title: Prevalence of depression among people with type 2 diabetes mellitus: a cross sectional study in Palestine.
abstract: BACKGROUND
  Diabetes mellitus is a common chronic metabolic disorder and one of the main causes of death in Palestine. Palestinians are continuously living under stressful economic and military conditions which make them psychologically vulnerable. The purpose of this study was to investigate the prevalence of depression among type II diabetic patients and to examine the relationship between depression and socio-demographic factors, clinical factors, and glycemic control.
  
  
  METHODS
  This was a cross-sectional study at Al-Makhfiah primary healthcare center, Nablus, Palestine. Two hundred and ninety-four patients were surveyed for the presence of depressive symptoms using Beck Depression Inventory (BDI-II) scale. Patients' records were reviewed to obtain data pertaining to age, sex, marital status, Body Mass Index (BMI), level of education, smoking status, duration of diabetes mellitus, glycemic control using HbA1C test, use of insulin, and presence of additional illnesses. Patients' medication adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8).
  
  
  RESULTS
  One hundred and sixty four patients (55.8%) of the total sample were females and 216 (73.5%) were < 65 years old. One hundred and twenty patients (40.2%) scored ≥ 16 on BDI-II scale. Statistical significant association was found between high BDI-II score (≥ 16) and female gender, low educational level, having no current job, having multiple additional illnesses, low medication adherence and obesity (BMI ≥ 30 kg/m2). No significant association between BDI score and glycemic control, duration of diabetes, and other socio-demographic factors was found. Multivatriate analysis showed that low educational level, having no current job, having multiple additional illnesses and low medication adherence were significantly associated with high BDI-II scores.
  
  
  CONCLUSIONS
  Prevalence of depression found in our study was higher than that reported in other countries. Although 40% of the screened patients were potential cases of depression, none were being treated with anti-depressants. Psychosocial assessment should be part of routine clinical evaluation of these patients at primary healthcare clinics to improve quality of life and decrease adverse outcomes among diabetic patients.
authors: Department of Pharmacology/ Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine. waleedsweileh@yahoo.com.
authors: Waleed M
authors: WM
authors: Sweileh
authors: Hanadi M
authors: HM
authors: Abu-Hadeed
authors: Samah W
authors: SW
authors: Al-Jabi
authors: Sa'ed H
authors: SH
authors: Zyoud
mesh_terms: D000368:Aged; D018912:Arabs; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D015995:Prevalence; D011320:Primary Health Care; D011569:Psychiatric Status Rating Scales; D012737:Sex Factors
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents