Prevalence and Associated Factors of Depression among Patients with Diabetes at Jazan Province, Saudi Arabia: A Cross-Sectional Study

Prevalence and Impact of Psychological Disorders on Pharmacotherapy of Diabetic Patients in Low Resource Settings: A Prospective Assessment in Primary Healthcare Settings

Background

Prevalence of psychological disorders among individuals with diabetes is significantly higher as compared to the general population.

Aim

This study aimed to assess the prevalence and impact of psychological disorders on pharmacotherapy of diabetes patients.

Methodology

This cross-sectional study was conducted at two primary care hospitals in Pakistan from April to June 2023. The nine-item Patient Health Care Questionnaire (PHQ-9) scale was used to assess depression in the study's population, and its effects on pharmacotherapy of diabetes. Chi-square test was used to evaluate relationship between ordinal variables/categorical variables and depression whereas; Student's t-test was used to assess the relationship between numerical variables with depression.

Results

A total of 320 patients were assessed, comprising 120 (37.5%) males and 200 (62.5%) females, with a mean age of 52.5 (SD±11.8) years. The average duration of diabetes is 7.0 (SD±5.4). The average PHQ-9 score was 8.3 (SD±5.5). Depression was found to be prevalent in 43.7% of the study population. Gender (female) (p-value 0.002), advanced age (p-value 0.002), lower income (p-value 0.001), education levels (p-value 0.001), longer duration of diabetes (p-value 0.001), poor diabetes control according to BSR value (p-value 0.001), usage of injectable insulin (p-value 0.005), and concomitant diseases (p-value 0.001) were found to be independently linked with depression. Significant association was observed between depression and treatment adherence (p-value 0.0025), number of missed doses (p-value 0.045), and difficulty in diabetes management (p-value 0.0015).

Conclusion

Our study highlights significant prevalence of depression in study population and the prevalent depression negatively impacts on treatment adherence. It also revealed that depression complicates diabetes management resulting in poor medication adherence, poor diabetes control and diabetes related complications, making diabetes control more challenging and difficult.

Psychosocial and clinical factors associated with depression among diabetic patients in Amhara region comprehensive specialized hospitals, Ethiopia, 2022; a multicenter prevalence study

Background

Depression commonly coexists with diabetes leads to complications and worsens the outcome. Even though the problem affects low- and middle-income countries including Ethiopia, only a few studies have been done to show the magnitude of the problem and factors associated with it. So, the study was conducted to fill those gaps.

Objective

The main objective of this study was to assess psychosocial and clinical factors associated with depression among diabetic patients in Amhara region comprehensive specialized hospitals, Ethiopia, 2022.

Methods

A hospital-based cross-sectional study was conducted in randomly selected hospitals of Amhara region from January 7 to February 10, 2022. A total of 426 diabetic patients who were on outpatient follow-up were selected using a multistage sampling technique. A p-value of ≤0.25 in the bivariable analysis was used to select variables for the multivariable analysis. A p-value < 0.05 within a 95% confidence interval was considered to be significantly associated factors.

Result

Out of 426 interviewed diabetes patients 203 (47.7%) had depression. Moderate physical activity (AOR = 0.50, 95% CI (0.29, 0.86)). low medication adherence (AOR = 2.10, 95% CI (1.22, 3.62)), medium medication adherence (AOR = 1.78, 95% CI (1.04, 3.06)), and high social support (AOR = 0.54, 95% CI (0.33, 0.91)) were significantly associated with depression among diabetic patients.

Conclusion

The overall prevalence of depression among diabetic patients was higher than in other developing countries. Hence, special attention to preventing depression and maintaining mental illness among patients with chronic illnesses, especially diabetes should be given.

The Hidden Burden-Exploring Depression Risk in Patients with Diabetic Nephropathy: A Systematic Review and Meta-Analysis

INTRODUCTION

Diabetic nephropathy is a common complication among patients with diabetes mellitus, and it has been linked to a higher risk of depression. However, the magnitude of this association remains unclear. This study aimed to systematically review and meta-analyse the risk of depression in patients with diabetic nephropathy compared to diabetes patients without nephropathy.

