International Journal of Collaborative Research on Internal Medicine & Public Health

Depression and associated factors in diabetic patients attending an urban hospital of Bangladesh

Introduction: Diabetes mellitus is frequently associated with co-morbid depression, contributing double burden to the individual and society.

Aims & Objectives: To find out the proportion of depression among patients with type 2 diabetes mellitus and to determine factors associated with it.

Methods: A cross sectional study was conducted among 178 patients with type 2 diabetes mellitus attending Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka. Data were collected through face-to-face interview and reviewing documents. Depressive symptoms were measured using Centre for Epidemiological Studies Depression Scale; considering score 16-21 as mild to moderate depression and score F 22 as severe depression.

Results: The proportion of depression among the study population was 34.8% which included 14.6% with mild to moderate depression and 20.2% with severe depression. Both mild to moderate and severe depression were more common in females and among singles. Insulin users were six times more likely to develop severe depression (OR, 6.33 with 95% CI, 1.75 to 22.89) than users of oral anti-diabetic agents. Glycemic status measured by HbA1c was the best predictor. Both poor and fair glycaemic control were associated with any level of depression. Patients with poor glycemic control had odds ratio of 4.75 for mild to moderate depression (95% CI=1.37-16.41) and 10.39 for severe depression (95% CI,=3.66-29.43) in reference to good glycemic control. Patients with fair glycemic control were four times more likely to have mild to moderate depression (OR, 4.31 with 95% CI, 1.57 to 11.85) and severe depression (OR, 3.77 with 95% CI, 1.42 to 10.02) than patients with good glycemic control.

Conclusion: Depression was identified as a significant health problem among patients with type 2 diabetes mellitus. Both diabetes and depression should be considered simultaneously during treatment plan.

Author(s): Mahbubur Rahman , Md. Anisur Rahman , Meerjady Sabrina Flora , Muhammad Rakibuz- Zaman

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