Healthy Coping, Negative Emotions, and Diabetes Management

A Systematic Review and Appraisal

Edwin B. Fisher, PhD, Carolyn T. Thorpe, MPH, PhD, Brenda McEvoy DeVellis, PhD and Robert F. DeVellis, PhD

From the Department of Health Behavior and Health Education, School of Public Health, University of North Carolina at Chapel Hill (Dr Fisher, Dr DeVellis, Dr DeVellis), and the Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, North Carolina (Dr Thorpe).

Correspondence to Edwin B. Fisher, PhD, Department of Health Behavior and Health Education, School of Public Health, University of North Carolina at Chapel Hill, Rosenau Hall, CB #7440, Chapel Hill, NC 27599-7440 (fishere@email.unc.edu).

Purpose

The purpose of this systematic review is to assess the literature pertinent to healthy coping in diabetes management and to identify effective or promising interventions and areas needing further investigation.

Methods

A PubMed search identified 186 articles in English published between January 1, 1990, and July 31, 2006, addressing diabetes and emotion, quality of life, depression, adjustment, anxiety, coping, family therapy, behavior therapy, psychotherapy, problem solving, couples therapy, or marital therapy.

Results

Connections among psychological variables, behavioral factors, coping, metabolic control, and quality of life are appreciable and multidirectional. Interventions for which well-controlled studies indicate benefits for quality of life and/or metabolic control include general self-management, coping/problem-solving interventions, stress management, support groups, cognitive-behavioral therapy, behavioral family systems therapy, cognitive-analytic therapy, multisystemic therapy, medications for depression, and the Pathways intervention integrating case management, support of medication, and problem-solving counseling.

Conclusions

Psychological, emotional, related behavioral factors, and quality of life are important in diabetes management, are worthy of attention in their own right, and influence metabolic control. A range of interventions that achieve benefits in these areas provide a base for developing versatile programs to promote healthy coping.

Link to full-text version of the review in The Diabetes Educator journal