Factors associated with depression among Type-2 Diabetic Patients in Nepal

Abstract

Background: The worldwide health scenario is undergoing a shift from infectious diseases to non-communicable ones, and diabetes is now the seventh major contributor to global mortality. Depression, anticipated to be the second-highest contributor to Disability Adjusted Life Years by 2020, presents a notable public health challenge. The probability of experiencing depression is elevated two to three times in individuals with diabetes, particularly those diagnosed with Type 2 diabetes. Objectives: To assess the prevalence of depression and associated factors in Type 2 diabetic patients in Tribhuvan University Teaching Hospital. Methods: An analytical cross-sectional study was conducted among 151 Type 2 diabetic patients visiting Tribhuvan University Teaching Hospital, Nepal. Patients were selected by systematic random sampling at an interval of every third diabetic patient attending the Out-Patient Department. Depression was assessed using the Beck Depression Inventory. Data was analyzed using STATA-14 where logistic regression was performed to ascertain associations (P value <0.05) of sociodemographic, behavioral and clinical characteristics with depression. Results: The prevalence of depression among Type 2 diabetic patients was 28.5%. Among them, 15.2% had mild depression, 11.9% had moderate depression and 1.4% had severe depression. The odds of having depression was 1.24 times higher with 1 unit increase in HbA1C level (AOR=1.24, 95%CI:1.09-1.42, P-value=0.001), 4.62 times higher in patients having retinopathy as comorbidity (AOR=4.62, 95%CI:1.63-13.11, P-value=0.04) and 6.36 times higher in patients taking insulin for treatment (AOR=6.36, 95%CI:1.79-22.53, P-value=0.004) after adjusting for age, sex, occupation, marital status, ethnicity income and education. Conclusion: The study revealed that more than a quarter of Type 2 diabetic patients in this sample experienced depression. Factors such as HbA1C, treatment by insulin and retinopathy as comorbidity were identified as significant contributors. These findings highlight the emerging problem of depression among diabetic patients, emphasizing the need for integrated mental health services in diabetes care.