METHODS

We conducted a systematic literature review, searching multiple databases from January 1964 to March 2023, and included randomized controlled trials, non-randomized controlled trials, and observational studies. We assessed the risk of bias using the Newcastle Ottawa scale for observational studies. The statistical analysis was performed using STATA version 14.2, and pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated. A total of 60 studies were included.

RESULTS

The pooled OR for the risk of depression among patients with diabetic nephropathy was 1.78 (95% CI 1.56-2.04; I² = 83%; n = 56), indicating a significantly higher risk compared to diabetes patients without nephropathy (p < 0.001). Pooling the effect size across these studies showed that the pooled OR was 1.15 (95% CI 1.14-1.16; I² = 88%; n = 32). Subgroup analyses based on the type of diabetes and study region revealed no significant differences in the pooled estimates.

CONCLUSION

This study demonstrates that patients with diabetic nephropathy have a significantly higher risk of depression compared to diabetes patients without nephropathy. These findings highlight the importance of assessing and addressing the mental health of patients with diabetic nephropathy as part of their overall healthcare management.

A Systematic Review of Chronic Diseases and Their Prevalence Among the Population of Northern Borders Province (NBP) in Saudi Arabia

Estimation of the prevalence of chronic conditions is pivotal to effective healthcare planning and management. Therefore, our objective was to systemically review previous literature about the prevalence of chronic diseases among residents of Northern Borders Province (NBP) in Saudi Arabia. The electronic search has been done using scientific databases (PubMed, Ebsco, SciFinder, and Web of Science) and search engines up to September 2021. The following main key terms: chronic disease OR chronic conditions AND prevalence AND Northern Borders Province OR Northern Borders AND Saudi Arabia were applied. Other related terms with a more specific search were done with names of the main cities in the province and the most common diseases in Saudi Arabia. Duplicates were removed electronically by Endnote and manually. Extracted data were tabulated in the literature matrix. The risk of bias and quality of included studies were assessed using the "Strengthening the Reporting of Observational Studies in Epidemiology" (STROBE) checklist. Out of 63 observational studies that were assessed for eligibility, 21 observational studies were included to synthesize the evidence. These studies were conducted on Arar (n=16), Turaif (n=2), and Rafha (n=1), while the remaining were national studies in which NBP was one of the included regions (n=2). The most frequently studied diseases were diabetes (4 records), psychological diseases (4 records), and obesity (3 records). The most prevalent disease was gastroesophageal reflux disease (GERD), with an estimated prevalence of 61% among adults in Arar city. In conclusion, although some research is conducted about chronic diseases somewhere in NBP, further studies are needed to study chronic diseases using a representative sample of the whole NBP population.

Does awareness of diabetic status increase risk of depressive or anxious symptoms? Findings from the China Multi-Ethnic cohort (CMEC) study

INTRODUCTION

People with diabetes mellitus (DM) have increased risk of depressive symptoms (DS) or anxious symptoms (AS). This study explores whether awareness of DM will contribute to prevalence of DS or AS.

METHODS

The baseline data including 81,717 adults from Southwest China was analyzed. DS and AS were assessed using PHQ-2 and GAD-2. Exposures were defined as 1) having self-reported physician diagnosis of diabetes (self-reported DM), 2) no prior diagnosis of diabetes but meeting diagnostic criteria (newly diagnosed DM), 3) having self-reported physician diagnosis or meeting criteria of non-diabetic diseases (non-diabetic patients), 4) healthy participants. Generalized linear mixed models were used to assess impact of presence and awareness of DM on DS or AS, adjusting for regional and individual related factors.

RESULTS

The prevalence of DS in self-reported DM, newly diagnosed DM, non-diabetic patient and healthy participants was 7.08 %, 4.30 %, 5.37 % and 3.17 %. The prevalence of AS was 7.80 %, 5.77 %, 6.37 % and 3.91 %. After adjusting for related factors, compared with healthy participants, self-reported DM and non-diabetic patients were associated with DS [AOR_{DS, self-reported} = 1.443(1.218,1.710), AOR_{DS, nondiabetic patients} = 1.265(1.143,1.400)], while the association between newly diagnosed DM and DS was not statistically significant. The associations between self-reported DM, newly diagnosed DM, non-diabetic patients and AS were all statistically significant.

