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Abualhamael SA, Baig M, Alghamdi W, Gazzaz ZJ, Al-Hayani M, Bazi A. Quality of life, stress, anxiety and depression and associated factors among people with type 2 diabetes mellitus in Western region Saudi Arabia. Front Psychiatry 2024; 14:1282249. [PMID: 38288058 PMCID: PMC10823007 DOI: 10.3389/fpsyt.2023.1282249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/28/2023] [Indexed: 01/31/2024] Open
Abstract
Introduction The objective of this study is to evaluate the quality of life (QoL), depression, anxiety, and stress, along with associated factors among individuals with diabetes in Saudi Arabia. Methods This survey was conducted at King Abdulaziz University (KAU), Jeddah, Kingdom of Saudi Arabia (KSA). The assessment of depression, anxiety, and stress related to Type 2 Diabetes Mellitus (T2DM) was conducted using the DASS-21 questionnaire, while diabetes-related QoL was evaluated using the revised version of the diabetes QoL questionnaire (RV-DQoL13). Data were analyzed using SPSS-26. Results A total of 251 subjects were included in the study (165 [65.7%] males and 86 [34.3%] females, mean age 50.1 ± 14.5 years). The individuals with DM had a mean value of QoL of 29.16 ± 9.23, with 46.9% having poor QoL. Furthermore, in dimensions of QoL, almost half of the individuals reported high worry about the disease (49.6%), followed by a high diabetes impact (46.6%) and low life satisfaction (42.9%). The prevalence of depression, anxiety, and stress was 49.4, 71.7, and 49.8%, respectively. A significant correlation was found between depression, anxiety, and stress and DASS-21 scores with QoL (p < 0.001). The regression analysis indicated an association of distinct factors with QoL like age above 41 years (p = 0.004), being married (p < 0.001), being divorced (p = 0.04), higher education (p = 0.007), regular medicine intake (p = 0.01), regular exercise (p = 0.03), lipid profile (p = 0.01), HbA1c (p < 0.001), and DASS-21 scores (p < 0.001). Poor QoL score (TQoL score > 27) was significantly associated with depression, anxiety, and stress (p < 0.001). The participants with higher monthly income, shorter disease duration, regular medicine use, and altered lipid profile, and older subjects had a lower chance of depression, anxiety, and stress. Conclusion Approximately half of individuals with T2DM experienced poor QoL, while the prevalence rates for depression, anxiety, and stress were 49.4, 71.7, and 49.8%, respectively. Scores in the domains of impact, worry, and satisfaction were below optimal levels. Several factors were linked to QoL and depression, anxiety, and stress, and an association was observed between DASS-21 scores and QoL.
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Affiliation(s)
| | - Mukhtiar Baig
- Department of Clinical Biochemistry, Faculty of Medicine, Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Waleed Alghamdi
- Department of Psychiatry, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Zohair Jamil Gazzaz
- Department of Internal Medicine, Faculty of Medicine, Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Majid Al-Hayani
- Department of Internal Medicine, Faculty of Medicine, Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdulrahman Bazi
- Department of Internal Medicine, Faculty of Medicine, Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
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Sodhi B, Malik M, Agarwal P, Basu S. The prevalence and predictors of depression and disability in older adults and elderly patients with Diabetes in India: Cross-sectional analysis from the Longitudinal Study on Ageing. Diabetes Metab Syndr 2023; 17:102765. [PMID: 37086626 DOI: 10.1016/j.dsx.2023.102765] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 04/08/2023] [Accepted: 04/12/2023] [Indexed: 04/24/2023]
Abstract
AIM Depression is associated with multiple comorbidities, such as Diabetes Mellitus (DM), especially in the geriatric population. Elderly patients having depression-DM comorbidity are more likely to experience disabilities in daily activities (IADL/ADL). The study objective was to determine the prevalence and predictors of depression in elderly patients with DM in India and also report the prevalence of IADL/ADL (Activities of daily living/Instrumental activities of daily living) disabilities in depressed and non-depressed subgroups of patients with DM. METHODS We analyzed the Longitudinal Ageing Study in India (LASI) survey (2017-2018), focusing on individuals aged 45 years and older after excluding those with cognitive impairment. The effective sample size for this study was 66,606. RESULTS Findings indicate that 15.48% of participants had depression while 12.96% (95% CI: 11.04, 15.17) were comorbid for depression and DM. Amongst patients with DM, the prevalence of depression comorbidity was 19.89% (95% CI:16.92, 23.24). On adjusted analysis among patients with DM, urban residence compared to rural, and the availability of financial support was protective against the onset of depression while multimorbidity was a risk factor. CONCLUSIONS Depressive symptoms in the elderly especially with DM comorbidity are linked to a high burden of poor ADL and IADL. Sensitization of the community towards providing support to the elderly and early screening for IADL/ADL disabilities in depression-DM comorbid patients should be prioritized.
