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International Journal of Mental Health Systems
Published in: International Journal of Mental Health Systems 1/2019

Open Access 01-12-2019 | Mood Disorders | Research

Prevalence and predictors of depression, anxiety, and stress symptoms among patients with type II diabetes attending primary healthcare centers in the western region of Saudi Arabia: a cross-sectional study

Authors: Alhussain Alzahrani, Abdulrahman Alghamdi, Turki Alqarni, Reem Alshareef, Abdullah Alzahrani

Published in: International Journal of Mental Health Systems | Issue 1/2019

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Abstract

Background

Type 2 diabetes mellitus (T2DM) is a prevalent health problem, not only globally, but also in Saudi Arabia. A growing body of literature suggests a bi-directional association between T2DM and various mental health disorders. This study aimed to investigate the prevalence and predictors of depression, anxiety, and stress among T2DM patients in the western region of Saudi Arabia.

Methods

Between May and August 2018, a cross-sectional study was conducted among adult patients with T2DM in five public primary care centers in the western region of Saudi Arabia. Sociodemographic characteristics and symptoms of depression, anxiety, and stress were measured using the self-administered, previously validated Depression, Anxiety, and Stress Scale (DASS-21) questionnaire. Simple descriptive statistics were used. Forward binary logistic regression was used to identify predictors of depression, anxiety, and stress.

Results

A total of 450 adults with T2DM were included (56.9% men; 43.1% women). The prevalence of depression, anxiety, and stress was 33.8%, 38.3%, and 25.5%, respectively. Major predictors of psychological distress were age, sex, the presence of comorbidities, duration since T2DM diagnosis, and serum level of hemoglobin A1c. Compliance with diabetes management measures and older age were the only protective factors.

