CO-MORBID DEPRESSION IN ADULTS WITH TYPE 2 DIABETES MELLITUS – A STUDY OF PREVALENCE, SOCIO-DEMOGRAPHIC PROFILE, AND IMPACT ON GLYCEMIC CONTROL

Authors

  • SARMISTHA PRIYADARSHANI Department of Psychiatry and De-addiction Centre, MKCG Medical College and Hospital, Berhampur, Odisha, India
  • RUPA PRADHAN Department of General Medicine, MKCG Medical College and Hospital, Berhampur, Odisha, India. https://orcid.org/0009-0004-1513-9379

DOI:

https://doi.org/10.22159/ajpcr.2024v17i9.51237

Keywords:

Comorbid depression, T2DM, Sociodemographic variables, Diabetic treatment regimen

Abstract

Objectives: The objectives are to study the prevalence of depression in established type 2 diabetes mellitus (T2DM) patients and the association of the severity of depression with the level of glycemic control, second, to explore the relationship of co-morbid depression with the sociodemographic variables and diabetic complications, and third, to assess the association of co-morbid depression with the ongoing diabetic treatment regimen.

Methods: Data of OPD patients with established diagnosis of T2DM who came for follow-up were collected. A total of 224 patients underwent a clinical and psychiatric evaluation and details were analyzed as per the objectives of the study.

Results: The total sample of diabetic patients included 126 (56%) males and 98 (44%) females with the majority seen in the 45–60-year age group. The sociodemographic parameters were assessed and comorbid depression was seen in 83 diabetic patients. Among them, 42 had moderate depression. Females (n=43) outnumbered males and the majority were seen in the 45–60-year age group (n=39). Comorbid depression was most prevalent among unemployed (n=41), urban residents (n=48), joint family (n=49), Hindus (n=73), and people on only insulin treatment regimen (n=33) but all this was statistically insignificant, whereas illiterates (n=45), HbA1C level >7% (n=71), diabetes-related complications (n=50), and diabetic neuropathy being the most common (n=28) among all the complications were seen and this difference was statistically significant.

Conclusion: By taking all our research findings, it can be concluded that comorbid depression modifies the course and prognosis of diabetes.

Downloads

Download data is not yet available.

References

Loscalzo J, Fauci A, Kasper D, Hauser S, Longo D, Jameson JL. Harrison’s Principles of Internal Medicine. 21st ed. United States: Mcgraw Hill; 2022.

King H, Aubert RE, Herman WH. Global burden of diabetes 1995- 2005: Prevalence, numerical estimates and projections. Diabetes Care. 1998;21:1414-31. doi: 10.2337/diacare.21.9.1414

Gavard JA, Lustman PJ, Clouse RE. Prevalence of depression in adults with diabetes. An epidemiological evaluation. Diabetes Care. 1993;16:1167-78. doi: 10.2337/diacare.16.8.1167

Lustman PJ, Anderson RJ, Freedland KE, de Groot M, Carney RM, Clouse RE. Depression and poor glycaemic control: A meta-analytic review of the literature. Diabetes Care. 2000;23:934-42. doi: 10.2337/ diacare.23.7.934 5. De Groot M, Anderson R, Freedland KE, Clouse RE, Lustman PJ. Association of depression and diabetes complications: A meta-analysis. Psychosom Med. 2000;63:619-30. doi: 10.1097/00006842- 200107000-00015

Katon WJ, Simon G, Russo J, Von Kroff M, Lin EH, Ludman E, et al. Quality of depression care in a population based sample of patients with diabetes and major depression. Med Care. 2004;42:1222-9. doi: 10.1097/00005650-200412000-00009

Lin EH, Katon W, Von Kroff M, Rutter C, Simon GE, Oliver M, et al. Relationship of depression and diabetes self-care, medication adherence and preventive care. Diabetes Care. 2004;27:2154-60. doi: 10.2337/diacare.27.9.2154

Katon WJ, Rutter C, Simon G, Lin EH, Ludman E, Ciechanowski P, et al. The association of comorbid depression with mortality in patients with Type 2 diabetes. Diabetes Care. 2005;28:2668-72. doi: 10.2337/ diacare.28.11.2668

Black SA, Markides KS, Ray LA. Depression predicts increased incidence of adverse health outcomes in older Mexican Americans with Type 2 diabetes. Diabetes Care. 2003;26(10):2822-8. doi: 10.2337/ diacare.26.10.282

Davies M, Brophy S, Williams R, Taylor A. The prevalence, severity and impact of painful diabetic peripheral neuropathy in Type 2 diabetes. Diabetes Care. 2006;29:1518-22. doi: 10.2337/dc05-2228

