title: Sociodemographic, clinical, and psychosocial factors associated with depression among type 2 diabetic outpatients in Black Lion General Specialized Hospital, Addis Ababa, Ethiopia: a cross-sectional study.
abstract: BACKGROUND
  Depression is a common comorbidity among patients with type 2 diabetes. There are several reports supporting a bidirectional association between depression and type 2 diabetes. However, there is limited data from non-western countries. Therefore, the aim of this study was to assess the sociodemographic, clinical, and psychosocial factors associated with co-morbid depression among type 2 diabetic outpatients presenting to Black Lion General Specialized Hospital, Addis Ababa, Ethiopia.
  
  
  METHODS
  This institution based cross-sectional study design was conducted on a random sample of 276 type 2 diabetic outpatients. Type 2 diabetes patients were evaluated for depression by administering a validated nine-item Patient Health Questionnaire (PHQ-9). Risk factors for depression among type 2 diabetes patients were identified using multiple logistic regression analysis.
  
  
  RESULTS
  In total, 264 study participants were interviewed with a response rate of 95.6%. The prevalence of depression was 44.7%. In the multivariate analysis, the statistically significant risk factors for depression were monthly family income ≤ 650 (p-value = 0.056; OR = 2.0; 95% CI = 1.01, 4.2), presence of ≥3 diabetic complications (p-value = 0.03; OR = 3.3; 95% CI = 1.1, 10.0), diabetic nephropathy (p-value = 0.01; OR = 2.9; 95% CI = 1.2, 6.7), negative life events (p-value = 0.01; OR = 2.4; 95% CI = 1.2, 4.5), and poor social support (p-value = 0.001; OR = 2.7; 95% CI = 1.5, 5.0).
  
  
  CONCLUSIONS
  This study demonstrated that depression is a common co-morbid health problem with a prevalence rate of 44.7%. The presence of diabetic complications, low monthly family income, diabetic nephropathy, negative life event, and poor social support were the statistically significant risk factors associated with depression. We presume that the burden of mental health especially depression is high in the population with type 2 diabetes mellitus co-morbidity. Therefore, specific attention is needed to diagnose early and treat promptly.
authors.affiliation: Department of Nursing, College of Health Science, Debre Berhan University, Debre Berhan, P.O. BOX: 445, Ethiopia. tesfadej2003@gmail.com.
authors.forename: Tesfa Dejenie
authors.initials: TD
authors.lastname: Habtewold
authors.affiliation: International Medical Corps, Mental Health and Psychosocial Support Program, Dollo Ado Refugee Camp, Ethiopia.
authors.forename: Sisay Mulugeta
authors.initials: SM
authors.lastname: Alemu
authors.affiliation: Department of Nursing, College of Health Science, Debre Berhan University, Debre Berhan, P.O. BOX: 445, Ethiopia.
authors.forename: Yohannes Gebreegziabhere
authors.initials: YG
authors.lastname: Haile
mesh_terms: D000328:Adult; D000368:Aged; D044383:Black People / Q000706:statistics & numerical data*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D003866:Depressive Disorder / Q000453:epidemiology; D048909:Diabetes Complications / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000523:psychology; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010045:Outpatients / Q000706:statistics & numerical data; D015995:Prevalence; D012307:Risk Factors; D012944:Social Support
keywords: Clinical factors; Cross-sectional study; Depression; Diabetes; Ethiopia; Outpatient; Psychosocial factors; Sociodemographic factors