Depression Screening in Diabetes Care to Improve Outcomes: Are We Meeting the Challenge?

Diabetes Educ. 2016 Oct;42(5):646-51. doi: 10.1177/0145721716662917. Epub 2016 Aug 24.


Purpose: Evidence-based guidelines recommend regular depression screening among individuals with type 2 diabetes mellitus (T2DM). The purpose of this study is to examine depression screening patterns among a primary care population with T2DM, through use of the Patient Health Questionnaire-9 (PHQ-9).

Methods: In total, 1817 patients with T2DM were analyzed through a retrospective observational study at 2 sites, a regional health center and a federally qualified health center (FQHC). The T2DM sample was divided into those with and without a major depressive disorder (MDD) diagnosis. Depression screening rates and depression severity were assessed through the PHQ-9.

Results: Both sites had higher rates of PHQ-9 screening among individuals with a history of MDD (64.82%) vs those without MDD (11.39%). Individuals from the FQHC without a history of depression had a higher mean PHQ-9 score (10.11) than those with a previous MDD diagnosis at both RHS and FQHC (7.16 and 9.85, respectively).

Conclusions: Depression screening rates among individuals with diabetes and no history of MDD were remarkably low. Patients with diabetes but no MDD diagnosis who sought health care at a FQHC clinic had more depressive symptoms than those with a history of MDD at both sites. Individuals with diabetes and who have a MDD diagnosis are much more likely to receive regular depression screening than those without MDD, which leaves a substantial proportion of patients with undetected depression. Depression screening must be enhanced for all individuals with diabetes, particularly for low-income individuals and those without a previous diagnosis of MDD.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cross-Sectional Studies
  • Depression / diagnosis*
  • Depression / psychology
  • Depressive Disorder, Major / diagnosis*
  • Depressive Disorder, Major / psychology
  • Diabetes Mellitus, Type 2 / psychology*
  • Female
  • Humans
  • Male
  • Mass Screening / methods*
  • Middle Aged
  • Primary Health Care / methods*
  • Psychiatric Status Rating Scales
  • Retrospective Studies
  • Surveys and Questionnaires