Top

International Journal of Diabetes in Developing Countries

Published in:

01-09-2018 | Original Article

Factors affecting risk of anxiety and depression among diabetic and hypertensive patients who refer to family health centers

Authors: Nilüfer Emre, Kenan Topal, Tamer Edirne, Çiğdem Gereklioğlu

Published in: International Journal of Diabetes in Developing Countries | Issue 3/2018

Abstract

This cross-sectional study was carried out to investigate the factors which influence risk of anxiety and depression among diabetic and hypertensive patients who refer to family health centers. The Hospital Anxiety and Depression Scale (HADS) was applied for assessment of emotional status of the patients and the Hypertension Compliance Assessment Scale (HCAS) was applied for assessment of adherence to anti-hypertensive therapy. Of a total of 380 patients, 170 had hypertension (HT), 83 had type 2 diabetes mellitus (T2DM), and 127 had both HT and T2DM. According to HADS, 18.7% of the patients had risk of anxiety, 24.7% had risk of depression, and 12.6% had both risk of anxiety and depression. Mean HAD-Anxiety (HADS-A) score and HADS-Depression (HADS-D) score were significantly lower in the patients who had an adequate compliance to medication therapy (5.1 ± 4.1 and 3.8 ± 3.4, respectively) compared to the patients who had a low compliance to therapy (7.6 ± 4.3 and 5.8 ± 4.0, respectively) according to the Hypertension Compliance Assessment Scale (χ ² = 15.26, p < 0.01 and χ ² = 13.80, p < 0.01). Mean HADS-D score was found significantly lower among the diabetic patients with good glycemic control (3.7 ± 2.9) compared to the patients with poor glycemic control (4.5 ± 3.7) (χ ² = 25.00, p < 0.05). Anxiety and depression are among the most frequent disorders as hypertension and diabetes in primary care setting. We revealed that risk of anxiety and/or depression was greater among hypertensive and diabetic patients, consistently with the previous studies. Our study also revealed that this condition negatively affected treatment compliance in hypertensive patients and glycemic control in diabetic patients.

Satman İ, İmamoğlu Ş, Yılmaz C, Akalın S. Guidelines for diagnosis, treatment and follow-up of patients with diabetes mellitus and its complications, the society of endocrinology and metabolism of turkey (SEMT) 2013, 6^th Ed., (in Turkish) Ankara: Bayt Publishing; 2013. (ISBN 978-605-4011-16-2), Available at: http://www.turkendokrin.org/files/pdf/diabetes_klvz2011_web.pdf, Accessed: February 15, 2016.

Pick Up J, Williams G. Hypertension and diabetes mellitus. In: Pickup JC, Williams G, editors. Textbook of diabetes. 2nd ed. Oxford: Blackwell Science; 1997. p. 1–19.

Çayır A, Turan Mİ. Cardiac disorders related to diabetes mellitus, Ankara Med J 2015; 15(4): 231–234 Available at: http://www.ankaramedicaljournal.com/article/view/1047000143/5000139877 Accessed: December 28, 2016.

Jahan F, Jabbar A, Naqvi H, Awan S. Depression in patients with diabetes mellitus and its impact on diabetes self-care, medication adherence and glycemic control. Int J Diabetes Dev Ctries. 2011;31(3):154–60.CrossRef

Hacıhasanoğlu R, Karakurt P, Yıldırım A, Uslu S. Anxiety and depression among individuals with chronic disease who refer to primary health care centers. TAF Prev Med Bull 2010; 9(3): 209–216. Available at: http://www.ejmanager.com/mnstemps/1/khb_009_03-209.pdf, Accessed: May 10, 2016.

Gulseren L, Hekimsoy Z, Gulseren Ş, Bodur Z, Kultur S. Depression-anxiety, quality of life and disability in patients with diabetes mellitus. Turkish J Psychiatry. 2001;12(2):89–98.

