Comparison of Depression Level in Diabetic and Non-diabetic Patients in Birjand

Document Type : Original Article

Authors
Mohammad Khodashenas Roudsari 1
Saeid Mohtasham 2
Ali ‌Jafari 3
1 Department of Internal Medicine, Shaheed Rajaee Hospital, Ramsar International Campus, Mazandaran University of Medical Sciences, Ramsar, Iran
2 Department of Psychiatry, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
3 Department of Internal Medicine, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
10.30491/jcm.2025.507788.1024
Abstract
Background and Aim: With changes in lifestyle, diet, and urbanization, the prevalence of chronic diseases, including diabetes, has risen. Depression is one of the most common mental illnesses. Previous studies indicate that the incidence of depression is higher among individuals with diabetes compared to those without, which can worsen the prognosis for diabetic patients. This study was conducted due to a lack of similar evaluations in Birjand.
Methods: This descriptive-analytical case-control study was conducted on outpatient diabetic patients referred to the Valiasr Hospital Diabetes Clinic in Birjand, as well as patient attendants in the Valiasr and Imam Reza Birjand Clinics. After obtaining informed consent from the patients, a demographic information questionnaire and the Beck Depression Inventory were completed.
Results: The mean level of depression between the two study groups showed a significant difference. Specifically, the level of depression in the diabetic group was 3.14 ± 0.57, while in the non-diabetic group it was 2.07 ± 0.72. Diabetic patients exhibited a higher mean level of depression. The level of depression was not significantly correlated with the duration of the disease, but was found to be higher in patients treated with injectable drugs compared to those treated with oral medications.
Conclusion: Depression is more common in people with type 1 diabetes and those receiving injectable treatments than in non-diabetics. Therefore, in order to reduce the complications of depression in diabetic patients, it is recommended that all healthcare providers be encouraged to monitor depression levels in diabetic patients.
Keywords
Diabetes
Depression
Beck test
  1. Shahbazian H, Amani R, Shahbazian H, Shahbazian N, Shahbazian M. What the diabetic patients must beknow. Qom: Darolnashre Eslam press; 2004. [In Persian]
  2. Muchtar RS, Dingin IT. The Influence of Diabetic Foot Exercise on Sugar Levels In Type 2 Diabetes Mellitus Patients at Tanjung Buntung Public Health Center 2018. International Journal of Education and Curriculum Application. 2018; 1(1):1-6.
  3. Ta S. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014;37(1):81-90. doi:2337/dc14-S081
  4. Federation ID. Diabetes Atlas: Prevalence & projections 2008 [access 26 Jul 2011]. Available from: www.eatlas.idf.org/index2983.html
  5. World Health Organization. Diabetes 2020 [access 8 June 2020. Available from: https:// who.int/news-room/fact-sheets/detail/diabetes
  6. Papatheodorou K, Banach M, Bekiari E, Rizzo M, Edmonds M. Complications of diabetes 2017. Journal of Diabetes Research. 2018;2018: 3086167. doi:1155/2018/3086167
  7. Benjamin J, Sadock BJ, Sadock VA, Ruiz P. Kaplan and Sadock's comprehensive textbook of psychiatry. lippincott Williams & wilkins; 2017.
  8. World Health Organization. Depression 2020 [access 30 January 2020]. Available from: https://www. who.int/news-room/fact-sheets/detail/depression
  9. Van Den Eede F. Kaplan and sadock’s synopsis of Behavioral Sciences/Clinical Psychiatry. Tijdschrift voor Psychiatrie. 2016. pp. 78-9.
  10. Téllez-Zenteno JF, Cardiel MH. Risk factors associated with depression in patients with type 2 diabetes mellitus. Archives of Medical Research. 2002;33(1):53-60. doi:1016/s0188-4409(01) 00349-6
  11. Zahiroddin AR, Sadighi G. Depression among 100 diabetics referring to university hospitals. Research in Medicine. 2003;27(3):203-7.
