PREVALENCE OF DEPRESSION AMONG DIABETIC PATIENTS ATTENDING OUTPATIENT AND INPATIENT
DOI:
https://doi.org/10.61751/ijmmr/2.2024.06Keywords:
diabetes mellitus, glycemic control, hyperglycemia; diabetes complicationsAbstract
Diabetes mellitus is a collection of metabolic illnesses characterised by persistent hyperglycemia, resulting in consequences affecting several organ systems. Depression is a common and impactful psychosocial condition in diabetic patients, further hindering glycemic control and negatively affecting overall health outcomes. The present study investigated the depression prevalence among diabetes mellitus patients in outpatient treatment and its impact on diabetes management. This hospital-based cross-sectional observational study was conducted over 18 months. A sample of 125 diabetes mellitus patients was selected based on a 9% prevalence rate with a 5% margin of error and a 95% confidence interval. Depression was evaluated via the 9-item Patient Health Questionnaire Depression Screening Tool. Clinical evaluation comprised HbA1c, fasting plasma glucose, and postprandial glucose measurements. Statistical analysis was conducted utilising SPSS software. The study determined that 29.6% of diabetic patients were diagnosed with depression, with varying degrees of severity. Depression was associated with poorer glycemic control, evidenced by significantly higher levels of HbA1c, fasting plasma glucose, and postprandial glucose. Patients with depression also had a higher prevalence of diabetes-related complications, such as nephropathy and neuropathy. The study concluded that depression is prevalent among patients with diabetes and has a significant impact on diabetes management. The practical value of this study is that integrated care, including screening and treatment of mental disorders, is crucial to the improvement of the outcomes of diabetes patients
Received: 21.08.2024 | Revised: 01.11.2024| Accepted: 26.11.2024
References
Snoek FJ. Mental health in diabetes care. Time to step up. Front Clin Diabetes Healthc. 2022;3:1039192. DOI: 10.3389/fcdhc.2022.1039192
Yen FS, Wei JCC, Shih YH, Hsu CC, Hwu CM. Impact of individual microvascular disease on the risks of macrovascular complications in type 2 diabetes: A nationwide population-based cohort study. Cardiovasc Diabetol. 2023;22:109. DOI: 10.1186/s12933-023-01821-8
Jha BK, Sherpa ML, Imran M, Mohammed Y, Jha LA, Paudel KR, et al. Progress in understanding metabolic syndrome and knowledge of its complex pathophysiology. Diabetology. 2023;4(2):134–59. DOI: 10.3390/diabetology4020015
Akshatha S, Nayak UB. The psychological distress associated with type 2 diabetes mellitus represents an unmet need for drug discovery. Med Drug Discov. 2024;23:100196. DOI: 10.1016/j.medidd.2024.100196
Abuhegazy H, Mujairi A, Banah F, Agdi Y, Elkeshishi H, Kamel A, et al. Depression and associated risk factors among type 2 diabetic patients: A cross sectional study on a convenience sample from the diabetic center, Khamis Mushait; Saudi Arabia. Neuropsychiatr Dis Treat. 2022;18:1975–84. DOI: 10.2147/NDT.S374752
Agyekum JA, Gyamfi T, Yeboah K. Depression, poor sleep quality, and diabetic control in type 2 diabetes patients at Sunyani Regional Hospital, Ghana: A case-control study. Middle East Curr Psychiatry. 2023;30:45. DOI: 10.1186/s43045-023-00317-1
Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract. 2019;157:107843. DOI: 10.1016/j.diabres.2019.107843
Ranasinghe P, Jayawardena R, Gamage N, Sivanandam N, Misra A. Prevalence and trends of the diabetes epidemic in urban and rural India: A pooled systematic review and meta-analysis of 1.7 million adults. Ann Epidemiol. 2021;58:128–48. DOI: 10.1016/j.annepidem.2021.02.016
Carrozzino D, Patierno C, Fava GA, Guidi J. The Hamilton rating scales for depression: A critical review of clinimetric properties of different versions. Psychother Psychosom. 2020;89(3):133–50. DOI: 10.1159/000506879
The ADA’s 2022 standards of medical care in diabetes update [Internet]. [cited 2024 July 19]. Available from: https://www.niddk.nih.gov/health-information/professionals/diabetes-discoveries-practice/ada-2022-standards-of-medical-care-in-diabetes-update
PHQ-9 Patient Depression Questionnaire [Internet]. [cited 2024 July 19]. Available from: https://med.stanford.edu/fastlab/research/imapp/msrs/_jcr_content/main/accordion/accordion_content3/download_256324296/file.res/PHQ9%20id%20date%2008.03.pdf
WMA Declaration of Helsinki – Ethical Principles for Medical Research Involving Human Participants [Internet]. [cited 2024 July 19]. Available from: https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/
Omar SM, Musa IR, Idrees MB, Adam I. Prevalence of depression and associated factors among patients with type 2 diabetes mellitus in eastern Sudan. BMC Psychiatry. 2021;21:336. DOI: 10.1186/s12888-021-03357-1
Ismail M, Seif MH, Metwally N, Neshnash M, Joudeh AI, Alsaadi M, et al. Prevalence and determinants of depression among patients with Type 2 diabetes mellitus attending family medicine clinics in Qatar. Am J Med Open. 2023;9:100014. DOI: 10.1016/j.ajmo.2022.100014
Ebrahim M, Tamiru D, Hawulte B, Misgana T. Prevalence and associated factors of depression among diabetic outpatients attending diabetic clinic at public hospitals in Eastern Ethiopia: A cross-sectional study. SAGE Open Med. 2021;9. DOI: 10.1177/20503121211066244
El Mahalli AA. Prevalence and predictors of depression among type 2 diabetes mellitus outpatients in eastern province, Saudi Arabia. Int J Health Sci (Qassim). 2015; 9:119–26.