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Affiliation(s)
- Baani Sodhi
- Indian Institute of Public Health- Delhi, Public Health Foundation of India, New Delhi, India
| | - Mansi Malik
- Indian Institute of Public Health- Delhi, Public Health Foundation of India, New Delhi, India
| | | | - Saurav Basu
- Indian Institute of Public Health- Delhi, Public Health Foundation of India, New Delhi, India.
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Bassi S, Nazar GP, Joshi N, Sharma N, Pandian A, Deepa M, Mohan S, Patel SA, Ali MK, McNeill A, Tandon N, Mohan V, Prabhakaran D, Arora M. Anxiety and depression among adult tobacco users during the COVID-19 restrictions in India. Front Psychiatry 2022; 13:964949. [PMID: 36081465 PMCID: PMC9445265 DOI: 10.3389/fpsyt.2022.964949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
Background The world witnessed a highly contagious and deadly disease, COVID-19, toward the end of 2019. India is one of the worst affected countries. We aimed to assess anxiety and depression levels among adult tobacco users and people who recently quit tobacco during COVID-19 lockdown in India. Materials and methods The study was conducted across two Indian cities, Delhi and Chennai (July-August, 2020) among adult tobacco users (n = 801). Telephonic interviews were conducted using validated mental health tools (Patient Health Questionnaire-PHQ-9 and Generalized Anxiety Disorder-GAD-7) to assess the anxiety and depression levels of the participants. Descriptive analysis and multiple logistic regression were used to study the prevalence and correlates of depression and anxiety. Results We found that 20.6% of tobacco users had depression symptoms (3.9% moderate to severe); 20.7% had anxiety symptoms (3.8% moderate to severe). Risk factors associated with depression and anxiety included food, housing, and financial insecurity. Conclusion During COVID-19 lockdown, mental health of tobacco users (primarily women) was associated with food, housing and financial insecurity. The Indian Government rightly initiated several health, social and economic measures to shield the most vulnerable from COVID-19, including a ban on the sale of tobacco products. It is also necessary to prioritize universal health coverage, expanded social security net, tobacco cessation and mental health services to such vulnerable populations during pandemic situations.
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Affiliation(s)
- Shalini Bassi
- Health Promotion Division, Public Health Foundation of India, New Delhi, India
- Health Related Information Dissemination Amongst Youth (HRIDAY), New Delhi, India
| | - Gaurang P. Nazar
- Health Related Information Dissemination Amongst Youth (HRIDAY), New Delhi, India
| | - Nishigandha Joshi
- Health Related Information Dissemination Amongst Youth (HRIDAY), New Delhi, India
| | - Nitika Sharma
- Health Related Information Dissemination Amongst Youth (HRIDAY), New Delhi, India
| | - Aishwarya Pandian
- Los Angeles County Department of Public Health, Los Angeles, CA, United States
| | - Mohan Deepa
- Madras Diabetes Research Foundation & Dr. Mohan’s Diabetes Specialities Centre, Chennai, Tamil Nadu, India
| | - Sailesh Mohan
- Centre for Chronic Conditions and Injuries (CCCI), Public Health Foundation of India & Centre for Chronic Disease Control, New Delhi, India
| | - Shivani A. Patel
- Hubert Department of Global Health, Emory University, Atlanta, GA, United States
| | - Mohammed K. Ali
- Hubert Department of Global Health, Emory University, Atlanta, GA, United States
| | - Ann McNeill
- King’s College London, London, United Kingdom
| | - Nikhil Tandon
- Department of Endocrinology, All India Institute of Medical Sciences, National Capital Territory of Delhi, New Delhi, India
| | - Viswanathan Mohan
- Madras Diabetes Research Foundation & Dr. Mohan’s Diabetes Specialities Centre, Chennai, Tamil Nadu, India
| | - Dorairaj Prabhakaran
- Centre for Chronic Conditions and Injuries (CCCI), Public Health Foundation of India & Centre for Chronic Disease Control, New Delhi, India
| | - Monika Arora
- Health Promotion Division, Public Health Foundation of India, New Delhi, India
- Health Related Information Dissemination Amongst Youth (HRIDAY), New Delhi, India
