[Patients with diabetes mellitus: psychosocial stress and use of psychosocial support: a multicenter study].

Background: In a multicenter study the association of psychosocial stress and the use of psychosocial support in patients with diabetes mellitus was evaluated.

Patients And Method: In a sample of 410 patients with diabetes mellitus (Type I: n 157, Type II: n = 253) stress in different facets of daily life was assessed using the revised Questionnaire on Stress in Patients with Diabetes (QSD-R). Self-constructed items were used to assess the use of psychosocial support during the course of the illness. Diabetics with a mean global stress score above standard deviation were defined as extremely handicapped and compared to the less handicapped sample.

Results: Extreme psychosocial stress could be found in 68 diabetics (16.6%). Not the type of diabetes but the use of insulin within the Type-II diabetic sample revealed an impact on psychosocial stress. Diabetics with extreme psychosocial stress showed worse diabetic control compared to less stressed diabetics. Profiles of psychosocial stress showed maximal stress with regard to depression in both types of diabetes; this was followed by fear of hypoglycemia in the sub-sample of Type I and physical complaints in the sub-sample of Type-II diabetics. Family members, primary care physicians and diabetologists were the main sources of psychosocial support.

Conclusion: A considerable number of diabetic patients suffers from extreme psychosocial stress often associated with poor diabetic control. These patients need psychosocial care which should primarily be offered in diabetologic centers incorporating both the patients' family and family background.