İncirkuş K, Nahcivan NÖ. Validity and reliability study of turkish version of the patient assessment of chronic illness care-patient form. DEUHYO ED 2011; 4 (1):102-9. Available at: http://acikerisim.deu.edu.tr/xmlui/bitstream/handle/12345/4592/102-109incirkus.pdf?sequence=1&isAllowed=y, Accessed: June 11, 2016.

Vatansever Ö, Ünsar S. Determination of medical treatment adherence, self-efficacy levels of patients with essential hypertension and affecting factors. Turk Soc Cardiol Turkish J Cardiovasc Nurs 2014; 5(8): 66–74. Available at: https://www.journalagent.com/kvhd/pdfs/KVHD_5_8_66_74.pdf, Accessed: May 10, 2016.

American Diabetes Association. Standards of medical care in diabetes 2015. Diabetes Care. 2015;38:58–67.CrossRef

10.

Zigmond AS, Snaith PR. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983; 67(6): 361–70. Available at: http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0447.1983.tb09716.x/pdf Accessed: July 15, 2016.

11.

Aydemir Ö, Güvenir T, Küey L, Kültür S. Reliability and validity of the Turkish version of hospital anxiety and depression scale. Turkish J Psychiatry 1997; 8(4): 280–287. Available at: https://www.researchgate.net/publication/301778685_Hastane_Anksiyete_ve_Depresyon_Olcegi_Turkce_Formunun_Gecerlilik_ve_Guvenilirlik_Calismasi_Reliability_and_Validity_of_the_Turkish_version_of_Hospital_Anxiety_and_Depression_Scale, Accessed: July 15, 2016.

12.

Mert H, Özçakar N, Kuruoğlu E. A multidisciplinary special study module research: treatment compliance of patients with hypertension. Turkish J Fam Pract 2011; 15(1): 7–12. Available at: http://www.turkailehekderg.org/wp-content/uploads/2014/06/c15-s01-02.pdf, Accessed: March 18, 2016.

13.

Demirezen E. Using antihypertensive drugs in Turkey and in Germany, Adherence to drug treatment in Turks. Istanbul University Health Sciences Institute, Nursing Program; PhD Thesis, Istanbul, 2006. Avaliable at: http://katalog.istanbul.edu.tr/client/tr_TR/default_tr/search/results?qu=Kullanan+T%C3%BCrklerde+%C4%B0la%C3%A7+Tedavisine+Uyum&te =, Accessed: March 29, 2016.

14.

Snaith RP. The Hospital Anxiety and Depression Scale. Health and Quality of Life Outcomes 2003; 1: 29. Avaliable at:https://hqlo.biomedcentral.com/track/pdf/10.1186/1477-7525-1-29?site=hqlo.biomedcentral.com Accessed: March 31, 2016.

15.

Yarış F, Ayanaoğlu S, Dikici MF, Aksoy H, Özgür R, Ekizoğlu İ. Depression in diabetes mellitus type 2. Turkish J Fam Pract 2000; 4 (1–4): 24–26. Available at: http://www.turkailehekderg.org/wp-content/uploads/2014/07/c04-s1-4-05.pdf, Accessed: March 1, 2015.

16.

Jonas BS, Franks P, Ingram DD. Are symptoms of anxiety and depression risk factors for hypertension? Longitudinal evidence from the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study. Arch Fam Med 1997; 6:43-9. Available at: http://triggered.edina.clockss.org/ServeContent?issn= 1063-3987&volume=6& issue=1&spage=43, Accessed: May 23, 2016.

17.

Cheung BMY. Au THY, Chan SY, Lam CM, Lau SH Lee RP. Lee SF, Lo WS, Sin EHF, Tang MY, Tsang HH. The relationship between hypertension and anxiety or depression in Hong Kong Chinese. Exp Clin Cardiol 2005; 10(1):21-24. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716224/pdf/ecc10 021.pdf, Accessed: August 31, 2015.

18.

Ali S, Stone MA, Peters JL, Davies MJ, Khunti K. The prevalence of comorbid depression in adults with type 2 diabetes: a systematic review and meta-analysis. Diabet Med. 2006;23:1165–73.CrossRefPubMed

19.