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Tran NN, Nguyen VQ, Vo HL, Hoang TPN, Bui VS, Nguyen VT. Depression among patients with type 2 diabetes mellitus: Evidence from the Northeast region of Vietnam. Diabetes Metab Syndr 2021; 15:102293. [PMID: 34598010 DOI: 10.1016/j.dsx.2021.102293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 09/07/2021] [Accepted: 09/15/2021] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND AIMS Herein, we aim to examine the prevalence of depression in type 2 diabetic patients at a provincial general hospital located in the Northeast region of Vietnam and to explore its relationship with some sociodemographic, lifestyle and medical history characteristics. MATERIALS AND METHODS This was a single-centre cross-sectional descriptive study. The patients of both sexes who were at the age of 18 years or above, were treated at our institution and were diagnosed with type 2 diabetes mellitus, previously or during the study period. A total of 220 patients were included in the study. RESULTS Depression prevalence was 32.27% according to ICD-10. The severity of depression was categorized as mild in 77.46% patients, moderate in 19.72% patients and severe in 2.82% patients. The odds of depression was 0.18 (95%CI 0.05-0.69, p = 0.012) less for those known as the upper social class compared with those in lower social class. Those who were not on insulin treatment had significantly higher odds of depression than those on treatment with insulin (OR 2.06, 95%CI: 1.01-4.21). Individuals on treatment without oral diabetes drugs had higher odd of depression compared to those being treated with oral diabetes drugs (OR 2.77, 95%CI: 1.14-6.73). Also, hypertension was an increasing contributor to the depression prevalence (OR 2.32, 95%CI: 1.10-4.90). CONCLUSIONS A high prevalence of depression among type 2 diabetic patients was documented. Only significant factors for depression were lower social class, co-morbid hypertension and none of the insulin treatment or oral diabetes drugs.
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Affiliation(s)
- Nguyen-Ngoc Tran
- Department of Psychiatry, Hanoi Medical University, Hanoi, 100000, Vietnam; National Institute of Mental Health, Bach Mai Hospital, Hanoi, 100000, Vietnam
| | | | - Hoang-Long Vo
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, 100000, Vietnam.
| | | | - Van-San Bui
- Department of Psychiatry, Hanoi Medical University, Hanoi, 100000, Vietnam; National Institute of Mental Health, Bach Mai Hospital, Hanoi, 100000, Vietnam
| | - Van-Tuan Nguyen
- Department of Psychiatry, Hanoi Medical University, Hanoi, 100000, Vietnam; National Institute of Mental Health, Bach Mai Hospital, Hanoi, 100000, Vietnam.
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Basu G, Nandi D, Biswas S, Roy SK. Quality of life and depression among diabetic patients attending the lifestyle clinic of a teaching hospital, West Bengal. J Family Med Prim Care 2021; 10:321-326. [PMID: 34017747 PMCID: PMC8132776 DOI: 10.4103/jfmpc.jfmpc_1709_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 10/27/2020] [Accepted: 11/30/2020] [Indexed: 11/09/2022] Open
Abstract
CONTEXT The coexistence of diabetes and depression has resulted in poor quality of life. Reported literature suggested the need for research for assessing the correlates of both quality of life along with depression in diabetic persons. AIMS To assess the quality of life (QOL), the prevalence of depression and associated factors in diabetic patients attending the lifestyle clinic of a tertiary healthcare facility in Eastern India. SETTINGS AND DESIGN This hospital-based descriptive, cross-sectional research recruited 219 patients with diabetes to assess the QOL and depression in the lifestyle clinic of a tertiary healthcare facility. METHODS AND MATERIALS The quality of life was assessed with the help of the World Health Organization (WHO) QOL BREF instrument. Depression was determined by a standardized Patient Health Questionnaire - 9(PHQ-9). The sociodemographic and diabetes-related information were collected by a semistructured questionnaire. Clinical and anthropometric examinations were conducted. STATISTICAL ANALYSIS USED All the available data were initially coded and then analyzed using the SPSS 22.0 licensed software. RESULTS The participants had a median age of 54 years. Illiteracy was significantly more among females. Hypertension was the most common comorbidity. Gender-wise difference in mean of weight, height, hip circumference, and QOL score in the psychosocial domain was significant. The mean QOL score was least in the social domain and highest in the environmental domain. Literate patients had a statistically significantly better QOL. Depression was observed significantly more in females, illiterates, and unemployed respondents. CONCLUSIONS Diabetic women with lesser literacy have an increased risk of poor QOL. Women, illiterates, and the unemployed suffered more from depression. Therefore, a target-specific, routine, and well-planned clinic approach is needed to improve the QOL and mental health of respondents.
