Skip to main content
Top
Published in: BMC Primary Care 1/2010

Open Access 01-12-2010 | Research article

The prevalence and correlates of depression and anxiety in a sample of diabetic patients in Sharjah, United Arab Emirates

Authors: Nabil Sulaiman, Aisha Hamdan, Hani Tamim, Dhafir A Mahmood, Doris Young

Published in: BMC Primary Care | Issue 1/2010

Login to get access

Abstract

Background

Type 2 diabetes is very prevalent in the Gulf region, particularly in the United Arab Emirates (UAE) which has the second highest prevalence in the world. Factors contributing to this include changes in diet, adoption of sedentary lifestyles, and the consequent increase in rates of obesity. These changes are primarily due to rapid economic development and affluence. The aim of this study was to estimate the prevalence of psychological distress and its correlates in diabetic patients in the United Arab Emirates.

Methods

Patients diagnosed with diabetes attending diabetes mini-clinics in the primary health care centres or hospitals of Sharjah were invited to participate in this cross-sectional study. Patients were interviewed using structured questionnaires to gather data on socio-demographics, lifestyle factors, diabetes complications, and medication usage. The K6 was administered as a screening tool for mental health concerns.

Results

Three hundred and forty-seven participants completed the interview. The majority of participants were females (65.4%) and the mean age was 53.2 (sd = 14.6). Approximately 12.5% of patients obtained a score of 19 or above (cut-off score) on the K6, indicating possible mental health concerns. Twenty-four percent had diabetes complications, mainly in the form of retinopathy, peripheral vascular disease and peripheral neuropathy. A significant relationship was found between scores on the K6, these complications of diabetes and the use of oral hypoglycemic and lipid lowering therapies.