LIMITATIONS

DS and AS were assessed through self-report and may suffer recall or information bias.

CONCLUSIONS

The association between awareness of diabetes and DS/AS suggests to pay attention to distinguish between self-reported and newly diagnosed DM and screening for DS and AS in diabetic population.

Effects of routinely collected health information system variables on the readmission of patients with type 2 diabetes

OBJECTIVES

This research explores the association between variables routinely collected in a health information system and the readmission of patients with type 2 diabetes within 30 days of discharge.

METHODS

This retrospective cohort study was conducted at King Fahd Hospital of the University (KFHU) in Al-Khobar, KSA. The study population comprised patients with type 2 diabetes who were admitted to the hospital from January 2016 to November 2016. Data were obtained from the hospital's information system at KFHU. The association between the readmission of patients with type 2 diabetes and routinely collected health information system variables such as demographics, type of diabetes, length of stay, and discharge type were analyzed.

RESULTS

A total of 497 cases met the inclusion criteria. Of these, 31 (6.2%) cases were readmitted within 30 days. Type 2 diabetes was the only variable found to be significantly associated with readmission within 30 days (χ2 (1, N = 497) = 6.116, p = 0.0134). Diabetes type (p = 0.0133) and discharge type (p = 0.0403) were the only variables that displayed significance utilizing a logistic regression model.

CONCLUSION

Overall, the routinely collected demographic, diagnostic, and administrative variables were found to be poor predictors of 30-day readmission for type 2 diabetes at the institution studied. Nonetheless, the only significant variables in the prediction of 30-day readmission were diabetes type and discharge type. To determine the predictors of readmission, it is recommended that future studies include height and weight to the routinely collected health information system variables. We also suggest that future studies be based on data collected over several years or on pooled data collected from several hospitals.

Prevalence of Depression Among Patients With Type 2 Diabetes at King Abdullah Medical City

Introduction Diabetes is one of the most common endocrine diseases worldwide. Type 2 diabetes and depression are commonly comorbid, high-prevalence, chronic disorders. Individuals with diabetes mellitus may have concurrent mental health disorders and are shown to have poorer disease outcomes. However, the evidence for clinical correlation is still unclear. Objectives To find the prevalence of depression among patients with type 2 diabetes at King Abdullah Medical City (KAMC). Materials and methods A cross-sectional observational study was conducted at KAMC in Makkah, the Kingdom of Saudi Arabia. Study participants were 267 people with type 2 diabetes (aged between 18-70 years). Those who had preexisting depression or drank alcohol, pregnant women, and postpartum women were excluded from the study. Participants' clinical and demographic data and depression assessment were obtained on phone through an interview and using the Arabic version of the Patient Health Questionnaire-9 (PHQ-9), respectively. Glycated hemoglobin (HbA1c) test results of participants were collected electronically. Results The participants' mean age was 57.88 ± 8.71 years, and 64.4% were males. Only 15.4% were current smokers and 16.9% were ex-smokers. The most common medical condition was hypertension (65.2%) and the majority (92.1%) had uncontrolled HbA1c with a mean value of 8.37 ± 1.92. Among the studied patients, 73% suffered from different degrees of depression; 36%, 19.9%, 8.6%, 5.2%, and 3.4% of the participants were suffering from minimal, mild, moderate, moderately severe, and severe depression, respectively. Only neuropathy was a significant risk factor of depression (odds ratio=2.87, 95% confidence interval=1.18-6.97, p=0.02). Conclusion Depressive symptoms are common in patients with uncontrolled type 2 diabetes who also suffer from neuropathy and retinopathy. Hypertension, cardiovascular diseases, and unhealthy diet had a significant correlation with depression.

