|Year : 2022 | Volume
| Issue : 2 | Page : 146-149
Correlation of depression and anxiety in type 2 diabetes mellitus patients in a tertiary care hospital
Ashok Kamat1, Laxmi Kamat2
1 Department of Psychiatry, KAHER Institute of Nursing Sciences, Belagavi, Karnataka, India
2 Department of Obstetrics and Gynecology, KAHER Institute of Nursing Sciences, Belagavi, Karnataka, India
|Date of Submission||09-Feb-2022|
|Date of Decision||15-Nov-2022|
|Date of Acceptance||06-Dec-2022|
|Date of Web Publication||19-Jan-2023|
Dr. Ashok Kamat
KAHER Institute of Nursing Sciences, Belagavi, Karnataka
Source of Support: None, Conflict of Interest: None
Context: People with type 2 diabetes are more likely than the general population to have depressive And anxiety symptoms. Type 2 diabetics are being studied for depression and anxiety.
Aim: To investigate the Prevalence and correlates of Depression and Anxiety in Type 2 Diabetes Mellitus Patients.
Settings and Design: The Department of Endocrine and Medicine at Vijaya Hospital in Belagavi, South India, did a descriptive research.
Methods and Materials: In a study on depression and anxiety, 384 people with type 2 diabetes were administered the Hospital Anxiety and Depression Scale (HADS).
Statistical analysis used: Descriptive and inferential statistical analysis were done using SPSS software.
Results: Depression and anxiety were found in 32.56% and 37.76% of the 384 patients assessed, respectively. P = 0.0001 showed a strong connection between anxiety and depressive symptoms (r = 0.7046) in this study. Type 2 diabetes duration, type of therapy and HADS-Anxiety were known to have a significant association. HADS-Depression revealed a significant association with age, qualification, type 2 diabetes duration, and treatment type (P < 0.05) in the same way as HADS-Depression does.
Conclusion: According to the findings of this study, anxiety and sadness are widespread among people with type 2 diabetes. Furthermore, a strong link between depression and anxiety was observed across a wide range of variables. Depression and anxiety symptoms in people with type 2 diabetes should be assessed and treated on a frequent basis.
Keywords: Anxiety, Depression, Tertiary care hospital, Type 2 diabetes mellitus
|How to cite this article:|
Kamat A, Kamat L. Correlation of depression and anxiety in type 2 diabetes mellitus patients in a tertiary care hospital. Indian J Phys Ther Res 2022;4:146-9
|How to cite this URL:|
Kamat A, Kamat L. Correlation of depression and anxiety in type 2 diabetes mellitus patients in a tertiary care hospital. Indian J Phys Ther Res [serial online] 2022 [cited 2023 Jun 2];4:146-9. Available from: https://www.ijptr.org/text.asp?2022/4/2/146/368048
| Introduction|| |
Insulin deficiency and insulin resistance are the key pathophysiological features that characterize diabetes, which is characterized by chronic hyperglycemia due to insulin deficiency. Obesity, overeating, exercise, stress, and the aging process are all contributing factors to type 2 diabetes, as is a genetic predisposition to insulin resistance and secretion issues. Everywhere in the globe, diabetes is on the rise. Diabetes has risen to the status of a serious public health concern in the 21st century, since its prevalence has increased fivefold in the previous 15 years. It is on the rise. The diabetes population in developing countries is expected to reach 438 million by 2030 (representing more than 70% of the world's total population). Depression and anxiousness impact people all around the world, and they are a global problem. According to one research, anxiety and sadness are twice as frequent among diabetics as they are in the general population. In India, over 50 million people have type 2 diabetes. Diabetes will soon become India's capital. Diabetes mellitus is also associated with depression and anxiety.Depression affects an estimated 340 million individuals globally on a regular basis. Depression and anxiety have a global average prevalence of 25% and 7.3%, respectively. Women are more likely than men to suffer from depression disorders. Depression affects 10%–2% of the population at some point in their lives. Diabetes, depression, and anxiety are far more common than the national average, ranging from 12%–28% to 4%–58%. According to numerous studies, the prevalence varies from 12% to 48% depending on the area.
In terms of mental health issues, anxiety is up there at the top. Disease-specific and nonspecific risk factors help identify persons at risk, which is necessary for later treatment. In comparison to the general population, those who have medical issues are more likely to suffer from depression. There is a substantial correlation between depression and other disorders; thus, depression screening methods may be useful.
| Subjects and Methods|| |
The research was done using a nonexperimental descriptive study design. It took place between May 2018 and March 2019, according to reports. At the Vijay Hospital, Belagavi, in the southern Indian state of Karnataka, 384 patients with type 2 diabetes mellitus received outpatient therapy. It was conveyed orally and in writing with the surveys about the study's goals and advantages. It was made clear to patients that their participation in the study would not affect their medical care in any way. Participants who agreed to partake in the research had to fill out a formal permission form. The interviewers were taught how to use the Hospital Anxiety and Depression Scale (HADS) and patient data to conduct interviews. For ease of understanding, the survey was also translated into the native language of Kannada.
