CDE Psychosocial Aspects of Diabetes 1 — Questions and Answers
Question 1: Which validated tool is specifically designed to assess diabetes-related emotional distress?
- PHQ-9
- PAID (Problem Areas in Diabetes) scale (Correct answer)
- GAD-7
- Beck Depression Inventory
Correct answer: PAID (Problem Areas in Diabetes) scale
The PAID scale is specifically designed to measure emotional distress related to diabetes management and its burdens, making it the most appropriate tool for diabetes-specific distress.
Question 2: How does diabetes distress differ from clinical depression?
- Diabetes distress is more severe and always requires antidepressants
- Diabetes distress is specifically related to living with diabetes while depression is a psychiatric disorder with broader symptoms (Correct answer)
- Diabetes distress only occurs in type 1 diabetes
- Clinical depression resolves when blood glucose is well controlled
Correct answer: Diabetes distress is specifically related to living with diabetes while depression is a psychiatric disorder with broader symptoms
Diabetes distress is emotional burden specifically tied to the demands of diabetes management, distinct from clinical depression which is a psychiatric condition with broader symptom criteria.
Question 3: According to ADA standards, psychosocial health in people with diabetes should be assessed:
- Only at the time of initial diagnosis
- Every five years regardless of disease status
- At diagnosis, at periodic intervals, and when disease or treatment changes occur (Correct answer)
- Only when a patient explicitly reports feeling depressed
Correct answer: At diagnosis, at periodic intervals, and when disease or treatment changes occur
The ADA recommends assessing psychosocial health at diagnosis, at regular intervals, and whenever clinical or life changes occur that may impact self-management.
Question 4: A patient with type 2 diabetes scores 22 on the PHQ-9. This score indicates:
- Mild depression
- Moderate depression
- Moderately severe depression
- Severe depression (Correct answer)
Correct answer: Severe depression
PHQ-9 scores of 20–27 indicate severe depression, warranting prompt clinical attention and likely referral to a mental health professional.
Question 5: Which of the following is a recognized psychosocial barrier to effective diabetes self-management?
- High health literacy
- Strong social support network
- Fear of hypoglycemia (Correct answer)
- Access to continuous glucose monitoring
Correct answer: Fear of hypoglycemia
Fear of hypoglycemia is a significant psychosocial barrier that leads many patients to intentionally maintain higher blood glucose levels to avoid low blood sugar episodes.
Question 6: "Diabulimia" is best defined as:
- Overeating due to depression in people with diabetes
- Deliberate insulin omission or restriction to lose weight in individuals with type 1 diabetes (Correct answer)
- Binge eating disorder exclusively associated with type 2 diabetes
- Extreme carbohydrate restriction to dangerous levels
Correct answer: Deliberate insulin omission or restriction to lose weight in individuals with type 1 diabetes
Diabulimia is an eating disorder specific to type 1 diabetes in which individuals restrict insulin to purge calories through glucosuria, leading to dangerous chronic hyperglycemia.
Question 7: Research consistently shows that comorbid depression in people with diabetes is associated with:
- Improved medication adherence
- Better glycemic control outcomes
- Poorer self-management behaviors and worse health outcomes (Correct answer)
- Decreased overall healthcare utilization
Correct answer: Poorer self-management behaviors and worse health outcomes
Comorbid depression in diabetes is associated with reduced self-management adherence, worse glycemic control, increased risk of complications, and higher healthcare costs.
CDE Psychosocial Aspects of Diabetes 1
Which validated tool is specifically designed to assess diabetes-related emotional distress?