Conclusions

The results of this study demonstrate a strong correlation between mental health status and diabetic complications. In particular, patients who are depressed tended to have poorer self-care, more severe physical symptoms and were less likely to adhere to prescribed care regimens. These findings raise the possibility that improving the mental health as part of a comprehensive management plan for diabetes may improve the overall long term outcomes of these patients.
Literature
1.
go back to reference Collins M, Corcoran P, Perry I: Anxiety and depression symptoms in patients with diabetes. Diabet Med. 2009, 26 (2): 153-161. 10.1111/j.1464-5491.2008.02648.x.CrossRefPubMed Collins M, Corcoran P, Perry I: Anxiety and depression symptoms in patients with diabetes. Diabet Med. 2009, 26 (2): 153-161. 10.1111/j.1464-5491.2008.02648.x.CrossRefPubMed
2.
go back to reference Lustman PJ, Anderson RJ, Freedland KE, de Groot M, Carney RM: Depression and poor glycemic control: a meta-analytic review of the literature. Diabetes Care. 2000, 23: 434-442. 10.2337/diacare.23.3.434.CrossRef Lustman PJ, Anderson RJ, Freedland KE, de Groot M, Carney RM: Depression and poor glycemic control: a meta-analytic review of the literature. Diabetes Care. 2000, 23: 434-442. 10.2337/diacare.23.3.434.CrossRef
3.
go back to reference de Groot M, Anderson RJ, Freedland KE, Clouse RE, Lustman PJ: Association of depression and diabetes complications: a meta-analysis. Psychosom Med. 2001, 63: 619-630.CrossRefPubMed de Groot M, Anderson RJ, Freedland KE, Clouse RE, Lustman PJ: Association of depression and diabetes complications: a meta-analysis. Psychosom Med. 2001, 63: 619-630.CrossRefPubMed
4.
go back to reference Kinder AC, Kamarck TW, Baum A, Orchard TJ: Depressive symptomology and coronary heart disease in type I diabetes mellitus: A study of possible mechanisms. Health Psychol. 2002, 21: 542-552. 10.1037/0278-6133.21.6.542.CrossRefPubMed Kinder AC, Kamarck TW, Baum A, Orchard TJ: Depressive symptomology and coronary heart disease in type I diabetes mellitus: A study of possible mechanisms. Health Psychol. 2002, 21: 542-552. 10.1037/0278-6133.21.6.542.CrossRefPubMed
5.
go back to reference DiMatteo MR, Lepper HS, Croghan TW: Depression is a risk factor for non-compliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med. 2000, 160: 2101-2107. 10.1001/archinte.160.14.2101.CrossRefPubMed DiMatteo MR, Lepper HS, Croghan TW: Depression is a risk factor for non-compliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med. 2000, 160: 2101-2107. 10.1001/archinte.160.14.2101.CrossRefPubMed
6.
go back to reference Egede LE, Zheng D, Simpson K: Comorbid depression is associated with increased health care use and expenditures in individuals with diabetes. Diabetes Care. 2002, 25 (3): 464-470. 10.2337/diacare.25.3.464.CrossRefPubMed Egede LE, Zheng D, Simpson K: Comorbid depression is associated with increased health care use and expenditures in individuals with diabetes. Diabetes Care. 2002, 25 (3): 464-470. 10.2337/diacare.25.3.464.CrossRefPubMed
7.
go back to reference Anderson RJ, Freedland KE, Clouse RE, Lustman PJ: The prevalence of comorbid depression in adults with diabetes. Diabetes Care. 2001, 24: 1069-1078. 10.2337/diacare.24.6.1069.CrossRefPubMed Anderson RJ, Freedland KE, Clouse RE, Lustman PJ: The prevalence of comorbid depression in adults with diabetes. Diabetes Care. 2001, 24: 1069-1078. 10.2337/diacare.24.6.1069.CrossRefPubMed
8.
go back to reference Barker CLL, Ford ES, Zhang X, Strine TW, Mokdad AH: Diabetes and anxiety in US adults: findings from the 2006 Behavioral Risk Factor Surveillance System. Diabetic Med. 2008, 25: 878-881. 10.1111/j.1464-5491.2008.02477.x.CrossRefPubMed Barker CLL, Ford ES, Zhang X, Strine TW, Mokdad AH: Diabetes and anxiety in US adults: findings from the 2006 Behavioral Risk Factor Surveillance System. Diabetic Med. 2008, 25: 878-881. 10.1111/j.1464-5491.2008.02477.x.CrossRefPubMed
9.
go back to reference Moussavi S, Somnath C, 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): 851-858. 10.1016/S0140-6736(07)61415-9.CrossRefPubMed Moussavi S, Somnath C, 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): 851-858. 10.1016/S0140-6736(07)61415-9.CrossRefPubMed
11.
go back to reference International Diabetes Federation: Diabetes Atlas. 2006, 3 International Diabetes Federation: Diabetes Atlas. 2006, 3
13.
