Abstract
In diabetes mellitus, which is a common lifestyle-related disease, environmental factors such as overeating, obesity, lack of exercise and stress, are closely related to development of the disease, as are genetic factors. Thus, medical treatment for diabetes places a great deal of more emphasis on diet therapy and exercise therapy. However, it is difficult to get patients to adhere to treatment due to the fact that they have few symptoms at the early stages of the disease. Therefore, psychosocial and behavioral interventions are considered essential parts of the process of providing the motivation needed to change a patient's behavior in order to improve their habits and subsequently to maintain these behavioral changes. Intervention involves a complicated regimen of treatment and progression of the diabetic complications. It is important to first understand the psychological aspects and the social factors associated with an individual's background so that these approaches may function smoothly in a clinical setting. Questionnaires are used to assess anxiety, depression and alexithimia, as well as hypoglycemic fear, which is peculiar to diabetes. Furthermore, in stress related diabetes, life satisfaction, social support, self-esteem, behavior stress coping, and eating behavior were all studied. The authors were involved in a liaison-consultation system, in which the physician, psychiatrist, and psychologist all played a key role in making this system work effectively in a clinical setting. Patients who had been judged to require counseling by an internist or from the results of a questionnaire focusing on psychosocial issues, were assessed to determine if they had a psychiatric disorder and thus to require medication and continuous counseling. The counseling was held in a consultation room established next to the physician's office. Compliance with psychological intervention was excellent, and a tendency for an improvement in glycemic control was seen during the liaison session. Psychological and behavioral intervention in the treatment of patients with diabetes is thought to be effective for increasing adherence to treatment and thus in achieving good glycemic control. The relationship between patients and families and also between patients and the medical personnel was believed to be important.
