Factors associated with depression in the patients with diabetes mellitus type 2

Admir Šabanović; Nataša Maksimović; Mirjana Stojanović-Tasić; Marijan Bakić; Anita D Grgurević

doi:10.2298/VSP170328029S

Admir Šabanović Primary Health Center Bijelo Polje, Bijelo Polje, Montenegro
Nataša Maksimović University of Belgrade, Faculty of Medicine, Institute of Epidemiology, Serbia
Mirjana Stojanović-Tasić University of Priština – Kosovska Mitrovica, Faculty of Medicine, Kosovska Mitrovica, Serbia
Marijan Bakić Institute for Public Health of Montenegro, Podgorica, Montenegro
Anita D Grgurević University of Belgrade, Faculty of Medicine, Institute of Epidemiology, Serbia

DOI: https://doi.org/10.2298/VSP170328029S

Keywords: depression, diabetes mellitus, type 2, patient health questionnaire, montenegro

Abstract

Abstract

Background/Aim. The assessment of association of depression and diabetes mellitus type 2 using the Patient Health Questionaire (PHQ-9) has not been done in Montenegro. The aim of this study was to assess the prevalence of depression in the patients with type 2 diabetes mellitus, and to identify the risk factors associated with the presence of depression. Methods. A cross-sectional study was conducted at the General Hospital in Bijelo Polje, from July to September, 2015. It included 70 patients over 35 years of age with the diagnosis of diabetes for at least six months. For the assessment of depression presence and intensity PHQ–9 was used. All variables associated with the presence of depression at a significance level of p < 0.05 were included into the final method of the multivariate logistic regression analysis. Results. Comorbidities were statistically significant more frequent among patients with depression (χ² = 5.40; p = 0.020). Duration of diabetes over five years was significantly associated with depression (χ² = 12.48; p < 0.001). Depression occurred more frequently among physically inactive subjects (χ² = 10.74; p = 0.005). The presence of diabetic polyneuropathy (χ² = 6.04; p = 0.014) and cataract (χ² = 5.351; p = 0.021) were also significantly associated with depression. A multivariate logistic regression analysis showed that the duration of diabetes over five years and presence of cataract were independently associated with depression. Conclusion. The risk factors for depression among the subjects with diabetes were disease duration more than five years and the presence of cataract. Since depression is a serious disease and can be a risk factor for many chronic diseases, the best way of prevention is its early detection and treatment.

References

REFERENCES

World Health Organization. What is depression. Available from: www.who.int/mental_health/management/depression/definition/en

World Health Organization. Depression, fact sheets. Available from: www.who.int. depression/factsheets

Republička stručna komisija za izradu i implementaciju vodiča dobre kliničke prakse. Nacionalni vodič dobre kliničke prakse za dijagnostiku i lečenje depresije. Beograd: Ministarstvo zdravlja Republike Srbije; 2011.

Stanković Ž, Jašović-Gašić M. Comorbidity of depression and type 2 diabetes: Risk factors and clinical significance. Vojnosa-nit Pregl 2010; 67(6): 493–500.

Li C, Ford ES, Strine TW, Mokdad AH. Prevalence of depres-sion among U.S. adults with diabetes: findings from the 2006 behavioral risk factor surveillance system. Diabetes Care 2008; 31(1): 105–7.

de Groot M, Anderson R, Freedland KE, Clouse RE, Lustman PJ. Association of depression and diabetes complications: a meta-analysis. Psychosom Med 2001; 63(4): 619–30.

Sneed JR, Culang-Reinlieb ME. The vascular depression hypothesis: an update. Am J Geriatr Psychiatry 2011; 19(2): 99–103.

Schmitz N, Gariépy G, Smith KJ, Malla A, Wang J, Boyer R, et al. The pattern of depressive symptoms in people with type 2 di-abetes: a prospective community study. J Psychosom Res 2013; 74(2): 128–34.

Janssen EP, Köhler S, Stehouwer CD, Schaper NC, Dagnelie PC, Sep SJ, et al. The Patient Health Questionnaire-9 as a Screening Tool for Depression in Individuals with Type 2 Diabetes Mellitus: The Maastricht Study. J Am Geriatr Soc 2016; 64(11): e201–6.

Larijani B, Khoram M, Bayat S, Gorgani KM, Bandarian F, Ak-hondzadeh S, et al. Association between depression and di-abetes. German J Psychiatry 2004; 7: 62–5.

Willborn RJ, Barnacle M, Maack B, Petry N, Werremeyer A, Strand MA. Use of the 9-item patient health questionnaire for depression assessment in primary care patients with type 2 diabetes. J Psychosoc Nurs Ment Health Serv 2016; 54(1): 56–63.

van der Zwaan GL, van Dijk SEM, Adriaanse MC, van Marwijk HWJ, van Tulder MW, Pols AD, et al. Diagnostic accuracy of the Patient Health Questionnaire-9 for assessment of depres-sion in type II diabetes mellitus and/or coronary heart disease in primary care. J Affect Disord 2016; 190: 68–74.

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

Schmitz N, Messier L, Nitka D, Ivanova A, Gariepy G, Wang J, et al. Factors associated with disability and depressive symptoms among individuals with diabetes: a community study in Que-bec. Psychosomatics 2011; 52(2): 167–77.

Roy T, Lloyd CE, Parvin M, Mohiuddin KG, Rahman M. Preva-lence of co-morbid depression in out-patients with type 2 di-abetes mellitus in Bangladesh. BMC Psychiatry 2012; 12: 123.

Das-Munshi J, Stewart R, Ismail K, Bebbington PE, Jenkins R, Prince MJ. Diabetes, common mental disorders, and disability: findings from the UK National Psychiatric Morbidity Survey. Psychosom Med 2007; 69(6): 543–50.

Miyaoka Y, Miyaoka H, Motomiya T, Kitamura S, Asai M. Impact of sociodemographic and diabetes-related characteristics on depressive state among non-insulin-dependent diabetic patients. Psychiatry Clin Neurosci 1997; 51(4): 203–6.

Mezuk B, Eaton WW, Golden SH, Ding Y. The influence of educational attainment on depression and risk of type 2 diabetes. Am J Public Health 2008; 98(8): 1480–5.

Reddy P, Philpot B, Ford D, Dunbar JA. Identification of depres-sion in diabetes: the efficacy of PHQ-9 and HADS-D. Br J Gen Pract 2010; 60(575): e239–45.

Von Korff M, Katon W, Lin EH, Simon G, Ludman E, Oliver M, et al. Potentially modifiable factors associated with disability among people with diabetes. Psychosom Med 2005; 67(2): 233–40.

Nasser J, Habib F, Hasan M, Khalil N. Prevalence of depression among people with diabetes attending diabetes clinics at pri-mary health settings. Bahrain Med Bull 2009; 31: 1–7.

Kawakami N, Takatsuka N, Shimizu H, Ishibashi H. Depressive symptoms and occurrence of type 2 diabetes among Japanese men. Diabetes Care 1999; 22(7): 1071–6.

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(5): 837–45.

Cosgrove MP, Sargeant LA, Griffin SJ. Does depression increase the risk of developing type 2 diabetes? Occup Med (Lond) 2008; 58(1): 7–14.

Brown LC, Majumdar SR, Newman SC, Johnson JA. History of depression increases risk of type 2 diabetes in younger adults. Diabetes Care 2005; 28(5): 1063–7.