Abstract
BackgroundIn patients with diabetes, the prevalence of depression and anxiety symptoms is about two to four times greater than in the general population. The association between diabetes and mental health disorders could be exacerbated in a stressful environment, and psychological distress could increase depressive symptoms and cause adverse diabetes outcomes.ObjectivesTo assess the prevalence of mental health disorders in patients with diabetes during the social distancing period due to COVID-19 pandemic.MethodsThis is a cross-sectional study developed to assess the impact of social distancing on a cohort of adults with type 1 (n = 52) and type 2 diabetes (n = 68) in Brazil. Inclusion criteria involved having an HbA1c test collected in the past 3 months and having a valid telephone number in electronic medical records. The primary outcome was the prevalence of minor psychiatric disorders, assessed by survey (SRQ-20). Secondary outcomes included the prevalence of diabetes related emotional distress, eating and sleeping disorders, all assessed by validated surveys at the moment of the study. Statistical analyses included unpaired t-test for continuous variables and χ2 test for categorical variables.ResultsOverall (n = 120), participants had a mean age of 54.8 ± 14.4 years-old, and HbA1c of 9.0 ± 1.6% (75 ± 17.5 mmol/mol); 93% of patients showed signs of current mental suffering based on the surveys measured. Almost 43% of patients showed evidence of significant psychological distress, with a significant greater tendency in patients with type 2 diabetes. The presence of diabetes related emotional distress was found in 29.2% of patients; eating disorders in 75.8%; and moderate/severe sleeping disorders in 77.5%.ConclusionsWe found a high prevalence of evidence of psychological distress among patients with diabetes during the COVID-19 pandemic and this highlights the need for mental health access and support for patients with type 1 and type 2 diabetes.
Highlights
In patients with diabetes, the prevalence of depression and anxiety symptoms is about two to four times greater than in the general population
We found a high prevalence of evidence of psychological distress among patients with diabetes during the COVID-19 pandemic and this highlights the need for mental health access and support for patients with type 1 and type 2 diabetes
Diabetes mellitus and psychiatric disorders share a mutual interface: the challenge of living and overcoming diabetes may result in emotional overload, and the Alessi et al Diabetol Metab Syndr (2020) 12:76 presence of depression and anxiety symptoms may be associated with lower treatment adherence, leading to worse glycemic control [1, 2]
Summary
The prevalence of depression and anxiety symptoms is about two to four times greater than in the general population. Diabetes mellitus and psychiatric disorders share a mutual interface: the challenge of living and overcoming diabetes may result in emotional overload, and the Alessi et al Diabetol Metab Syndr (2020) 12:76 presence of depression and anxiety symptoms may be associated with lower treatment adherence, leading to worse glycemic control [1, 2]. Some cases of depression might result from low levels of insulin-like growth factor (IGF) into the brain, wich was shown to produce antidepressant behavioural responses in experimental studies [6,7,8]. A highly significant association between leptin levels, depressed mood and sleep disturbances has been shown in normal-weight individuals [6, 9]. Ghrelin can exert antidepressant effects in men and carbohydrates appear to lead to ghrelin suppression [6, 10, 11]
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