Unconscious loss processing in diabetes: associations with medication adherence and quality of care

Abstract

Recent psychodynamic research hypothesises a connection between diabetes adaptation and the feeling of loss and damage enacted by such a chronic disease. This study aims at exploring the associations between damaged ego-related strategies in persons with diabetes and: 1) age, gender, type and duration of diabetes, and related treatment, 2) depressive symptoms, 3) indicators of adherence and quality of care. A convenience sample of 109 persons (56% female; n = 61 with type 2 diabetes) with a mean age of 56.12 years (SD = 15.30) was enrolled. Participants completed measures of damaged ego-related strategies (empathic identification, mania, frustration, destructiveness) (PET), depression (BDI-II), self-care (SDSCA), medication adherence (Morisky Scale) and quality of care (Score-Q index). Linear multiple stepwise regressions and Pearson’s correlations were performed. Age was negatively associated with empathic identification (β = .317, p < .01) and positively with destructiveness (β = .323, p < .01). Depressive symptoms negatively correlated with empathic identification (r = −.34, p < .01). Moreover, medication adherence was associated with higher empathic identification (r = .22, p < .05) and lower mania (r = −.30, p < .01), while quality of care was negatively associated with destructiveness (r = −.25, p < .05). Overall, a successful loss processing seems promising in lowering depression and non-adherence in persons with diabetes. Specifically, the need for psychological support for older persons is advocated.

Keywords:

• psychodynamic
• adherence
• diabetes
• quality of care
• depression

Acknowledgements

We would like to thank all the participants to the study who dedicated their time to complete all the measures with patience and dedication. Also, we thank the physicians and the nurses who helped us to make the administration possible.

Disclosure statement

No potential conflict of interest was reported by the authors.