Conclusion

Patients with T2DM had significantly high rates of depression, anxiety, and stress. We recommend periodic screening of patients with T2DM for psychological distress using easy and inexpensive validated screening tools like the DASS-21 questionnaire. Further larger-scale studies are needed to investigate the causes and outcomes of these higher rates of psychological distress among Saudi patients with diabetes.
Literature
1.
2.
3.
WHO. Saudi Arabia—World Health Organization—diabetes country profiles, 2016. 2016.
4.
5.
6.
Lazarus R, Folkman S. Stress, appraisal, and coping. New York: Springer; 1984.
7.
8.
World Health Organization. Depression and other common mental disorders. Geneva: WHO; 2017.
9.
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 Fam Pract. 2013;14:69.CrossRef
10.
11.
Sun N, Lou P, Shang Y, Zhang P, Wang J, Chang G, et al. Prevalence and determinants of depressive and anxiety symptoms in adults with type 2 diabetes in China: a cross-sectional study. BMJ Open. 2016;6(8):e012540.CrossRef
12.
Tovilla-Zárate C, Juárez-Rojop I, Jimenez Y, Jiménez MA, Vázquez S, Bermúdez-Ocaña D, et al. Prevalence of anxiety and depression among outpatients with type 2 diabetes in the mexican population. PLoS ONE. 2012;7(5):e36887.CrossRef
13.
Datta D. Prevalence & determinants of depression in type 2 diabetes patients. Indian J Med Res. 2011;132:195–200.
14.
15.
Sulaiman N, Hamdan A, Tamim H, Mahmood DA, Young D. The prevalence and correlates of depression and anxiety in a sample of diabetic patients in Sharjah, United Arab Emirates. BMC Fam Pract. 2010;11:80.CrossRef
16.
Ajlouni K, Khader YS, Batieha A, Ajlouni H, El-Khateeb M. An increase in prevalence of diabetes mellitus in Jordan over 10 years. J Diabetes Complicat. 2008;22(5):317–24.CrossRef
17.
Moussavi S, Chatterji S, Verdes E, Tandon A, Patel V, Ustun B. Depression, chronic diseases, and decrements in health: results from the World Health Surveys. Lancet. 2007;370(9590):851–8.CrossRef
18.
Gemeay EM, Moawed SA, Mansour EA, Ebrahiem NE, Moussa IM, Nadrah WO. The association between diabetes and depression. Saudi Med J. 2015;36(10):1210–5.CrossRef
19.
Al Hayek AA, Robert AA, Al Saeed A, Alzaid AA, Al Sabaan FS. Factors associated with health-related quality of life among saudi patients with type 2 diabetes mellitus: a cross-sectional survey. Diabetes Metab J. 2014;38(3):220–9.CrossRef
20.
Al-Muzien N, Al-Sowielem L. Prevalence of depression in diabetics attending primary healthcare centers in the Eastern Province of Saudi Arabia. J Bahrain Med Soc. 2014;25(1):14–8.CrossRef
21.
El Mahalli A. Prevalence and predictors of depression among type 2 diabetes mellitus outpatients in Eastern Province, Saudi Arabia. Int J Health Sci (Qassim). 2015;9(2):119–26.
22.
23.
Alghmadi A. A high prevalence of depression among diabetic patients at a teaching hospital in Western Saudi Arabia. Neurosciences. 2004;9(2):108–12.
24.
25.
Alduraywish A, Fattah DA, Abd-eltawab A, Al-ruwili M, Alhassan A, Alnafe N, et al. Depression and anxiety and their correlates in patients with diabetes mellitus in Al-Jouf Region, Saudi Arabia. Clin Med Diagn. 2017;7(2):48–56.
26.
27.
28.
Moussa MT, Lovibond P, Laube R, Megahead HA. Psychometric properties of an arabic version of the depression anxiety stress scales (DASS). Res Soc Work Pract. 2017;27(3):375–86.CrossRef
29.
30.
31.
Cols-Sagarra C, López-Simarro F, Alonso-Fernández M, Mancera-Romero J, Pérez-Unanua MP, Mediavilla-Bravo JJ, et al. Prevalence of depression in patients with type 2 diabetes attended in primary care in Spain. Prim Care Diabetes. 2016;10(5):369–75.CrossRef
32.
Krag M, Hasselbalch L, Siersma V, Nielsen ABS, Reventlow S, Malterud K, et al. The impact of gender on the long-term morbidity and mortality of patients with type 2 diabetes receiving structured personal care: a 13 year follow-up study. Diabetologia. 2016;59(2):275–85.CrossRef
33.
Scott KM, Bruffaerts R, Tsang A, Ormel J, Alonso J, Angermeyer MC, et al. Depression-anxiety relationships with chronic physical conditions: results from the World Mental Health surveys. J Affect Disord. 2007;103(1–3):113–20.CrossRef
34.
Alkhathami AD, Alamin MA, Alqahtani AM, Alsaeed WY, Alkhathami MA, Al-Dhafeeri AH. Depression and anxiety among hypertensive and diabetic primary health care patients: could patients’ perception of their diseases control be used as a screening tool? Saudi Med J. 2017;38(6):621–8.CrossRef
35.
Tan KC, Chan GC, Eric H, Maria AI, Norliza MJ, Oun BH, et al. Depression, anxiety and stress among patients with diabetes in primary care: a cross-sectional study. Malays Fam Physician. 2015;10(2):9–21.PubMedPubMedCentral
36.
Ströhle A. Physical activity, exercise, depression and anxiety disorders. J Neural Transm. 2009;116(6):777–84.CrossRef
37.
Fisher L, Skaff MM, Mullan JT, Arean P, Glasgow R, Masharani U. A longitudinal study of affective and anxiety disorders, depressive affect and diabetes distress in adults with type 2 diabetes. Diabet Med. 2008;25(9):1096–101.CrossRef
38.
Bickett A, Tapp H. Anxiety and diabetes: innovative approaches to management in primary care. Exp Biol Med. 2016;241(15):1724–31.CrossRef
39.
Gonzalez JS, Peyrot M, McCarl LA, Collins EM, Serpa L, Mimiaga MJ, et al. Depression and diabetes treatment nonadherence: a meta-analysis. Diabetes Care. 2008;31(12):2398–403.CrossRef
40.
Wong CA, Sap M, Schwartz A, Town R, Baker T, Ungar L, et al. Twitter sentiment predicts affordable care act marketplace enrollment. J Med Internet Res. 2015;17(2):e51.CrossRef
41.
Katon W, Fan MY, Unützer J, Taylor J, Pincus H, Schoenbaum M. Depression and diabetes: a potentially lethal combination. J Gen Intern Med. 2008;23(10):1571–5.CrossRef
42.
Collins MM, Corcoran P, Perry IJ. Anxiety and depression symptoms in patients with diabetes: original article: psychology. Diabet Med. 2009;26(2):153–61.CrossRef
Metadata
Title
Prevalence and predictors of depression, anxiety, and stress symptoms among patients with type II diabetes attending primary healthcare centers in the western region of Saudi Arabia: a cross-sectional study
Authors
Alhussain Alzahrani
Abdulrahman Alghamdi
Turki Alqarni
Reem Alshareef
Abdullah Alzahrani
Publication date
01-12-2019
Publisher
BioMed Central
Published in
International Journal of Mental Health Systems / Issue 1/2019
Electronic ISSN: 1752-4458
DOI
https://doi.org/10.1186/s13033-019-0307-6

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