go back to reference Saadi H, Carruthers SG, Nagelkerke N, Al-Maskari F, Afandi B, Reed R, Lukic M, Nicholls MG, Kazam E, Algawi K, Al-Kaabi J, Leduc C, Sabri S, El-Sadig M, Elkhumaidi S, Agarwal M, Benedict S: Prevalence of diabetes mellitus and its complications in a population-based sample in Al-Ain, United Arab Emirates. Diabetes Res Clin Pract. 2007, 78: 369-377. 10.1016/j.diabres.2007.04.008.CrossRefPubMed Saadi H, Carruthers SG, Nagelkerke N, Al-Maskari F, Afandi B, Reed R, Lukic M, Nicholls MG, Kazam E, Algawi K, Al-Kaabi J, Leduc C, Sabri S, El-Sadig M, Elkhumaidi S, Agarwal M, Benedict S: Prevalence of diabetes mellitus and its complications in a population-based sample in Al-Ain, United Arab Emirates. Diabetes Res Clin Pract. 2007, 78: 369-377. 10.1016/j.diabres.2007.04.008.CrossRefPubMed
15.
go back to reference El-Sharkawy T: 'Diabetes in United Arab Emirates and other Arab Countries: Need for epidemiological and genetic studies'. Genetic Disorders in the Arab World: United Arab Emirates. 2004, Centre for Arab Genomic Studies (CAGS), 1: [http://www.cags.org.ae/cbc07db.pdf] El-Sharkawy T: 'Diabetes in United Arab Emirates and other Arab Countries: Need for epidemiological and genetic studies'. Genetic Disorders in the Arab World: United Arab Emirates. 2004, Centre for Arab Genomic Studies (CAGS), 1: [http://​www.​cags.​org.​ae/​cbc07db.​pdf]
16.
go back to reference El-Rufaie OEF, Bener A, Ali TA, Abuzeid MSO: Psychiatric morbidity among type II diabetic patients: a controlled primary care survey. Prim Care Psychiatry. 1997, 3: 189-194. El-Rufaie OEF, Bener A, Ali TA, Abuzeid MSO: Psychiatric morbidity among type II diabetic patients: a controlled primary care survey. Prim Care Psychiatry. 1997, 3: 189-194.
17.
go back to reference Commonwealth Department of Health and Aged Care (DHAC): National Physical Activity Guidelines For Australians. 1999, Canberra, Australia. Commonwealth Department of Health and Aged Care (DHAC) Commonwealth Department of Health and Aged Care (DHAC): National Physical Activity Guidelines For Australians. 1999, Canberra, Australia. Commonwealth Department of Health and Aged Care (DHAC)
18.
go back to reference Kessler RC, Barker PR, Colpe LJ, Epstein JF, Gfroerer JC, Hiripi E, Howes MJ, Normand S-LT, Manderscheid RW, Walters EE, Zaslavsky AM: Screening for serious mental illness in the general population. Arch Gen Psychiatry. 2003, 60 (2): 184-189. 10.1001/archpsyc.60.2.184.CrossRefPubMed Kessler RC, Barker PR, Colpe LJ, Epstein JF, Gfroerer JC, Hiripi E, Howes MJ, Normand S-LT, Manderscheid RW, Walters EE, Zaslavsky AM: Screening for serious mental illness in the general population. Arch Gen Psychiatry. 2003, 60 (2): 184-189. 10.1001/archpsyc.60.2.184.CrossRefPubMed
19.
go back to reference Kessler RC, Green JG, Gruber MJ, Sampson NA, Bromet E, Cuitan M, et al: Screening for serious mental illness in the general population with the K6 screening scale: results from the WHO World Mental Health (WMH) Survey Initiative. Int J Methods in Psychiatr Res. Kessler RC, Green JG, Gruber MJ, Sampson NA, Bromet E, Cuitan M, et al: Screening for serious mental illness in the general population with the K6 screening scale: results from the WHO World Mental Health (WMH) Survey Initiative. Int J Methods in Psychiatr Res.
20.
go back to reference Lee HJ, Chapa D, Kao CW, Jones D, Kapustin J, Smith J, Krichten C, Donner T, Thomas S, Friedmann E: Depression, quality of life, and glycemic control in individuals with type 2 diabetes. J Am Acad Nurse Pract. 2009, 21 (4): 214-224. 10.1111/j.1745-7599.2009.00396.x.CrossRefPubMed Lee HJ, Chapa D, Kao CW, Jones D, Kapustin J, Smith J, Krichten C, Donner T, Thomas S, Friedmann E: Depression, quality of life, and glycemic control in individuals with type 2 diabetes. J Am Acad Nurse Pract. 2009, 21 (4): 214-224. 10.1111/j.1745-7599.2009.00396.x.CrossRefPubMed
21.
go back to reference Ismail K, Winkley K, Stahl D, Chalder T, Edmonds M: A cohort study of people with diabetes and their first foot ulcer: the role of depression on mortality. Diabetes Care. 2007, 30 (6): 1473-1479. 10.2337/dc06-2313.CrossRefPubMed Ismail K, Winkley K, Stahl D, Chalder T, Edmonds M: A cohort study of people with diabetes and their first foot ulcer: the role of depression on mortality. Diabetes Care. 2007, 30 (6): 1473-1479. 10.2337/dc06-2313.CrossRefPubMed
22.
go back to reference Katon W, Rutter C, Simon G, Lin E, Ludman E, Ciechanowski P, Kinder L, Young B, Von Korff M: The association of comorbid depression with mortality in patients with type 2 diabetes. Diabetes Care. 2005, 28 (11): 2668-2672. 10.2337/diacare.28.11.2668.CrossRefPubMed Katon W, Rutter C, Simon G, Lin E, Ludman E, Ciechanowski P, Kinder L, Young B, Von Korff M: The association of comorbid depression with mortality in patients with type 2 diabetes. Diabetes Care. 2005, 28 (11): 2668-2672. 10.2337/diacare.28.11.2668.CrossRefPubMed