Khuwaja AK, Lalani S, Dhanani R, Azam IS, Rafique G, White F. Anxiety and depression among outpatients with type 2 diabetes: A multi-centre study of prevalence and associated factors. Diabetol Metab Syndr. 2010;2:72. DOI: 10.1186/1758-5996-2-72
Sunny AK, Khanal VK, Sah RB, Ghimire A. Depression among people living with type 2 diabetes in an urbanizing community of Nepal. PLoS One. 2019;14(6):e0218119. DOI: 10.1371/journal.pone.0218119
Paulraj S, Rajasekaran S, Mathew AC. Prevalence of depression and its associated factors in adults with diabetes mellitus: A cross-sectional study in a tertiary care centre. Adv Med Sci An Int J. 2017;4(1/2/3):1–9. DOI: 10.5121/ams.2017.4301
Khan ZD, Lutale J, Moledina SM. Prevalence of depression and associated factors among diabetic patients in an outpatient diabetes clinic. Psychiatry J. 2019;2019(1):2083196. DOI: 10.1155/2019/2083196
Anugraha A, Kantipudi SJ, Mahadevan S. Prevalence of depression among patients of type 2 diabetes mellitus without overt complications and its association with glycemic control in a Tertiary Care Center in India – a cross-sectional study. Ann Indian Psychiatry. 2023;7(3):244–50. DOI: 10.4103/aip.aip_205_22
Siddiqui S, Jha S, Waghdhare S, Agarwal NB, Singh K. Prevalence of depression in patients with type 2 diabetes attending an outpatient clinic in India. Postgrad Med J. 2014;90(1068):552–6. DOI: 10.1136/postgradmedj-2014-132593
Sekhri S, Verma A. Study of depression and its associated factors among patients of diabetes mellitus (DM) and hypertension (HTN) attending a Primary Health Center (PHC) in a rural area of New Delhi, India. Cureus. 2023;15(1):e33826. DOI: 10.7759/cureus.33826
Kamble B, Rath RS, Misra P, Rai SK, Kant S. Prevalence of depression and health related quality of life among patients with diabetes mellitus and hypertension attending a secondary care hospital in district Faridabad, Haryana. Indian J Commun Health. 2022;34(1):118–22. DOI: 10.47203/IJCH.2022.v34i01.022
Taneja N, Adhikary M, Chandramouleeswaan S, Kapoor SK. Prevalence of common mental disorders among patients with diabetes mellitus and hypertension in an urban east Delhi slum – a cross sectional study. Telangana J Psychiatry. 2015;1(1):27–31. DOI: 10.4103/2455-8559.314415
Khullar S, Dhillon H, Kaur G, Sharma R, Mehta K, Aggarwal R, et al. The prevalence and predictors of depression in type 2 diabetic population of Punjab. Community Ment Health J. 2016;52:479–83. DOI: 10.1007/s10597-015-9985-y
Albasheer OB, Mahfouz MS, Solan Y, Khan DA, Muqri MA, Almutairi HA, et al. Depression and related risk factors among patients with type 2 diabetes mellitus, Jazan area, KSA: A cross-sectional study. Diabetes Metab Syndr. 2018;12(2):117–21. DOI: 10.1016/j.dsx.2017.09.014
Aschner P, Gagliardino JJ, Ilkova H, Lavalle F, Ramachandran A, Mbanya JC, et al. High prevalence of depressive symptoms in patients with type 1 and type 2 diabetes in developing countries: Results from the international diabetes management practices study. Diabetes Care. 2021;44(5):1100–7. DOI: 10.2337/dc20-2003
Ashok VG, Ghosh SS. Prevalence of depression among hypertensive patients attending a rural health centre in Kanyakumari. Natl J Community Med. 2019;10(3):172–5.