American Diabetes Association. Standard of medical care in diabetes. Diabetes Care. 2008;31 Suppl 1:S12-54. doi: 10.2337/dc08-S012

Molitch ME, DeFronzo RA, Franz MJ, Keane WF, Mongensen CE, Parving HH, et al. Nephropathy in diabetes. Diabetes Care. 2004;27 Suppl 1:S79-83. doi: 10.2337/diacare.27.2007.s79

Palinkas LA, Barrett-Connor E, Wingard DL. Type 2 diabetes and depressive symptoms in older adults: A population based study. Diabet Med. 1991;8:532-6. doi: 10.1111/j.1464-5491.1991.tb01646.x

American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2010;33 Suppl 1:S62-9. doi: 10.2337/ dc10-S062, PMID: 20042775

Beck AT, Steer RA, Brown GK. Beck Depression Inventory. 2nd ed Manual. San Antonio, TX: The Psychological Corporation; 1996. doi: 10.1007/978-1-4419-1005-9_441

Rao AV. Depression illness in India. Indian J Psychiatry. 1984;26:301- 11. PMC3011191

World Federation for Mental Health. Diabetes and Depression. Woodbridge, VA, USA; 2010. Available from: https://www.wfmh. org/img/what-we-do/publications/depression-awareness-packet-english-2010.pdf

Mohan V, Sandeep S, Deepa R, Shah B, Varghese C. Epidemiology of type 2 diabetes: Indian scenario. Indian J Med Res. 2007;125:217-30. PMID: 17496352

Bromet E, Andrade LH, Hwang I, Sampson NA, Alonso J, de Girolamo G, et al. Cross national epidemiology of DSM IV Major depressive episode. BMC Med. 2011;9:90. doi: 10.1186/1741-7015-9- 90, PMC3163615

Joseph N, Unnikrishnan B, Raghavendra Babu YP, Kotian MS, Nelliyanil M. Proportion of depression and its determinants among Type 2 diabetes mellitus patients in various tertiary care hospitals in Mangalore city of South India. Indian J Endocrinol Metab. 2013;17:681-8. doi: 10.4103/2230-8210.113761, PMC3743370

Raval A, Dhanaraj E, Bhansali A, Grover S, Tiwari P. Prevalence and determinants of depression in Type 2 diabetes patients in tertiary care centre. Indian J Med Res. 2010;132:195-200. PMID: 20716820

Poongothai S, Anjana RM, Pradeepa R, Ganesan A, Unnikrishnan R, Rema M, et al. Association of depression with complications of type 2 diabetes- the Chennai Urban Rural Epidemiology study (CURES 102). J Assoc Physicians India. 2011;59:644-8. PMID: 22479744

Anderson RJ, Freedland KE, Clouse RE, Lustman PJ. The prevalence of comorbid depression in adults with diabetes: A meta-analysis. Diabetes Care. 2001;24:1069-78. doi: 10.2337/diacare.24.6.1069, PMID: 11375373

Kaplan H, Sadock B. Synopsis of Psychiatry. 10th ed. Philadelphia, PA: Williams and Wilkins; 2009. PMC2802389

Tellez Zenteno JF, Cardiel MH. Risk factors associated with depression in patients with type 2 diabetes mellitus. Arch Med Res. 2002;33:53-60. doi: 10.1016/s0188-4409(01)00349-6, PMID: 11825632

Larijani B, Bayat MK, Gorgani MK, Bandarian F, Akhondzadeh S, Sadjadi SA. Association between depression and diabetes. German J Psychiatry. 2004 Oct 29;7(3):62-5.

Chaudhry R, Mishra P, Mishra J, Parminder S, Mishra BP. Psychiatric morbidity among diabetic patients: A hospitalized study. Ind Psychiatry J. 2010;19:47-9. PMID: 21694791, doi: 10.4103/0972- 6748.77637, PMC3105558

Murrell SA, Himmelfarb S, Wright K. Prevalence of depression and its correlates in older adults. Am J Epidemiol. 1983;117:173-85. doi: 10.1093/oxfordjournals.aje.a113528, PMID: 6829547

Rezvanfar MR, Salehi B, Rafiee M, Shirian F. Correlation of HbA1c and major depressive disorder in type 2 diabetic patients. IJDO. 2010;2(1):16-9.

Roupa Z, Koulouri A, Sotiropoulou P, Makrinika E, Marneras X, Lahana I, et al. Anxiety and depression in patients with Type 2 Diabetes mellitus, depending on sex and body mass Index. Health Sci J. 2009 Jan;3(1):32-40.