  12. Katon WJ. The comorbidity of diabetes mellitus and depression. The American Journal of Medicine. 2008;121(11):S8-15. doi:1016/j. amjmed.2008.09.008
  13. Sartorius N. Depression and diabetes. Dialogues in Clinical Neuroscience. 2018;20(1):47-52. doi:31887/DCNS.2018.20.1/nsartorius
  14. Lustman PJ, Anderson RJ, Freedland KE, De Groot M, Carney RM, Clouse RE. Depression and poor glycemic control: a meta-analytic review of the literature. Diabetes Care. 2000;23(7):934-42. doi:2337/diacare.23.7.934
  15. Braunwald E, Fauci AS, Kasper DL, Hauser SL, Longo DL, Jameson JL. Harrison's principles of internal medicine: McGraw Hill; 2001.
  16. Calhoun D, Beals J, Carter EA, Mete M, Welty TK, Fabsitz RR, et al. Relationship between glycemic control and depression among American Indians in the Strong Heart Study. Journal of Diabetes and its Complications. 2010;24(4):217-22. doi:1016/j.jdiacomp.2009.03.005
  17. Ludman EJ, Katon W, Russo J, Von Korff M, Simon G, Ciechanowski P, et al. Depression and diabetes symptom burden. General Hospital Psychiatry. 2004;26(6):430-6. doi:1016/j. genhosppsych.2004.08.010
  18. McKellar JD, Humphreys K, Piette JD. Depression increases diabetes symptoms by complicating patients’ self-care adherence. The Diabetes Educator. 2004;30(3):485-92. doi: 1177/014572170403000320
  19. Park H, Hong Y, Lee H, Ha E, Sung Y. Individuals with type 2 diabetes and depressive symptoms exhibited lower adherence with self-care. Journal of Clinical Epidemiology. 2004;57(9):978-84. doi:1016/j.jclinepi.2004.01.015
  20. Lin EH, Katon W, Von Korff M, Rutter C, Simon GE, Oliver M, et al. Relationship of depression and diabetes self-care, medication adherence, and preventive care. Diabetes Care. 2004;27(9):2154-60. doi:2337/diacare.27.9.2154
  21. Anderson D, Horton C, O'Toole ML, Brownson CA, Fazzone P, Fisher EB. Integrating depression care with diabetes care in real-world settings: lessons from the Robert Wood Johnson Foundation Diabetes Initiative. Diabetes Spectrum. 2007;20(1):10-6. doi:10.2337/diaspect.20.1.10
  22. Gonzalez JS, Safren SA, Cagliero E, Wexler DJ, Delahanty L, Wittenberg E, et al. Depression, self-care, and medication adherence in type 2 diabetes: relationships across the full range of symptom severity. Diabetes Care. 2007;30(9):2222-7. doi:2337/dc07-0158
  23. Kilbourne AM, Reynolds III CF, Good CB, Sereika SM, Justice AC, Fine MJ. How does depression influence diabetes medication adherence in older patients?. The American Journal of Geriatric Psychiatry. 2005;13(3):202-10. doi:1176/appi.ajgp.13.3.202
  24. Shaban C, Fosbury JA, Cavan DA, Kerr D, Skinner TC. The relationship between generic and diabetes specific psychological factors and glycaemic control in adults with type 1 diabetes. Diabetes Research and Clinical Practice. 2009; 85(3):e26-9. doi:1016/j.diabres.2009.05.006
  25. Paschalides C, Wearden AJ, Dunkerley R, Bundy C, Davies R, Dickens CM. The associations of anxiety, depression and personal illness representations with glycaemic control and health-related quality of life in patients with type 2 diabetes mellitus. Journal of Psychosomatic Research. 2004;57(6):557-64. doi:1016/j. jpsychores.2004.03.006
  26. Black SA, Markides KS, Ray LA. Depression predicts increased incidence of adverse health outcomes in older Mexican Americans with type 2 diabetes. Diabetes Care. 2003;26(10):2822-8. doi:2337/diacare.26.10.2822
  27. Papelbaum M, Lemos HM, Duchesne M, Kupfer R, Moreira RO, Coutinho WF. The association between quality of life, depressive symptoms and glycemic control in a group of type 2 diabetes patients. Diabetes Research and Clinical Practice. 2010;89(3):227-30. doi:1016/j.diabres.2010.0 5.024
  28. Roy MS, Roy A, Affouf M. Depression is a risk factor for poor glycemic control and retinopathy in African-Americans with type 1 diabetes. Psychosomatic Medicine. 2007;69(6):537-42. doi:1097/PSY.0b013e3180df84e2
  29. Sultan S, Luminet O, Hartemann A. Cognitive and anxiety symptoms in screening for clinical depression in diabetes A systematic examination of diagnostic performances of the HADS and BDI-SF. Journal of Affective Disorders. 2010; 123(1-3):332-6. doi:1016/j.jad.2009.09.022
  30. Noroozinejad GH, Boustani H, Neamat PS, Behrouzian F. Comparison of depression among diabetic and non-diabetic patients. Jundishapur Scientific Medical Journal. 2006.
