title: Investigating the association between diabetes mellitus, depression and psychological distress in a cohort of South African teachers.
abstract: BACKGROUND
  Diabetes mellitus (DM) may increase the risk of depression as a result of a sense of threat of debilitating complications or because of associated lifestyle changes. Depression may increase the risk of type 2 diabetes as a result of poor health behaviours.
  
  
  OBJECTIVE
  To determine the association between diabetes mellitus, depression and psychological distress in a cohort of South African (SA) teachers.
  
  
  METHODS
  Teachers from 111 public schools in the Metro South District of the Cape Metropolitan area, SA, were invited to participate in this study. The Center for Epidemiologic Studies Depression Scale (CES-D) and the Kessler Psychological Distress Scale (K10) were used to assess depression and psychological distress, respectively. A professional nurse completed a physical examination and collected blood for measurement of glucose, cholesterol and serum creatinine.
  
  
  RESULTS
  Of the 388 teachers who completed the questionnaires, 67.5% were female and the average age was 46.2 years (standard deviation 8.7). Psychological distress was identified in 28.1% of the cohort and depression in 15.5%, and 7.7% were found to fulfil criteria for DM. A diagnosis of DM was associated with an increased risk of depression (adjusted odds ratio (AOR) 3.90; 95% confidence interval (CI) 1.33-11.37) and psychological distress (AOR 3.62; 95% CI 1.31-10.00).
  
  
  CONCLUSIONS
  The high prevalence of obesity and DM in this cohort of SA teachers is of concern. A diagnosis of DM was strongly associated with an increased risk of depression and psychological distress.
authors.affiliation: Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Cape Town, South Africa. abduldomingo@gmail.com.
authors.forename: Abdul Kader
authors.initials: AK
authors.lastname: Domingo
authors.forename: Laila
authors.initials: L
authors.lastname: Asmal
authors.forename: Soraya
authors.initials: S
authors.lastname: Seedat
authors.forename: Tonya M
authors.initials: TM
authors.lastname: Esterhuizen
authors.forename: Carien
authors.initials: C
authors.lastname: Laurence
authors.forename: Jimmy
authors.initials: J
authors.lastname: Volmink