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Affiliation(s)
- Gandhari Basu
- Department of Community Medicine, College of Medicine & JNM Hospital, WBUHS, West Bengal, India
| | - Dipanjan Nandi
- Department of Medical Intern, College of Medicine & JNM Hospital, WBUHS, West Bengal, India
| | - Sujata Biswas
- Department of Physiology, College of Medicine & JNM Hospital, WBUHS, West Bengal, India
| | - Suman Kumar Roy
- Department of Community Medicine, College of Medicine & JNM Hospital, WBUHS, West Bengal, India
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Patra S, Patro BK, Mangaraj M, Sahoo SS. Screening for depression in diabetes in an Indian primary care setting: Is depression related to perceived quality of life? Prim Care Diabetes 2020; 14:709-713. [PMID: 32345555 DOI: 10.1016/j.pcd.2020.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 02/18/2020] [Accepted: 03/26/2020] [Indexed: 11/28/2022]
Abstract
AIMS To screen for depression in diabetes and evaluate the contributing factors in a primary care setting in India. To evaluate the relationship of depression with perceived quality of life. METHODS We used convenience sampling method in this cross-sectional study. 388 consecutive patients with type 2 diabetes mellitus were enrolled over a period of one year. 50.3% patients screened positive on Patient Health Questionnaire (PHQ-9) out of which 21.4% reported moderate to severe depression. Male gender, middle age and poor glycaemic control were associated with depression. In stepwise linear regression analysis when depression category was included as an independent variable, significant difference in regression equations were found. Other independent variables which were included in regression equation were age, education, gender, income lifestyle, glycosylated haemoglobin and Body Mass Index whereas dependent variables were transformed domains of World Health Organization Quality of Life questionnaire. RESULTS There is high prevalence of depression in primary care in type 2 diabetes patients in this Indian setting. Depression was strongly associated with all four domains of quality of life. Highest association with depression was seen in Physical domain (β -0.385, p = 0.000) followed by Social domain (β -0.372, p = 0.000). CONCLUSIONS High prevalence of depression and its association with poor quality of life indicates need for improved recognition of depression for improving diabetes outcomes in this centre.
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Affiliation(s)
- Suravi Patra
- Department of Psychiatry, All India Institute of Medical Sciences Bhubaneswar, Odisha, India.
| | - Binod Kumar Patro
- Department of Community & Family Medicine, All India Institute of Medical Sciences Bhubaneswar, Odisha, India.
| | - Manaswini Mangaraj
- Department of Biochemistry, All India Institute of Medical Sciences Bhubaneswar, Odisha, India.
| | - Soumya Swaroop Sahoo
- Department of Community & Family Medicine, All India Institute of Medical Sciences Bhubaneswar, Odisha, India.
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Kalra G, Gill S, Tang TS. Depression and Diabetes Distress in South Asian Adults Living in Low- and Middle-Income Countries: A Scoping Review. Can J Diabetes 2020; 44:521-529.e1. [PMID: 32792106 DOI: 10.1016/j.jcjd.2020.06.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 06/03/2020] [Accepted: 06/04/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES In this study, we conducted a scoping review to identify the prevalence of both depression and diabetes distress in patients with type 2 diabetes in low- and middle-income countries in South Asia. METHODS This scoping review was grounded in the methodology of Arksey and O'Malley by searching for relevant studies using Ovid MEDLINE, PsycINFO and Cumulative Index of Nursing and Allied Health Literature databases, as well as grey literature sources and hand searches. Two reviewers independently screened and extracted data from articles that met the inclusion criteria. RESULTS A total of 46 studies were included, with only 1 addressing both depression and diabetes distress. We present 42 total articles on depression and 5 on diabetes distress. The prevalence of type 2 diabetes and elevated depressive symptoms ranged from 11.6% to 67.5%, whereas the prevalence of diabetes distress ranged from 18.0% to 76.2%. CONCLUSIONS The prevalence of elevated depressive symptoms was found to be much higher than that reported in data from high-income countries and in data on South Asians living in high-income countries. Diabetes distress was found to be lower compared with other studies; however, the scarcity of data makes this observation inconclusive. Variations in depression inventories, lack of culturally tailored inventories and the focus on urban clinic-based populations are identified as limitations and areas requiring further research. Our review provides evidence for the need of increased mental health screening and treatment in diabetes care in South Asian countries.
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Affiliation(s)
- Gunisha Kalra
- Faculty of Health Sciences-Global Health, McMaster University, Hamilton, Ontario, Canada
| | - Simran Gill
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tricia S Tang
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
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“Is there a medicine for these tensions?” Barriers to treatment-seeking for depressive symptoms in rural India: A qualitative study. Soc Sci Med 2020; 246:112741. [DOI: 10.1016/j.socscimed.2019.112741] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 11/28/2019] [Accepted: 12/15/2019] [Indexed: 11/21/2022]
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Psychosocial and clinical factors associated with depression among individuals with diabetes in Bahir Dar City Administrative, Northwest Ethiopia. Ann Gen Psychiatry 2020; 19:18. [PMID: 32180824 PMCID: PMC7065366 DOI: 10.1186/s12991-020-00267-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 02/22/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In a context of the potential epidemic nature of both diabetes mellitus (DM) and depression had negative effects in cases of disability and mortality. Coexisting depression had been linked to morbidity and mortality in people with diabetes. Therefore, this study aimed to identify psychosocial and clinical factors associated to develop depression symptoms in diabetes patients. METHODS A systematic institution based cross-sectional study design was conducted from 1st March to 8th April 2016 among adult diabetes patent. Depression status was assessed by the Patient Health Questionnaire-9 (PHQ-9). Data were analyzed by logistic regression and at P < 0.05 with 95% CI was considered statistically significant. RESULT A total of 416 patients were included in this studied. Based on PHQ-9, self- reported depression symptom was 29.3% [95% CI 25.2, 33.4]. In the performed statistical evaluation, patients whose age was between 45 and 54 years old (AOR = 3.88; 95% CI 1.36, 11.08); being female (AOR = 2.43; 95% CI 1.29, 4.58); who has poor social support (AOR = 6.08; 95% CI 2.98, 12.40); and who has high fear of kidney problems secondary to DM (AOR = 6.12; 95% CI 1.75, 21.23) were statistically associated with depressive symptoms in diabetes patients. CONCLUSION This study demonstrated that complication fears, social support, being female and sexual dysfunction were found significantly associated with co-morbid depression in diabetes. Therefore, availed a social network of family and friends; providing diabetes education to address the patient's fear of complications; and considered a sexual function is an integral part of overall health in diabetic patients.
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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:e5145. [PMID: 31523573 PMCID: PMC6741377 DOI: 10.7759/cureus.5145] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Introduction Various clinical studies have reported that clinical depression is a common co-morbidity in patients with type 2 diabetes mellitus. Depression can badly affect the lifestyle of diabetic patients and impair the proper management of diabetes mellitus. Therefore, there exists a need to identify risk factors of depression in diabetic patients especially in relation to various clinical parameters, glycemic control and diabetic microvascular complications. Materials and methods It was a cross-sectional study conducted in a tertiary care hospital in Pakistan from August 2018 to April 2019. We recruited type 2 diabetic patients and measured their various clinical and hematological parameters. We evaluated depression using Patient Health Questionnaire (PHQ-9) and evaluated its relationship with glycemic control, duration of diabetes, fasting lipid profile and presence of various diabetic microvascular complications. Results There were 100 subjects in the study having a mean age 58.3 ± 12.4 (range: 36 - 71) years with a male to female ratio of 1:1.2. The mean duration of type 2 diabetes mellitus was 11.2 ± 9.2 years. The mean PHQ-9 score of the study population was 10.2 ± 8.1. The frequency of depression was found to be 40.0%. Depression was most frequently found in women and in patients between 40 to 60 years of age (60.0%). Depression was more common in patients with dyslipidemia (p-value = 0.0015). Patients with diabetic retinopathy, diabetic nephropathy and diabetic neuropathy were 3.8 times, 4.2 times and 2.1 times more likely to have clinical depression than the patients without these complications. Patients with glycated hemoglobin (HbA1c) worse than 7.5% had a significantly higher rate of depression than those whose HbA1c ranged from 6.5 - 7.5 % (p-value = 0.0028). Duration of diabetes mellitus did not significantly affect the frequency of depression in diabetic patients. Conclusion Depression is common in a large number of diabetic patients. Female gender, dyslipidemia, diabetic microvascular complications and impaired glycemic control are significantly associated with depression in diabetic patients.
