Frequency of depression in type 2 diabetes mellitus and an analysis of predictive factors.
OBJECTIVE
To determine frequency of depression in patients with diabetes mellitus type 2 and to identify predictive factors.


METHODS
The observational study was carried out at 1 Mountain Medical Battalion, Bagh, Azad Kashmir, Pakistan, from June 2013 to May 2014, and comprised type 2 diabetic patients who were not using anti-depressants and did not have history of other psychiatric illnesses. Demographic data, duration of diabetes, presence of hypertension and type of treatment were recorded and body mass index was calculated. Patient Health Questionnaire-9, translated into Urdu, was administered during face-to-face interviews. Scores >5 indicated depression, which was classified into different grades of severity using standard cut-off values.


RESULTS
Of the 133 patients, 51(38.35%) were depressed. Depression was mild in 34(26%), moderate in 12(9.6%), moderately severe in 4(2.9%) and severe in 1(0.7%) patient. On univariate binary logistic regression, female gender (odds ratio=3.07; 95% confidence interval = 1.43, 6.59), lesser education (odds ratio = 0.90; 95% confidence interval 0.84, 0.97) shorter duration of diabetes (odds ratio=0.87; 95% confidence interval = 0.80, 0.96) and higher body mass index (odds ratio=1.41; 95% confidence interval = 1.05, 1.25) were significantly associated with depression. Only shorter duration of diabetes (odds ratio=0.90; 95% confidence interval = 0.82, 0.99) remained significant after adjustment for confounders. Age, level of education, glycaemic control and type of treatment did not predict depression.


CONCLUSIONS
A significant proportion of type 2 diabetics were depressed. Shorter duration of diabetes reliably predicted depression in these patients.
Department of Medicine, 1 Mountain Medical Battalion, Bagh, Azad Kashmir, Pakistan.
Abdul Rehman
AR
Arshad
Department of Medicine, 1 Mountain Medical Battalion, Bagh, Azad Kashmir, Pakistan.
Kamran Yousaf
KY
Alvi
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D004522:Educational Status; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D050177:Overweight / Q000453:epidemiology* / Q000523:psychology; D010154:Pakistan / Q000453:epidemiology; D012307:Risk Factors; D012737:Sex Factors
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human
Pakistan, Diabetes, Depression, Risk factors.