Collins MM, Corcoran P, Perry IJ. Anxiety and depression symptoms in patients with diabetes. Diabet Med. 2009;26:153-61. doi: 10.1111/j.1464-5491.2008.02648.x, PMID: 19236618

Singh H, Raju M, Dubey V, Kurrey R, Bansal S, Malik M. A study of socio-demogrphic clinical and glycaemic control factors associated with co-morbid depression in type 2 diabetes mellitus. Ind Psychiatry J. 2014;23:134-42. doi: 10.4103/0972-6748.151687, PMID: 25788803, PMC4361976

Mier N, Bocanegra-Alonso A, Zhan D, Wang S, Stoltz SM, Acosta- Gonzalez RI, et al. Clinical depressive symptoms and diabetes in a binational border population. J Am Board Fam Med. 2008;21:223-33. doi: 10.3122/jabfm.2008.03.070255, PMID: 18467534

Mathew CS, Dominic M, Issac R, Jacob JJ. Prevalence of depression in consecutive patients with Type 2 diabetes mellitus of 5 year duration and its impact on glycaemic control. Indian J Endocrinol Metab. 2012;16:764-8. doi: 10.4103/2230-8210.100671, PMC3475901, PMID: 23087861

Zhang W, Xu H, Zhao S, Yin S, Wang X, Guo J, et al. Prevalence and influencing factors of co-morbid depression in patients with Type 2 diabetes mellitus: A General Hospital based study. Diabetol Metab Syndr. 2015;7:60. doi: 10.1186/s13098-015-0053-0, PMID: 26167205, PMC4499190

Sahota PK, Knowler WC, Looker HC. Depression, diabetes and glycaemic control in an American Indian community. J Clin Psychiatry. 2008;69:800-9. doi: 10.4088/jcp.v69n0513

Fisher L, Skaff MM, Mullan JT, Arean P, Glasgow R, Masharani U. A longitudinal study of affective and anxiety disorders, depressive affect and diabetes distress in adults with type 2 diabetes. Diabet Med. 2008;25:1096-101. doi: 10.1111/j.1464-5491.2008.02533.x, PMID: 19183314, PMC2635496

Aikens JE, Perkins DW, Piette JD, Lipton B. Association between depression and concurrent Type 2 diabetes outcomes varies by diabetes regimen. Diabet Med. 2008;25:1324-9. doi: 10.1111/j.1464- 5491.2008.02590.x, PMID: 19046223, PMC6398157

Trief PM, Morin PC, Izquierdo R, Teresi JA, Eimicke JP, Goland R, et al. Depresssion and glycaemic control in Elderly Ethnically diverse patients with diabetes. The IDEATel Project. Diabetes Care. 2006;29:830-5. doi: 10.2337/diacare.29.04.06.dc05-1769, PMID: 16567823

Papelbaum M, Moreira RO, Coutinho W, Kupfer R, Zagury L, Freitas S, et al. Depression, glycaemic control and Type 2 diabetes. Diabetol Metab Syndr. 2011;3:26. doi: 10.1186/1758-5996-3-26, PMID: 21978660, PMC3212883

Knol MJ, Twisk JW, Beekman AT, Heine RJ, Snoek FJ, Pouwer F. Depression as a risk factor for the onset of Type 2 Diabetes mellitus. A meta-analysis. Diabetologia. 2006;49:837-45. doi: 10.1007/s00125- 006-0159-x, PMID: 16520921

Egede LE. Disease- focused or integrated treatment: Diabetes and depression. Med Clin North Am. 2006;90:627-46. doi: 10.1016/j. mcna.2006.04.001, PMID: 16843766

Skaff MM, Mullan JT, Almeida DM, Hoffman L, Masharani U, Mohr D, et al. Daily negative mood affects fasting glucose in type 2 diabetes. Health Psychol. 2009;28:265-72. doi: 10.1037/a0014429, PMID: 19450031, PMC2810194

Richardson LK, Egede LE, Mueller M, Echols CL, Gebregziabher M. Longitudinal effects of depression on glycaemic control in veterans with Type 2 diabetes. Gen Hosp Psychiatry. 2008;30:509-14. PMID: 19061676

Published

07-09-2024

How to Cite

SARMISTHA PRIYADARSHANI, and RUPA PRADHAN. “CO-MORBID DEPRESSION IN ADULTS WITH TYPE 2 DIABETES MELLITUS – A STUDY OF PREVALENCE, SOCIO-DEMOGRAPHIC PROFILE, AND IMPACT ON GLYCEMIC CONTROL”. Asian Journal of Pharmaceutical and Clinical Research, vol. 17, no. 9, Sept. 2024, pp. 103-7, doi:10.22159/ajpcr.2024v17i9.51237.

Issue

Section

Original Article(s)