Strengths and weaknesses of the study
depressive, psychiatric, diabetes
CHRONIC DISEASES, DISORDERS, TYPE 2 DIABETES, DISEASES, DIABETES
The strengths of this study include a 12-month follow-up in a primary healthcare environment with validated measures of HRQoL and depressive symptoms. The patients in our study were from the normal patient flow of the health centre, they were on average almost 70 years old with an average of more than two chronic diseases, representing patients of Finnish primary care. The number of patients was considerably high, and the dropout rate was low. The study was implemented in the everyday work in the health centre and consisted of patients with common chronic diseases treated in primary care. There are some limitations of this study that need to be acknowledged. We did not know the exact duration of the diseases although the patients were in regular follow-up due to their chronic diseases. In Finland, almost all adult patients followed up in primary care with diabetes have type 2 diabetes. Therefore, in the present study type of diabetes was not specified which can be regarded as a limitation. The study protocol did not include the diagnostic procedure to define definite psychiatric disorders. The reason to refuse to participate in the study was not known, so we did not know if the refused patients differed from those who participated and it is possible that the participants were more interested in taking care of themselves than patients not participating. Although the patients seemed to be quite representative of primary care patients, the study was conducted in one health centre, which means one must be cautious in generalizing these results.