Illness perceptions and explanatory models in patients with type 2 diabetes and co-morbid depression.

This proposal relates to two important global health challenges: type 2 Diabetes Mellitus (DM) and depression. We believe the proposed work will lead to important insights into understanding patients’ thoughts, assumptions and beliefs about type 2 DM and depression and inform future treatment.

Patients’ thoughts, assumptions and beliefs are collectively referred to as cognitions. In the Common Sense Model of illness patient’s cognitions are categorised as: illness identity (the role of and attitude towards an illness), cause, timeline, consequences and control/cure. Existing research suggests that the Common Sense Model is applicable to a range of long term diseases and could provide a useful framework for developing future treatments. Patients’ illness cognitions are central to behaviour. Therefore patient’s cognitions about DM, particularly when associated with depression, will likely impact on diagnosis, treatment and recommended lifestyle modifications (including diet, exercise and medication).

We believe patients with DM will have DM-specific cognitions while patients with DM and depression may have additional depression-specific cognitions. The difference in cognitions may require different management approaches. We believe by modifying patients’ DM-specific cognitions their ability to self-manage their condition will increase; this includes making behavioural changes related to the treatment. Also, targeting depression-specific cognitions (when present) may improve self-management.

We will explore patient cognitions and illness models of DM by interviewing a wide range of patients with DM. These will be recruited from GP Practices and other specialist care services. Interviews will be audio-recorded, typed up and analysed by the research team who have expertise in this area. A questionnaire designed to help us understand patient’s thoughts, assumptions and beliefs will also be used. We will work closely with a patient advisory group to help support the research team deliver the study, and advise on publicising the results of the study to a lay and a clinical audience.