Katon W, Unutzer J, Russo J. Major depression: the importance of clinical characteristics and treatment response to prognosis. Depress Anxiety. 2010;27:19–26.CrossRefPubMed

20.

Mosaku K, Kolawole B, Mume C, Ikem R. Depression, anxiety and quality of life among diabetic patients: a comparative study. J Natl Med Assoc. 2008;100:73–8.CrossRefPubMed

21.

Tovilla-Za’rate C, Jua’rez-Rojop I, Peralta Jimenez Y, Jime’nez MA, Va’zquez S, et al. Prevalence of anxiety and depression among outpatients with type 2 diabetes in the Mexican population. PLoS ONE 2012; 7(5): e36887. Avaliable at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3356343/, Accessed: March 29, 2016.

22.

Elliott, I Poverty and mental health: a review to inform the Joseph Rowntree Foundation’s Anti-Poverty Strategy. London: Mental Health Foundation, 2016. Avaliable at: https://www.mentalhealth.org.uk/sites/default/files/Poverty%20and%20Mental%20Health.pdf, Accessed: January 15, 2015.

23.

Thomas J, Jones G, Scarinci I, Brantley P. A descriptive and comparative study of the prevalence of depressive and anxiety disorders in low-income adults with type 2 diabetes and other chronic illnesses. Diabetes Care. 2003;26(8):211–7.CrossRef

24.

Balhara Y, Sagar R. Correlates of anxiety and depression among patients with type 2 diabetes mellitus. Indian J Endocr Metab. 2011;15(1):50–4.CrossRef

25.

Wolff E, Gaudlitz K, von Lindenberger BL, Plag J, Heinz A, Ströhle A. Eur Arch Psychiatry Clin Neurosci. 2011;261(Suppl 2):S186–91.CrossRefPubMed

26.

Zschuckle E, Gaudlitz K, Ströhle A. Exercise and physical activity in mental disorders: clinical and experimental evidence. J Prev Med Public Health 2013; 46 (Suppl 1): S12–S21. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3567313/, Accessed: August 30, 2016.

27.

Goodwin RD. Association between physical activity and mental disorders among adults in the United States. Prev Med. 2003;36(6):698–703.CrossRefPubMed

28.

Wang PS, Bohn RL, Knight E, Glynn RJ, Mogun H, et al. Noncompliance with antihypertensive medications: the impact of depressive symptoms and psychosocial factors. J Gen Intern Med. 2002;17(7):504–11.CrossRefPubMedPubMedCentral

29.

Eren İ, Erdi Ö, Özcankaya R. Relationship between blood glucose control and psychiatric disorders in type II diabetic patients. Turkish J Psychiatry. 2003;14(3):184–91.

30.

Spielberger CD, Gorsuch RL, Lushene R, Vagg PR, Jacobs GA. Manual for the state-trait anxiety inventory (STAI). Palo Alto, CA: Consulting Psychologists Press; 1983.

31.

Beck AT. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561–7.CrossRefPubMed

Title: Factors affecting risk of anxiety and depression among diabetic and hypertensive patients who refer to family health centers
Authors: Nilüfer Emre
Kenan Topal
Tamer Edirne
Çiğdem Gereklioğlu
Publication date: 01-09-2018
Publisher: Springer India
Published in: International Journal of Diabetes in Developing Countries / Issue 3/2018
Print ISSN: 0973-3930
Electronic ISSN: 1998-3832
DOI: https://doi.org/10.1007/s13410-017-0592-z

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 3/2018

SNP in microRNA sequences or binding sites of miRNAs: association with type 2 diabetes mellitus susceptibility and in silico analysis

Is the CANVAS of canaglifozin wide?

A standardized approach based on dietary and multiple daily insulin injections for the management of diabetes in infants

Factors associated with anxiety in type 2 diabetes mellitus patients in Pakistan

Psychosocial factors and glycemic control in insulin-naïve and insulin-experienced people with type 2 diabetes: a path analysis model

Psychological comorbidity in diabetes mellitus—need for early recognition and treatment

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

At a glance: The STEP trials