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Arch Hellen Med, 30(6), November-December 2013, 688-699


Diabetes mellitus and psychopathology

K. Kontoangelos,1,3 C.C. Papageorgiou,1,3 A.E. Raptis,2 P. Tsiotra,2 E. Boutati,2
G.N. Papadimitriou,1 G. Dimitriadis,2 A.D. Rabavilas,3 S.A. Raptis2,4

1First Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, "Eginition" Hospital, Athens,
2Second Department of Internal Medicine, Propedeutic Research Institute and Diabetes Center, National and Kapodistrian University of Athens, Medical School, "Attikon" University Hospital, Athens,
3Mental Health Research Institute, National and Kapodistrian University of Athens, Athens,
4Hellenic National Center for Research, Prevention and Treatment of Diabetes Mellitus and its Complications (HNDC), Athens, Greece

According to the WHO, diabetes mellitus (DM) is extremely common and is expected to take epidemic form in the coming decade. The growing numbers of patients with type 1, but especially with type 2 DM is both a serious medical problem but also a pathological entity with socio-economic implications. DM is often accompanied by neuropsychological problems, including cognitive, emotional, anxiety and psychotic disorders, and even personality disorders, and there are many indicative signs of such a correlation. DM, especially type 1, may put patients at risk of developing depressive symptoms through biological mechanisms that link the metabolic changes of the condition with changes in brain structure and function. The cognitive changes that develop after hypoglycemia are not restored until at least 40−90 min after the blood glucose has returned to normal levels. Hypoglycemia also causes mood changes, increases stress and can result in depression due to fear of a new hypoglycemic episode, influencing the behavior of patients and affecting their optimal glycemic control. Generalised anxiety disorder (GAD) has been observed in 14% of patients with DM. One of the most important stress factors is the fear of the disease process in patients with DM of both types 1 and 2. Stress may develop secondary to hyperglycemia or other complications associated with DM. A series of studies has demonstrated a high prevalence of personality disorders in patients with type 2 DM, but it has also been argued that type A personality may be one of the risk factors for its onset. Studies focusing on the control of DM in relation to aspects of personality have stressed the involvement of maladaptive personality elements in the dysregulation of DM. The interaction of DM and neuropsychological parameters has also been supported by studies that focus on the neuropsychiatric treatment and care of patients with DM.

Key words: Diabetes mellitus type, Neuropsychiatric disorders, Psychopathology.

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