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Affiliation(s)
- Sabira Sharif
- Medicine, Allama Iqbal Medical College/Jinnah Hospital, Lahore, PAK
| | - Muhammad T Raza
- Medicine, Allama Iqbal Medical College/Jinnah Hospital, Lahore, PAK
| | - Samsam Mushtaq
- Medicine, Allama Iqbal Medical College/Jinnah Hospital, Lahore, PAK
| | - Bahjat Afreen
- Medicine, Allama Iqbal Medical College/Jinnah Hospital, Lahore, PAK
| | - Bushra Azam Hashmi
- Medicine, Ameer-Ud-Din Medical College & Postgraduate Medical Institute, Lahore General Hospital, Lahore, PAK
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Khaledi M, Haghighatdoost F, Feizi A, Aminorroaya A. The prevalence of comorbid depression in patients with type 2 diabetes: an updated systematic review and meta-analysis on huge number of observational studies. Acta Diabetol 2019; 56:631-650. [PMID: 30903433 DOI: 10.1007/s00592-019-01295-9] [Citation(s) in RCA: 164] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 02/02/2019] [Indexed: 02/06/2023]
Abstract
AIMS Depression is a common co-morbidity in patients with type 2 diabetes mellitus (T2DM). Untreated depression in these patients adversely affects self-care activities and other diabetes complications. The aim of this study is to estimate the prevalence of depression among patients with T2DM by conducting a meta-analysis of observational studies. METHODS MEDLINE, Web of Science, Science Direct, and Google Scholar databases were searched for all observational studies that assessed depression in T2DM. Relevant articles were searched using the combination of Medical Subject Heading (MeSH) terms of "depression", "depressive disorder", and "diabetes mellitus" published between January 2007 and July 2018. Random effects model was used to estimate the weighted prevalence rates and 95% CI using "metaprop program in STATA 11". RESULTS In total, the 248 included studies (with 273 reported prevalence) identified 83,020,812 participants; of them, 23,245,827 (28%; 95% CI 27, 29) suffered from different severity levels of depressive disorders. The prevalence of depression was separately reported in 137,372 males and 134,332 females. Of them, 31,396 males (23%, 95% CI: 20, 26) and 45,673 females (34%, 95% CI: 31, 38) were depressed. Compared with global estimate, depression prevalence was lower in Europe (24%) and Africa (27%), but higher in Australia (29%) and Asia (32%). The prevalence in America was equal to the estimated prevalence in the world (28%). Depression was more common in subjects younger than 65 compared with elderlies (31% vs. 21%). CONCLUSION Our findings demonstrated that almost one in four adults with T2DM experienced depression. Given the high prevalence of depressive disorders in diabetic patients, screening these patients for co-morbid depression and its relevant risk factors is highly recommended.
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Affiliation(s)
- Mohammad Khaledi
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fahimeh Haghighatdoost
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Biostatistics and Epidemiology Department, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ashraf Aminorroaya
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
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Féki I, Turki M, Zitoun I, Sellami R, Baati I, Masmoudi J. [Depression and coping strategies in the elderly with type 2 diabetes]. L'ENCEPHALE 2019; 45:320-326. [PMID: 30885441 DOI: 10.1016/j.encep.2019.01.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 01/15/2019] [Accepted: 01/22/2019] [Indexed: 11/25/2022]
Abstract
INTRODUCTION AND OBJECTIVES Elderly patients with diabetes have been shown to have more diabetes-related complications, and they are more likely to develop somatic and psychiatric comorbidities including cognitive dysfunction and depression. Several studies have shown a close association between diabetes and depression. This comorbidity may lead to functional disability and quality of life deterioration. Thus, the elderly will face various constraints through the coping strategies. In this context, we conducted our study to assess the prevalence of depressive symptoms in elderly patients with diabetes as well as its associated factors, and to investigate their coping strategies. METHODS We conducted a cross-sectional, descriptive and analytic study among 50 elderly patients (age≥65 years) being followed for type 2 diabetes at the outpatient department for chronic diseases of the Regional Hospital of Aguereb, Sfax, Tunisia. We used the "Activity of Daily Living" to assess the dependence level, the "Geriatric Depression Scale" to screen for depressive symptoms, and the "Brief Coping with Problems Experienced" to investigate the coping strategies. RESULTS The mean age of patients was 73.3 years, with a sex-ratio (M/F) of 0.62. Smoking and alcohol consumption were reported respectively in 20% and 4% of participants. The mean duration of diabetes was 7.7 years. Diabetes complications were noted in 70% of participants. Somatic comorbidities were noted in 94% of cases (hypertension 84%; dyslipidemia 34%). Psychiatric histories were reported in 18% of patients who suffered from anxio-depressive symptoms. No patient among those with mental disorder histories benefited from any psychiatric management prior to the study. Three patients (6%) had previously presented suicidal ideations but none of them had attempted suicide. The mean "Activity of Daily Living" score was 4.9 points. Patients were autonomous in 28%, and dependent in 4% of cases. The mean "Geriatric Depression Scale" score was 9.8 points. According to this scale, the prevalence of depressive symptoms was 34%. They were correlated with: smoking (P=0.04), psychiatric histories (P=0.031), absence of leisure activity (P=0.035), "Activity of Daily Living" score (P=0.028), long duration of diabetes (P=0.04) and the presence of suicidal ideation (P=0.013). According to the « Brief Coping with Problems Experienced », the problem-focused coping strategies were the most frequently used (44%), followed by emotion-focused (38%) and passive strategies (18%). Participants with depressive symptoms are significantly more likely to adopt emotion-focused coping strategies (P=0.01). CONCLUSION Our study highlighted a high prevalence of depressive symptoms among elderly patients with diabetes. This relationship seems to be bi-directional and may increase somatic complications and alter the quality of life, and then darken the prognosis. Thus, besides pharmacological treatment, regular depression screening and psychological support are essential to ensure a better control of diabetes and to improve well-being.