Prevalence of Mental Health Disorders among Elderly Diabetics and Associated Risk Factors in Indonesia

This cross-sectional study aimed to explore mental health disorders (MHD) prevalence among elderly diabetics in Indonesia. Data were extracted from the 2018 national basic health survey in Indonesia (abbreviated as RISKESDAS). The survey involved households randomly selected from 34 provinces, 416 districts, and 98 cities in Indonesia, with 1,017,290 respondents. The number of subjects selected in this study was 2818 elderly diabetic subjects. MHD was determined by self-reporting assessment. Secondary data acquired from RISKESDAS 2018 data involved age, sex, urban–rural residence status, marital status, educational level, employment status, obesity, hypertension, heart disease, stroke, family history of MHD, and DM duration. Binary logistic regression with a backward stepwise method was used to analyze the risk factors related to MHD. MHD prevalence among elderly diabetics in Indonesia was 19.3%. Factors associated with MHD among elderly diabetics were being female (prevalence odds ratio (POR) = 1.64; 95% CI: 1.126–2.394), married (POR = 0.05; 95% CI: 0.031–0.084), less education (POR = 3.37; 95% CI: 1.598–10.355), and stroke (POR = 1.61; 95% CI: 1.183–2.269). MHD prevalence among elderly diabetics in Indonesia was 19.3%, suggesting that screening for psychological problems and educating elderly diabetic patients is essential. Unmarried female elderly diabetics with less education and stroke were altogether more likely to experience MHD.

Mental Distress and Associated Factors Among Hospitalized Medical-Surgical Adult Inpatients in Public Hospitals, Addis Ababa, Ethiopia, 2020: Cross-Sectional Study

BACKGROUND

Mental distress is a mental or psychological syndrome which influences the health status, treatment effectiveness, and quality of care of a hospitalized medical-surgical inpatient. It is more common in a hospital setting than in a community setting. Thus, the aim of this study was to assess the prevalence of mental distress and associated factors among hospitalized medical-surgical adult inpatients in public hospitals, Addis Ababa, Ethiopia, 2020.

METHODS

An institutional-based cross-sectional study was conducted among a total of 408 study subjects from March 1 to 30, 2020. The study participants were recruited by systematic random sampling technique and data were collected using an interviewer-administered questionnaire. The collected data were entered into EpiData 3.1 and exported to SPSS version 26 for analysis, and then binary and multiple logistic regressions were performed to check the association between dependent and independent variables.

RESULTS

The prevalence of mental distress among hospitalized medical-surgical adult inpatients in public hospitals was 53.1%. Variables of being married [AOR = 2.67; 95% CI (1.065, 6.683)], private employee [AOR = 2.21; 95% CI (1.001, 4.900)], daily laborer [AOR = 4.70; 95% CI (1.218, 18.215)], rural residence [AOR = 1.85; 95% CI (1.047, 3.264)], drinking alcohol [AOR = 1.68; 95% CI (1.025, 2.740)], previous psychiatric illness [AOR = 3.40; 95% CI (1.078, 10.737)] and comorbidity [AOR = 1.93; 95% CI (1.200, 3.094)] were found to be significantly associated with mental distress.

CONCLUSION

The prevalence of mental distress was high and being married, a private employee, daily laborer, living in a rural area, previous history of psychiatric illness, alcohol use, and comorbidity were associated with mental distress among hospitalized adult inpatients. Therefore, healthcare providers should provide special consideration to those groups of patients admitted to the hospital.

Prevalence and associated factors of depression among diabetic outpatients attending diabetic clinic at public hospitals in Eastern Ethiopia: A cross-sectional study

Introduction:

Depression is one of the most common comorbid psychiatric disorders among diabetic patients. Depression among diabetic people has led to poor treatment adherence, defective treatment outcomes, and consequently worsened quality of life. However, there is a limited study conducted to assess the magnitude and factors associated with depression among diabetic patients in Ethiopia including this study area.

Objective:

This study aimed to assess the prevalence and factors associated with depression among adult diabetic outpatients attending diabetic clinic in Eastern Ethiopia.

Methods:

An institution-based cross-sectional study was conducted among 407 adult diabetic outpatients on treatment in Ethiopia in 2020. Patient Health Questionnaire-9 was used to assess depression among randomly selected samples. Bivariate and multivariate logistic regression was fitted to identify factors associated with depression among diabetic outpatients. A p value less than 0.05 with a 95% confidence interval was considered statistically significant.

