Depression and anxiety among patients with type 2 diabetes mellitus in Ibadan, Oyo State

Abstract

Background: The psychosocial burden of Diabetes Mellitus (DM) and its debilitating consequences could result in depression and anxiety. Several studies had been conducted on depression alone among diabetics in Nigeria. However, only few studies in addition to depression have explored the prevalence of anxiety and anxiety comorbidity with depression.

Aim: To determine the prevalence and factors associated with anxiety or depression among Type 2 DM patients.

Methods: This was a hospital based cross-sectional survey. Systematic random technique was used to select 273 Type 2DM patients aged 40 years and above attending a secondary health facility in Ibadan, Nigeria. Depression and anxiety were assessed by using Zung’s Self Depression Rating Scale and Beck Anxiety Inventory respectively. Data was analyzed using the Chi square test and multivariate logistic regression with a P value set at 0.05.

Results: The mean age of the respondents was 62.1 (+10.2) years and majority were female (85.3%). The prevalence of depression, anxiety and comorbidity of depression and anxiety were 27.5%, 16.5% and 4.4% respectively. Physical inactivity and uncontrolled blood glucose were found among 48.4% and 61.5% respondents respectively. Depression was significantly associated with physical inactivity [OR=0.58; 95% CI=0.34-0.93] and low-moderate social support [OR=1.85; 95% CI=1.08-3.17], while anxiety was significantly associated with religion. The predictors of depression and anxiety were low social support (OR=0.58; 95% CI=0.33-0.95 p=0.04) and Christianity (OR=2.25; 95% CI=1.10-4.61, P=0.03) respectively.

Conclusion: We recommend that clinicians should screen Type 2 DM patients for depression and anxiety, assess their level of social support, educate on the importance of physical activity and encourage physical activity.

Keyword: Depression, Anxiety, Type 2 Diabetes Mellitus, Comorbidity, Social support.

Résumé
Contexte: Le fardeau psychosocial du diabète sucré (DM) et ses conséquences débilitantes pourraient entraîner la dépression et l’anxiété. Plusieurs études ont été menées sur la dépression seule chez les diabétiques au Nigeria. Cependant, seulement peu d’études en plus de la dépression ont exploré la prévalence de l’anxiété et l’anxiété comorbidité avec la dépression.

Objectif: Déterminer la prévalence et les facteurs associés à l’anxiété ou à la dépression chez les patients atteints de DM de type 2.

Méthodes: Il s’agissait d’une enquête transversale en milieu hospitalier. Une technique aléatoire systématique a été utilisée pour sélectionner 273 patients de type 2DM âgés de 40 ans et plus fréquentant un établissement de santé secondaire à Ibadan, au Nigéria. La dépression et l’anxiété ont été évaluées en utilisant l’échelle d’évaluation de l’autodéfré dépression de Zung et l’inventaire de l’anxiété Beck respectivement. Les données ont été analysées à l’aide du test chi carré et de la régression logistique multivariée avec une valeur P fixée à 0,05.
Résultats: L’âge moyen des répondants était de 62,1 ans (+10,2 ans) et la majorité était une femme (85,3 %). La prévalence de la dépression, de l’anxiété et de la comorbidité de la dépression et de l’anxiété était de 27,5 %, 16,5 % et 4,4 % respectivement. L’inactivité physique et la glycémie incontrôlée ont été trouvées parmi 48,4 % et 61,5 % des répondants respectivement. La dépression était significativement associée à l’inactivité physique [OR=0,58; IC à 95 %=0,34-0,93] et à un soutien social faiblement modéré [OR=1,85; IC à 95 %=1,08-3,17], tandis que l’anxiété était significativement associée à la religion. Les prédicteurs de la dépression et de l’anxiété étaient un faible soutien social (OR=0,58; IC à 95 %=0,33-0,95 p=0,04) et christianisme (OR=2,25; IC à 95 %=1,10-4,61, P=0,03) respectivement.

Conclusion: Nous recommandons aux cliniciens de dépister la dépression et l’anxiété chez les patients de type 2, d’évaluer leur niveau de soutien social, d’éduquer sur l’importance de l’activité physique et d’encourager l’activité physique.

Mots-clés: Dépression, Anxiété, Diabète sucré de type 2, Comorbidité, Soutien social.

Correspondence: Prof. Olufunmilayo I. Fawole, Department of Epidemiology and Medical Statistics, Faculty of Public Health, University of Ibadan, Email address: fawoleo@ymail.com; Tel:08032180302

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