Prevalence of Depression among Diabetic Patients

Background: Diabetes mellitus is a common chronic metabolic disorder, and is among of the main causes of death in Palestine. Palestinians are continuously living under stressful economic and military conditions which make them psychologically vulnerable. The purpose of this study was to investigate the prevalence of depression among type II diabetic patients and to examine the relationship between depression and socio-demographic factors, clinical factors, and glycemic control. Methods: This was a cross-sectional clinical study at Al-Makhfiah primary healthcare center, Nablus, Palestine. Two hundred and ninety-four patients were surveyed, and Beck Depression Inventory (BDI-II) scale was used to assess the presence of depressive symptoms among them. Moreover, patients' records were reviewed to collect the socio-demographic characteristics of patients (age, gender, marital status, level of education, smoking status, body mass index (BMI)); and other information related to diabetes mellitus disease (duration of diabetes, glycemic control using the glycated hemoglobin (HbA1C) test, use of insulin); and presence of additional illnesses. In addition, medication adherence of the patients included was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8). Results: Out of 294 patients included, 164 (55.8%) patients were females and 216 (73.5%) were < 65 years old. One hundred and twenty patients (40.2%) scored ≥ 16 on BDI-II scale. Univaraite statistical analysis showed a significant association between high BDI-II score (≥ 16) and female gender, low educational level, having no current job, having multiple additional illnesses, low medication adherence and obesity (BMI ≥ 30kg/m2). On the other hand, no significant association was found between BDI-II score and glycemic control using (HbA1C), duration of diabetes, and the other socio-demographic factors. Multivatriate analysis showed that low educational level, having no current job, having multiple additional illnesses and low medication adherence were significantly associated with high BDI-II (≥ 16) scores. Conclusion: In the current study, the prevalence of depression was higher than that reported in other countries. Although 40% of the assessed patients were considered as potential cases of depression, none of them were being treated with anti-depressants. Psychosocial evaluation should be recommended as a routine clinical assessment of diabetic patients at primary healthcare clinics to improve their quality of life and reduce adverse outcomes. Key words: Diabetes mellitus, Depression, Palestine.