Inclusion and exclusion criteria
Participants in the study had to be diagnosed with type 2 diabetes and be between the age group of 30-60 years, with fasting glucose levels greater than 126 mg/dl and postprandial glucose levels less than 200 mg/dl. Participants who had been diagnosed with psychiatric problems or who were using antidepressants, as well as pregnant women and very unwell patients, were excluded from the study.
The institute's ethics committee approved the study protocol. After explaining the study's objectives, all participants were provided informed written consent.
Excel was used to enter and analyze the data collected throughout the research, and SPSS was used to run the statistical tests (V.20.0). On both continuous and categorical data, descriptive statistical analysis was performed. It was used to investigate the differences in the characteristics of participants, using the t-test for normally distributed variables. Depression and anxiety symptoms were examined independently or in combination in relation to glycemic control. For all analyses, the statistical significance threshold was at P < 0.05.
| Results|| |
Purposive sampling was used to choose 384 persons with type 2 diabetes who were not randomly chosen for the study. Participants in the study were asked to fill out a sociodemographic profile questionnaire as well as a standard HADS.
There were 384 participants in the current study, with 261 men (67.97%) and 123 women (32.03%). Between the age of 41 and 50 years, 52.08% of those who participated in this study were engaged. 108 (28.13%) were between the age of 30 and 40 years, with 76 (19.79%) between the age of 51 and 60 years. The majority of respondents (56.77%) had type 2 diabetes for 0–5 years, with 20 (5.21%) having it for more than 16 years. Nearly 247 (64.32%) of those polled were taking oral hypoglycemic medications, while 49 (12.76%) were taking both insulin and oral hypoglycemic medications. Majority (279, or 72.66%) were from middle-class families; however, just 39, or 10.16%, came from lower-class ones. Widowed women account for 28% of the population, while divorced women account for 18%. One in four respondents finished high school, 68 (17.71%) completed higher secondary education, 57 (14.84%) completed the secondary school, and 50 (13.03%) had no formal education at all, while 45 (11.72%) completed secondary school. Private employees comprised 36.45% of the respondents, while farmers comprised 5.21%.
[Table 1] reveals the correlation between depression and anxiety scores. Both the r-value (r = 0.7046, P = 0.0001) and the t-value (t: 19.4096, P = 0.0001), both at the 0.05 level of significance, showed a significant association between depression and anxiety levels. People who are depressed are more likely to be anxious, while those who are anxious are more likely to be depressed.
|Table 1: Correlation between depression and anxiety scores by Karl Pearson's correlation coefficient method (n=384)|
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[Table 2] reveals the relationship between demographic factors and depression scores. Considering the r-value and t-value at the 0.05 level of significance, age, qualification, length of type 2 diabetes, and treatment method all showed a positive correlation with depression levels. Sex, marital status, economic status, employment, type of family, and religion all had a negative correlation with depression levels.
|Table 2: Correlation between demographic characteristics with depression scores by Spearman's rank correlation method (n=384)|
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[Table 3] reveals the correlation between demographic characteristics and anxiety scores. Anxiety levels were strongly associated with the 0.05 level of significance for r-values and t-values for qualification, duration of type 2 diabetes, and treatment type. Age, gender, marriage status, socioeconomic status, occupation, family structure, and religion all had a detrimental impact on anxiety levels. The length of type 2 diabetes and the kind of treatment had a positive relationship with anxiety levels. Sex, race, marital status, socioeconomic class, career, family type, and religion all had a negative link with anxiety levels.
|Table 3: Correlation between demographic characteristics with anxiety scores by Spearman's rank correlation method (n=384)|
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| Discussion|| |
The goal of this study was to determine whether or not depression and anxiety are linked to poor glycemic control (diabetes) control.
In the current study, depression and anxiety were found in 32.56% and 37.76% of those with type 2 diabetes. Diabetes patients are increasing suffering from depression and anxiety, according to research from around the world, including India. In the current study, 32.56% of participants reported experiencing depression symptoms. Northern India (41.56%), the Netherlands (31%), Bahrain (33.3%), Malaysia (30.5%), and the United Kingdom (30.5%) all had similar results in the previous survey. A multicenter research in Pakistan discovered a frequency of 43.5%. With a frequency of up to 67.5%, depression is more frequent among patients with type 2 diabetes than in the overall population.,,,,, Depression is common in individuals with type 2 diabetes (T2DM) in 30%–83% of cases, according to research conducted in the United States and the United Kingdom. Depression rates in diabetics ranged from 8% to 61%, according to a meta-analysis of literature on the topic., These variations might be accounted by sample size, socioeconomic status, and other variables. As a consequence, the clinical study outcomes may be skewed by the absence of recording of key disease-related factors.