  31. Sadock BJ, Sadock VA. Kaplan and Sadock's synopsis of psychiatry: Behavioral Sciences/ Clinical Psychiatry: Lippincott Williams & Wilkins; 2011.
  32. De Groot M, Anderson R, Freedland KE, Clouse RE, Lustman PJ. Association of depression and diabetes complications: a meta-analysis. Biopsychosocial Science and Medicine. 2001;63 (4):619-30. doi:1097/00006842-200107000-00015
  33. Musselman DL, Betan E, Larsen H, Phillips LS. Relationship of depression to diabetes types 1 and 2: epidemiology, biology, and treatment. Biological Psychiatry. 2003;54(3):317-29. doi:1016/s0006-3223(03)00569-9
  34. Talbot F, Nouwen A. A review of the relationship between depression and diabetes in adults: is there a link?. Diabetes Care. 2000;23(10):1556-62. doi:2337/diacare.23.10.1556
  35. Gendelman N, Snell-Bergeon JK, McFann K, Kinney G, Paul Wadwa R, Bishop F, et al. Prevalence and correlates of depression in individuals with and without type 1 diabetes. Diabetes Care. 2009;32(4):575-9. doi:2337/ dc08-1835
  36. Alajmani DS, Alkaabi AM, Alhosani MW, Folad AA, Abdouli FA, Carrick FR, Abdulrahman M. Prevalence of undiagnosed depression in patients with type 2 diabetes. Frontiers in Endocrinology. 2019;10:259. doi:3389/fendo.2019.00259
  37. Al-Ghamdi AA. A high prevalence of depression among diabetic patients at a teaching hospital in Western Saudi Arabia. Neurosciences Journal. 2004;9(2):108-12.
  38. Mirzaei MA, Daryafti HA, Fallahzadeh HO, Azizi BA. Evaluation of depression, anxiety and stress in diabetic and non-diabetic patients. The Journal of Shahid Sadoughi University of Medical Sciences. 2016;24(5):387-97.
  39. Seydi Z, Abdolhoseini A. Comparing the Psychological Dimension of individuals with Diabetis and Non-Diabetics in Ilam, Iran. Quarterly Journal of Health Breeze. 2015;3(1):28-34.
  40. Bahadori Khosroshahi J, Khanjani Z. Depression and Quality of Life Between Diabetic and Non-Diabetic Patients. Journal Of Health Psychology. 2011.
  41. Mahmodi A. Comparison frequency and factors associated with depression in diabetics and non diabetics patients. Nursing And Midwifery Journal. 2008;6(2):88-93.
  42. Daneshvar S, Khodamoradi A, Ghazanfari Z, Montazeri A. Quality of life in diabetic patients: a comparative study. Payesh (Health Monitor). 2018;17(5):541-50.

  • Receive Date 23 September 2024
  • Revise Date 02 December 2024
  • Accept Date 18 December 2024