Results:

The overall prevalence of depression among diabetic outpatients was found to be 48.9% (95% confidence interval: 44.2%, 53.4%). Being female (adjusted odds ratio = 1.50, 95% confidence interval: 1.39, 2.73), Khat chewing (adjusted odds ratio = 1.88, 95% confidence interval: 1.22, 2.93), having poor and moderate social support (adjusted odds ratio = 1.79, 95% confidence interval: 1.07, 2.98 and adjusted odds ratio = 1.90, 95% confidence interval: 1.14, 3.17, respectively), taking both oral hypoglycemic agents and insulin medication (adjusted odds ratio = 1.33, 95% confidence interval: 1.13, 2.80) and duration of diabetes mellitus for more than 6 years (adjusted odds ratio = 5.40, 95% confidence interval: 3.42, 8.14) were significantly associated with depression.

Conclusion:

This study revealed a relatively high prevalence of depression in diabetic outpatients. A lesser level of social support, taking oral and insulin treatment regimes, longer duration of illness, using Khat, and being female were associated with depression among diabetic outpatients. Therefore, early screening and identification of such factors could help ameliorate some of the deleterious effects of depression in diabetic outpatients.

Psychological distress and self-management behaviours among patients with chronic hepatitis B receiving oral antiviral therapy

AIMS

To assess the prevalence and associated factors of psychological distress among patients with chronic hepatitis B receiving oral antiviral therapy and explore the association between psychological distress and self-management behaviours among this population.

DESIGN

A cross-sectional study.

METHODS

A convenience sample of 188 patients with chronic hepatitis B receiving oral antiviral therapy was recruited from March-October 2018 to complete a self-report questionnaire including the Chinese version of Depression Anxiety Stress Scale-21 and Chronic Hepatitis B Self-Management Scale. Logistic regression analysis and hierarchical multiple regression analysis were used to determine the factors associated with psychological distress and the association between psychological distress and self-management behaviours respectively.

RESULTS

The prevalence of depression, anxiety, and stress symptoms were 33.0%, 38.3% and 17.6% respectively. Depression was associated with older age, female gender, lower education level and longer treatment duration; anxiety was associated with female gender and longer treatment duration; and stress was associated with age of 31-40 years, female gender and unmarried status. There were significant associations between depression and anxiety symptoms and self-management behaviours.

CONCLUSION

Psychological distress was prevalent among patients with chronic hepatitis B receiving oral antiviral therapy and had a negative impact on self-management. Interventions targeting depression and anxiety symptoms may be beneficial to improve self-management behaviours for this population.

IMPACT

This study explored the factors associated with psychological distress in patients with chronic hepatitis B receiving oral antiviral therapy. The findings showed psychological distress was more common in patients who were with older age, female, less educated, unmarried and receiving longer duration of treatment and psychological distress was significantly associated with self-management behaviours. Nurses and other healthcare providers should provide interventions to reduce the risk of psychological distress and improve self-management behaviours for this population.

Prevalence of Depression among Type-II Diabetic Patients Attending the Diabetic Clinic at Arar National Guard Primary Health Care Center, Saudi Arabia

Background

Depression is a common comorbidity in type-II diabetic patients, which if undiagnosed leads to poor clinical outcomes.

Objectives

To determine the prevalence and risk factors of depression among type-II diabetic patients attending the National Guard Diabetic Clinic in Arar city. Subjects and methods. This cross-sectional study included every third type-II diabetic patient attending the National Guard Primary Health Care Center between the 1^st of January and 31^st of March 2019. Participants were interviewed using the Patient Health Questionnaire 9 (PHQ-9). Patients who scored ≥5 were considered to have depression. Chi-square test (χ²) was used to compare differences between categorical variables. P ≤ 0.05 was considered statistically significant.

Results

Of the total 422 diabetic patients approached for this study, 397 provided complete responses (94% response rate). Of these, 37% had depression: 23% mild, 9% moderate, and 5% severe. Diabetic patients with low education, poor income, and long duration of diabetes mellitus were found to be at higher risk of depression. Poor compliance with physical activities, diet regimen, family history of DM, and the presence of complications was also significantly associated with depression. On logistic regression analysis, low family income, duration of DM, poor compliance to physical activity, and presence of complications as neuropathy or libido were the main predictors of depression in diabetic patients.

Conclusion

More than one-third of type-II diabetic patients had depression. Regular screening of type-II diabetic patients for depression is a necessity, as it can affect the clinical outcome.