Anxiety was found to be more prevalent in 37.76% of the participants in the current study. Compared to the present research, prior study revealed a prevalence of anxiety of 69.9%, while other studies reported a low prevalence of anxiety.
Depression and anxiety were found to be more closely linked in type 2 diabetes patients (correlation coefficient, 0.7046; P = 0.0001), and there was also a significant correlation with age, qualification, length of time with diabetes (type 2), and the type of treatment used (P < 0.05). HADS-Anxiety was also found to have a significant correlation with these factors. This was in accordance with other studies that found a relation with duration of diabetes. However, there are limitations in our study.
| Conclusion|| |
Type 2 diabetes patients are more likely to experience anxiety and depression. The prognosis might be worsened by a number of factors. A diabetic management strategy that includes frequent screenings is therefore essential.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J, Dan Longo J, et al.
Harrison's Principles of Internal Medicine. 17th
ed. New York: McGraw Hill; 2008. p. 2275-6.
Anjana RM, Ali MK, Pradeepa R, Deepa M, Datta M, Unnikrishnan R, et al.
The need for obtaining accurate nationwide estimates of diabetes prevalence in India – Rationale for a national study on diabetes. Indian J Med Res 2011;133:369-80.
] [Full text]
Knol MJ, Heerdink ER, Egburts AC, Geerlinks MI, Gorter KJ, Neumans ME, et al. Depressive symptoms in subjects with diagnosed and undiagnosed type 2 diabetes. Psycosom Med. 2007; 69(4):300-5.
DIaMoND JED. Medicine. Diabe Ind. 2011; 469(7331):478-9.
Wittchen HU. Reliability and validity studies of the WHO-Composite International Diagnostic Interview (CIDI): a critical review. J Psychiatr Res. 1994 Jan 1;28(1):57-84.
Al-Amer RM, Sobeh MM, Zayed AA, Al-Domi HA. Depression among adults with diabetes in Jordan: Risk factors and relationship to blood sugar control. J Diabetes Complications 2011;25:247-52.
Balhara YP, Sagar R. Correlates of anxiety and depression among patients with type 2 diabetes mellitus. Indian J Endocrinol Metab 2011;15:S50-4.
Balhara YP, Sagar R. Correlates of anxiety and depression among patients with type 2 diabetes mellitus. Ind J Endocrinol Metab. 2011 Jul;15(Suppl1):S50.
Raval A, Dhanaraj E, Bhansali A, Grover S, Tiwari P. Prevalence & determinants of depression in type 2 diabetes patients in a tertiary care centre. Ind J Med Res. 2010 Aug 1;132(2):195.
Pouwer F, Geelhoed-Duijvestijn PH, Tack CJ, Bazelmans E, Beekman AJ, Heine RJ, et al. Prevalence of comorbid depression is high in out-patients with Type 1 or Type 2 diabetes mellitus. Results from three out-patient clinics in the Netherlands. Diabe Med. 2010 Feb;27(2):217-24.
Nasser J, Habib F, Hasan M, Khalil N. Prevalence of depression among people with diabetes attending diabetes clinics at primary health settings. Bahrain Med Bull. 2009 Sep;31:1-7.
Kaur G, Tee GH, Ariaratnam S, Krishnapillai AS, China K. Depression, anxiety and stress symptoms among diabetics in Malaysia: a cross sectional study in an urban primary care setting. BMC Family Pract. 2013 Dec;14(1):69.
Khullar S, Dhillon H, Kaur G, Sharma R, Mehta K, Aggarwal R, et al
. The prevalence and predictors of depression in type 2 diabetic population of Punjab. Commu Mental Health J. 2016;52:479-83.
Li C, Ford ES, Strine TW, Mokdad AH. Prevalence of depression among US adults with diabetes: findings from the 2006 behavioral risk factor surveillance system. Diabe Care. 2008 Jan 1;31(1):105-7.
Kendrick T, Dowrick C, McBride A, Howe A, Clarke P, Maisey S, et al.
Management of depression in UK general practice in relation to scores on depression severity questionnaires: analysis of medical record data. BMJ. 2009 Mar 19;338:b750.
Atiq Ur Rehman, Syeda Farhana Kazmi (2015).Prevalence and Level of Depression, Anxiety and Stress among Patients with Type-2 Diabetes Mellitus Ann. Pak. Inst. Med. Sci; 11(2): 81-86.
[Table 1], [Table 2], [Table 3]