No Substantial Psychological Impact of the Diagnosis of Type 2 Diabetes Following Targeted Population Screening: The Hoorn Screening Study

Adriaanse MC, Snoek FJ, Dekker JM, Spijkerman AM, Nijpels G, Twisk JW, Van Der Ploeg HM, Heine RJ. Diabet Med. 2004;21:992-998.

The purpose of this study was to determine the impact of the diagnosis of type 2 diabetes on 2 factors: psychological well-being and perceived health status. There have been very few studies on the psychological impact of a diagnosis of diabetes, and this is the first published study of its kind conducted in Europe.

The study population of 259 subjects consisted of 116 individuals with newly diagnosed type 2 diabetes and 143 nondiabetic individuals. Study subjects were recruited from a large Dutch screening project, in which 11,679 subjects (50 to 75 years of age) were invited to participate in a targeted screening for type 2 diabetes. In addition to screening for type 2 diabetes using the Symptom Risk Questionnaire (SRQ), participants’ psychological well-being and perceived health status were assessed using the 12-item Well-Being Questionnaire (W-BQ12) and the Medical Outcomes Study Short Form 36 (SF-36), administered prior to diagnosis, and 2 weeks, 6 months, and 12 months after diagnosis.

The results of both the W-BQ12 and SF-36 showed no significant mean differences between subjects who had been diagnosed with diabetes and nondiabetic subjects at 2 weeks and 12 months. At 6 months, subjects with diabetes had lower scores (indicating poorer health) for 2 of 8 dimensions of the SF-36 questionnaire, compared with nondiabetic subjects: Role Physical (mean difference [95% CI]; -8.2 [-16.2; -0.1]; P=0.046) and Role Emotional (-7.9 [-15.3; -0.5]; P=0.038). These findings were not statistically significant at 12 months.

This study showed there is no substantial impact of a diagnosis of type 2 diabetes on psychological well-being or perceived health status up to 1 year after diagnosis in patients identified in a targeted population screening. Possible explanations for this are that perceived quality of life may be related to the occurrence of diabetes-related complications in type 2 diabetes rather than initial diagnosis, or may be influenced by the way in which a diagnosis is communicated to patients by a physician, which was not documented in this study. More generally, this study shows that when using targeted population screening for type 2 diabetes, consideration of psychological impact is not required.