23.
go back to reference Williams M, Clouse R, Lustman P: Treating depression to prevent diabetes and its complications: understanding depression as a medical risk factor. Clin Diabetes. 2006, 24 (2): 79-86. 10.2337/diaclin.24.2.79.CrossRef Williams M, Clouse R, Lustman P: Treating depression to prevent diabetes and its complications: understanding depression as a medical risk factor. Clin Diabetes. 2006, 24 (2): 79-86. 10.2337/diaclin.24.2.79.CrossRef
24.
go back to reference Kinder L, Katon W, Ludman E, Russo J, Simon G, Lin , Ciechanowski P, Von Korff M, Young B: Improving depression care in patients with diabetes and multiple complications. J Gen Intern Med. 2006, 21 (10): 1036-1041. 10.1111/j.1525-1497.2006.00552.x.CrossRefPubMedPubMedCentral Kinder L, Katon W, Ludman E, Russo J, Simon G, Lin , Ciechanowski P, Von Korff M, Young B: Improving depression care in patients with diabetes and multiple complications. J Gen Intern Med. 2006, 21 (10): 1036-1041. 10.1111/j.1525-1497.2006.00552.x.CrossRefPubMedPubMedCentral
25.
go back to reference Wysocki T, Buckloh LM: Endocrine, metabolic, nutritional and immune disorders. Handbook of Clinical Health Psychology. Edited by: Boll TJ, Johnson SB, Perry NW, Rozensky RH. 2004, Washington, DC: American Psychological Association Wysocki T, Buckloh LM: Endocrine, metabolic, nutritional and immune disorders. Handbook of Clinical Health Psychology. Edited by: Boll TJ, Johnson SB, Perry NW, Rozensky RH. 2004, Washington, DC: American Psychological Association
26.
go back to reference Gonzalez JS, Peyrot M, McCarl LA, Collins EM, Serpa L, Mimiage MJ, Safren SA: Depression and diabetes treatment nonadherence: a meta-analysis. Diabetes Care. 2008, 31 (12): 2398-2403. 10.2337/dc08-1341.CrossRefPubMedPubMedCentral Gonzalez JS, Peyrot M, McCarl LA, Collins EM, Serpa L, Mimiage MJ, Safren SA: Depression and diabetes treatment nonadherence: a meta-analysis. Diabetes Care. 2008, 31 (12): 2398-2403. 10.2337/dc08-1341.CrossRefPubMedPubMedCentral
27.
go back to reference Gonzalez J, Safren S, Cagliero E, Wexler D, Delahanty L, Wittenberg E, Blais M, Meigs J, Grant R: Depression, self-care, and medication adherence in type 2 diabetes: relationships across the full range of symptom severity. Diabetes Care. 2007, 30 (9): 2222-2227. 10.2337/dc07-0158.CrossRefPubMedPubMedCentral Gonzalez J, Safren S, Cagliero E, Wexler D, Delahanty L, Wittenberg E, Blais M, Meigs J, Grant R: Depression, self-care, and medication adherence in type 2 diabetes: relationships across the full range of symptom severity. Diabetes Care. 2007, 30 (9): 2222-2227. 10.2337/dc07-0158.CrossRefPubMedPubMedCentral
28.
go back to reference Sulaiman N, Hamdan A, Al-Bedri DAM, Young D: Diabetes knowledge and attitudes towards prevention and health promotion: qualitative study in Sharjah, United Arab Emirates. Int J Food Safety, Nutrition and Public Health. 2009, 2 (1): 78-88. 10.1504/IJFSNPH.2009.026921.CrossRef Sulaiman N, Hamdan A, Al-Bedri DAM, Young D: Diabetes knowledge and attitudes towards prevention and health promotion: qualitative study in Sharjah, United Arab Emirates. Int J Food Safety, Nutrition and Public Health. 2009, 2 (1): 78-88. 10.1504/IJFSNPH.2009.026921.CrossRef
30.
go back to reference Okasha A: Mental health services in the Arab world. Arab Studies Quarterly. 2003, 25 (4): 39-52. Okasha A: Mental health services in the Arab world. Arab Studies Quarterly. 2003, 25 (4): 39-52.
31.
go back to reference El-Islam MF: Mental illness in Kuwait and Qatar. Al-Junun: Mental Illness in the Islamic World. Edited by: Al-Issa I, Madison WI. 2000, International Universities Press, Inc, 121-137. El-Islam MF: Mental illness in Kuwait and Qatar. Al-Junun: Mental Illness in the Islamic World. Edited by: Al-Issa I, Madison WI. 2000, International Universities Press, Inc, 121-137.
Metadata
Title
The prevalence and correlates of depression and anxiety in a sample of diabetic patients in Sharjah, United Arab Emirates
Authors
Nabil Sulaiman
Aisha Hamdan
Hani Tamim
Dhafir A Mahmood
Doris Young
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2010
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/1471-2296-11-80

Other articles of this Issue 1/2010

BMC Primary Care 1/2010 Go to the issue