Asefa A, Zewudie A, Henok A, Mamo Y, Nigussie T. Depression and its associated factors among diabetes mellitus patients attending selected hospitals in Southwest Ethiopia: A cross-sectional study. Psychiatry J. 2020;2020:6486030. DOI: 10.1155/2020/6486030
Bawadi H, Al-Shahwani A, Arafeh D, Al-Asmar D, Moawad J, Shi Z, et al. Depressive symptoms among patients with diabetes in Qatar: Frequency and potential determinants. Healthcare. 2021;9(3):302. DOI: 10.3390/healthcare9030302
Deischinger C, Dervic E, Leutner M, Kosi-Trebotic L, Klimek P, Kautzky A, et al. Diabetes mellitus is associated with a higher risk for major depressive disorder in women than in men. BMJ Open Diabetes Res Care. 2020;8(1):e001430. DOI: 10.1136/bmjdrc-2020-001430
Khiro MAK, Alshahrani AAS, Jabali SHY, Alyahya YAM, Alamri MM. Prevalence of depression among diabetic patients attending the Armed Forces Hospital, Southern Region, Saudi Arabia: A prospective cross-sectional study. J Family Med Prim Care. 2024;13(1):323–9. DOI: 10.4103/jfmpc.jfmpc_1174_23
Aminu AS, Chandrasekaran V, Nair S. Depression among patients with diabetes: A community-based study in South India. J Med Sci. 2017;37(6):237–44. DOI: 10.4103/jmedsci.jmedsci_118_16
Wang Y, Xu W, Mak IL, Chin WY, Yu EYT, Lam CLK, et al. Trends of clinical parameters and incidences of diabetes mellitus complications among patients with type 2 diabetes mellitus in Hong Kong, 2010-2019: A retrospective cohort study. eClinMed. 2023;60:101999. DOI: 10.1016/j.eclinm.2023.101999
Das R, Singh O, Thakurta RG, Khandakar MR, Ali SN, Mallick AK, et al. Prevalence of depression in patients with type II diabetes mellitus and its impact on quality of life. Indian J Psychol Med. 2013;35(3):284–9. DOI: 10.4103/0253-7176.119502
Andreoulakis E, Hyphantis T, Kandylis D, Iacovides A. Depression in diabetes mellitus: A comprehensive review. Hippokratia. 2012;16(3):205–14.
Maimaitituerxun R, Chen W, Xiang J, Kaminga AC, Wu XY, Chen L, et al. Prevalence of comorbid depression and associated factors among hospitalized patients with type 2 diabetes mellitus in Hunan, China. BMC Psychiatry. 2023;23(1):158. DOI: 10.1186/s12888-023-04657-4
Ciechanowski PS, Katon WJ, Russo JE. Depression and diabetes: Impact of depressive symptoms on adherence, function, and costs. Arch Intern Med. 2000;160(21):3278–85. DOI: 10.1001/archinte.160.21.3278
Lloyd CE, Roy T, Nouwen A, Chauhan AM. Epidemiology of depression in diabetes: International and cross-cultural issues. J Affect Disord. 2012;142:S22–9. DOI: 10.1016/S0165-0327(12)70005-8
Mahan SJ, Mahammad MM. Depression and associated factors among type 2 diabetics in Karbala City, Iraq: As a model of anti-depressant drugs. Int J Drug Deliv Technol. 2023;13(3):1125–30. DOI: 10.25258/ijddt.13.3.55
Sharif S, Raza MT, Mushtaq S, Afreen B, Hashmi BA, Ali MH. Frequency of depression in patients with type 2 diabetes mellitus and its relationship with glycemic control and diabetic microvascular complications. Cureus. 2019;11(7):e5145. DOI: 10.7759/cureus.5145
Reddy P, Philpot B, Ford D, Dunbar JA. Identification of depression in diabetes: The efficacy of PHQ-9 and HADS-D. Br J Gen Pract. 2010;60(575):e239–45. DOI: 10.3399/bjgp10X502128
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