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Affiliation(s)
- I Féki
- Service de psychiatrie « A », CHU Hédi Chaker, 3029 Sfax, Tunisie
| | - M Turki
- Service de psychiatrie « A », CHU Hédi Chaker, 3029 Sfax, Tunisie.
| | - I Zitoun
- Service de psychiatrie « A », CHU Hédi Chaker, 3029 Sfax, Tunisie
| | - R Sellami
- Service de psychiatrie « A », CHU Hédi Chaker, 3029 Sfax, Tunisie
| | - I Baati
- Service de psychiatrie « A », CHU Hédi Chaker, 3029 Sfax, Tunisie
| | - J Masmoudi
- Service de psychiatrie « A », CHU Hédi Chaker, 3029 Sfax, Tunisie
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13
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Hussain S, Habib A, Singh A, Akhtar M, Najmi AK. Prevalence of depression among type 2 diabetes mellitus patients in India: A meta-analysis. Psychiatry Res 2018; 270:264-273. [PMID: 30273857 DOI: 10.1016/j.psychres.2018.09.037] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 09/10/2018] [Accepted: 09/17/2018] [Indexed: 02/07/2023]
Abstract
Depression as a co-morbid condition in type 2 diabetes mellitus (T2DM) patients is associated with significant morbidity, mortality, and rising health economic burden. Indian healthcare system is heavily burdened with T2DM, and it is important to understand the prevalence of depression associated with T2DM. This meta-analysis conducted as per the registered protocol (PROSPERO registration: CRD42016051552), searched for published studies in the databases including MEDLINE and Embase till 31st August 2018. The modified Newcastle-Ottawa Scale was used to assess the methodological quality. The pooled prevalence of depression among T2DM patients was estimated as primary outcomes, while prevalence based on demographic sub-group was estimated as the secondary outcome. In total, 43 studies including 10,270 patients fulfilled the eligibility criteria and were included in the analysis. The pooled prevalence of depression in T2DM patients was found to be 38% (95% CI: 31%-45%). Presence of depression in people with type 2 diabetes was more often associated with the presence of complications with an odds ratio of 2.33, 95% CI: 1.62-3.36, p < 0.00001. Overall, the study found a high prevalence of depression among T2DM patients in India. Diabetes management programs in India may consider early screening of depression in T2DM patients.
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Affiliation(s)
- Salman Hussain
- Department of Pharmaceutical Medicine (Division of Pharmacology)(,) School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi(,) India
| | - Anwar Habib
- Department of Medicine(,) Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India
| | | | - Mohd Akhtar
- Department of Pharmacology(,) School of Pharmaceutical Education and Research, Jamia Hamdard(,) New Delhi 110062(,) India
| | - Abul Kalam Najmi
- Department of Pharmacology(,) School of Pharmaceutical Education and Research, Jamia Hamdard(,) New Delhi 110062(,) India.
