot, M. (2002). Was Willis right? Thoughts on the interaction of depression and diabetes. Diabetes/Metabolism Research and Reviews, 18, 173–175.CrossRefGoogle ScholarPubMed
Rubin, R.R., Ciechanowski, P., Egede, L.E., Lin, E.H., & Lustman, P.J. (2004). Recognizing and treating depression in patients with diabetes. Current Diabetes Reports, 4, 119–125.CrossRefGoogle ScholarPubMed
Sarason, I.G., Levine, H.M., Bashman, R.B., & Sarason, B.R. (1983). Assessing social support: The Social Support Questionnaire. Journal of Personality and Social Psychology, 44, 127–139.CrossRefGoogle Scholar
Schade, D.S., & Burge, M.R. (1995). Brittle diabetes: Etiology and treatment. Advances in Endocrinology and Metabolism, 6, 289–319.Google ScholarPubMed
Schade, D.S., Eaton, R.P., Drumm, D.A., & Duckworth, W.C. (1985). A clinical algorithm to determine the etiology of brittle diabetes. Diabetes Care, 8, 5–11.CrossRefGoogle ScholarPubMed
Seiffge-Krenke, I., & Stemmler, M. (2003). Coping with everyday stress and links to medical and psychosocial adaptation in diabetic adolescents. Journal of Adolescent Health, 33(3), 180–188.CrossRefGoogle ScholarPubMed
Sieber, M., Buddeberg, C., & Wolf, C. (1991). Reliabilitat und Validitat des Zürcher Fragebogens zur Krankheitsverarbeitung (ZKV-R) [Reliability and validity of the Zurich Questionnaire of Coping with Illness]. Schweizer Archiv für Neurologie und Psychiatrtrie, 142, 553–67.Google ScholarPubMed
Skinner, T.C., & Hampson, S.E. (2001). Personal models of diabetes in relation to self-care, well-being, and glycaemic control. A prospective study in adolescence. Diabetes Care, 24, 828–833.CrossRefGoogle ScholarPubMed
Skinner, T.C., John, M., & Hampson, S.E. (2000). Social support and personal models of diabetes as predictors of self-care and well-being: a longitudinal study of adolescents with diabetes. Journal of Pediatric Psychology, 25, 257–267.CrossRefGoogle ScholarPubMed
Spielberger, C. D., Gorsuch, R. L., Lushene, T. E., Vagg, P. R., & Jacobs, G. A. (1983). Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press.Google Scholar
Surwit, R.S., & Schneider, M.S. (1993). Role of stress in the etiology and treatment of diabetes mellitus. Psychosomatic Medicine, 55, 380–393.CrossRefGoogle ScholarPubMed
Talbot, F., & Nouwen, A. (2000). A review of the relationship between depression and diabetes in adults: Is there a link? Diabetes Care, 23, 1556–1562.CrossRefGoogle ScholarPubMed
Talbot, F., Nouwen, A., Gingras, J., Belanger, A., & Audet, J. (1999). Relations of diabetes intrusiveness and personal control to symptoms of depression among adults with diabetes. Health Psychology, 18, 537–542.CrossRefGoogle ScholarPubMed
Toljamo, M., & Hentinen, M. (2001). Adherence to self-care and glycaemic control among people with insulin-dependent diabetes mellitus. Journal of Advanced Nursing, 34, 780–786.CrossRefGoogle ScholarPubMed
Wales, J.K. (1995). Does psychological stress cause diabetes? Diabetic Medicine, 12, 109–112.CrossRefGoogle ScholarPubMed
Wasserman, L.I. (1995). Psichodiagnosticheskaya shkala dlia otzenki urovnia sotzialnoy frustrirovannosty [A psychodiagnostic scale for social frustration assessment]. The Bekhterev Review of Psychiatry and Medical Psychology, 2, 113–122.Google Scholar
Wasserman, L.I., Gromov, S.A., Mikhailov, V.A., Lynnik, S.D., & Flerova, I.L. (2002). Concepts of rehabilitation and quality of life: Their continuity and differences in modern approaches. International Journal of Mental Health, 31, 24–37.CrossRefGoogle Scholar
Wasserman, L.I., Iovlev, B.V., Karpova, E.B., & Vuks, A.Ya. (2005). Psichologicheskaya diagnostika otnosheniya k bolezni [Psychological diagnosis of attitude towards disease.] St.Petersburg: V.M. Bekhterev Psychoneurological Research Institute.Google Scholar
Wasserman, L.I., & Shchelkova, O.Yu. (2004). Meditzinskaya psichodiagnostica: teoriya, praktika i obucheniye [Medical psychodiagnostics: Introduction to theory, practice and training]. Moscow, St. Petersburg: Akademia, Filologicheskiy facultet SPbGU (Saint Petersburg State University: Faculty of Philology).Google Scholar
Wasserman, L.I., & Trifonova, E.A. (2004). Quality of life and the structure of neurosis-like symptomatology in persons with insulin-dependent diabetes mellitus. International Journal of Mental Health, 33, 47–57.CrossRefGoogle Scholar
Wasserman, L.I, & Zaitsev, V.P. (Eds.) (1990). Psichologicheskaya diagnostika otnosheniya k bolezni pri nervno-psichichecskoy i somaticheskoy patologii [Psychological diagnosis of attitude towards disease in neuro-psychiatric and somatic disorders]. Leningrad: V.M. Bekhterev Psychoneurological Research Institute.Google Scholar
Wredling, R.A., Theorell, P.G., Roll, H.M., Lins, P.E., & Adamson, U.K. (1992). Psychosocial state of patients with IDDM prone to recurrent episodes of severe hypoglycaemia. Diabetes Care, 15, 518–521.CrossRefGoogle Scholar
Wrigley, M., & Mayou, R. (1991). Psychosocial factors and admission for poor glycaemic control: a study of psychological and social factors in poorly controlled insulin dependent diabetic patients. Journal of Psychosomatic Research, 35, 335–343.CrossRefGoogle ScholarPubMed
Zhang, X., Norris, S. L., Gregg, E. W., Cheng, Y. J., Beckles, G., & Kahn, H.S. (2005). Depressive symptoms and mortality among persons with and without diabetes. American Journal of Epidemiology, 161, 652–660.CrossRefGoogle ScholarPubMed
Zigmond, A.S., & Snaith, R.P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandavica, 67, 361–70.CrossRefGoogle ScholarPubMed
Zung, W.W.K. (1965). A self-rating depression scale. Archives of General Psychiatry 12, 63–70.CrossRefGoogle ScholarPubMed