Unraveling the concepts of distress, burnout, and depression in type 1 diabetes: A scoping review

Dona A Kiriella; Sumaiya Islam; Olutobi Oridota; Nancy Sohler; Coralie Dessenne; Carine de Beaufort; Guy Fagherazzi; Gloria A Aguayo

doi:10.1016/j.eclinm.2021.101118

Unraveling the concepts of distress, burnout, and depression in type 1 diabetes: A scoping review

EClinicalMedicine. 2021 Aug 28:40:101118. doi: 10.1016/j.eclinm.2021.101118. eCollection 2021 Oct.

Authors

Dona A Kiriella¹, Sumaiya Islam¹, Olutobi Oridota¹, Nancy Sohler¹, Coralie Dessenne², Carine de Beaufort^{3

4}, Guy Fagherazzi⁵, Gloria A Aguayo⁵

Affiliations

¹ Community Health and Social Medicine Department, CUNY School of Medicine, New York, NY, United States.
² Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg.
³ Department of Paediatric Diabetes and Endocrinology, Paediatric Clinic, Hospital Centre of Luxembourg, Luxembourg, Luxembourg.
⁴ Department of Paediatric Endocrinology. Free University Brussels, UZ-VUB, Brussels, Belgium.
⁵ Deep Digital Phenotyping Research Unit, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg.

Abstract

Background: Psychological complications are frequent in type 1 diabetes (T1D) but they might be difficult to distinguish one from the other in clinical practice. Our objective was to study the distinguishing characteristics, overlaps and their use in the literature between three concepts of T1D: depression, diabetes distress (DD) and diabetes burnout (DB).

Methods: A scoping review (PRISMA guidelines) performed in three databases (PubMed/MEDLINE, PsycInfo, Web of Science) with the keywords: T1D, depression, diabetes and burnout, from January 1990 to June 2021. We selected original studies with participants with T1D, which reported depression, DD, or DB. We extracted information about the concepts, their sub-concepts and screening tools.

Findings: Of the 4763 studies identified, 201 studies were included in the study. Seventy-three percent, 57% and 45% of sub-concepts do not overlap in depression, DD, and DB, respectively. We observed overlap between depression (27%)/DD (27%) and between DD (20%)/DB (50%).

Interpretation: A number of sub-concepts distinguish depression and DD. Overlaps between concepts suggest that a more precise definition is still lacking. DB is still a relatively new concept and more research is needed to better understand how it can present itself differently, in order to personalize care in comparison to those having DD.

Keywords: Depression; Diabetes burnout; Diabetes distress; Diagnostic questionnaires; Exhaustion; Fear of hypoglicaemia; Insulin pump; Psychological burden; Selfmanagement; Type 1 diabetes.