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14
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Naskar S, Victor R, Nath K. Depression in diabetes mellitus-A comprehensive systematic review of literature from an Indian perspective. Asian J Psychiatr 2017; 27:85-100. [PMID: 28558904 DOI: 10.1016/j.ajp.2017.02.018] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 02/18/2017] [Accepted: 02/18/2017] [Indexed: 12/18/2022]
Abstract
UNLABELLED Diabetes and depression are rapidly growing chronic health conditions that have significant negative impact upon the physical, psychological, social and occupational functioning, quality of life and often leads to socio-economic burden. Presence of both these comorbid diseases results in various short term and long term complications and increases the mortality as compared to those with depression or diabetes alone. OBJECTIVES Systematic review of the epidemiological data, risk factors and relationship between depression and glycaemic control among the Indian studies. METHODS We searched Pubmed, Pubmed Central, Google Scholar and Directory of Open Access Journal (DOAJ) databases to identify relevant Indian studies. RESULTS Substantial variation in the prevalence of depression in people with diabetes was found across the 41 selected studies; according to this review the range is 2% to 84% (T1DM - 2-7%; T2DM - 8%-84%). Correlates of depression in diabetic patients are advancing age, female gender, low literacy rate, burden of being from a lower socioeconomic status, rural domicile, marriage and duration of diabetes of >2years, diabetes related complications and poor glycaemic control. Sedentary life without adequate physical activities, lack of self-care are often the factors that precipitates depression in a T2DM patient and vice versa. CONCLUSION According to this review, among Indian population there is a significant association between depression and diabetes.
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Affiliation(s)
- Subrata Naskar
- Department of Neuropsychiatry, Institute of Neurosciences, Kolkata, West Bengal, India.
| | - Robin Victor
- Department of Psychiatry, Silchar Medical College and Hospital, Silchar, Assam, India
| | - Kamal Nath
- Department of Psychiatry, Silchar Medical College and Hospital, Silchar, Assam, India
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Gulati S, Misra A, Pandey RM. Effect of Almond Supplementation on Glycemia and Cardiovascular Risk Factors in Asian Indians in North India with Type 2 Diabetes Mellitus: A 24-Week Study. Metab Syndr Relat Disord 2017; 15:98-105. [PMID: 28051354 PMCID: PMC5333560 DOI: 10.1089/met.2016.0066] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Background: Type 2 diabetes (T2D) statistics have reached menacing proportions in India. Appropriate dietary intervention, as part of healthy lifestyle, is imperative to curb further spread of this disease. Objectives: This pre–post intervention study was conducted in New Delhi, India, to investigate the effects of daily consumption of almonds for 24 weeks in T2D subjects, specifically on measures of glycemia and cardiovascular disease (CVD) risk factors. Methods and Study Design: In this study, the 24-week intervention period was preceded by a control diet and exercise run-in period of 3 weeks. Raw almonds (20% of energy intake) were provided to the patients for consumption along with diet and physical activity counseling. Patients were assessed for anthropometry, blood pressure, measures of glycemia (fasting blood glucose, glycosylated hemoglobin), lipids [total cholesterol (TC), triglycerides, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, lipoprotein(a)], surrogate marker of atherosclerosis (Pulse wave velocity), and marker of inflammation (high sensitivity C-reactive protein [hs-CRP]) at baseline and after the intervention period. Results: Statistically significant improvement in mean values for various parameters post intervention was as follows: waist circumference (P < 0.03), waist-to-height ratio (P < 0.005), TC (P < 0.002), serum triglycerides (P < 0.004), low-density lipoprotein cholesterol (P < 0.01), glycosylated hemoglobin (P < 0.04), and hs-CRP (P < 0.01). A trend toward improvement in pulse wave velocity (P < 0.06) was also observed. Conclusion: The study findings illustrate that incorporation of almonds in a well-balanced healthy diet leads to multiple beneficial effects on glycemic and CVDs risk factors in Asian Indian patients with T2D.
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Affiliation(s)
- Seema Gulati
- 1 Diabetes Foundation (India), SDA , New Delhi, India .,2 National Diabetes , Obesity and Cholesterol Foundation (N-DOC), New Delhi, India .,3 Center of Nutrition & Metabolic Research (C-NET) , New Delhi, India
| | - Anoop Misra
- 1 Diabetes Foundation (India), SDA , New Delhi, India .,2 National Diabetes , Obesity and Cholesterol Foundation (N-DOC), New Delhi, India .,3 Center of Nutrition & Metabolic Research (C-NET) , New Delhi, India .,4 Fortis C-DOC Center of Excellence for Diabetes , Metabolic Diseases and Endocrinology, New Delhi, India .,5 Fortis Flt. Lt. Rajan Dhall Hospital , Vasant Kunj, New Delhi, India
| | - Ravindra M Pandey
- 6 All India Institute of Medical Sciences (AIIMS) , New Delhi, India
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