Abstract
BackgroundDepression is one of the commonest co-existing medical conditions among patients with diabetes mellitus (DM). A bidirectional relationship between depression and DM exists, complicating glycaemic control leading to an increase in diabetic complications. There is a dearth of information regarding the prevalence of depression and associated factors among patients with DM in Botswana.AimThis study aimed to determine the prevalence of depression and associated factors among patients with DM. The study also assessed the association between depression and glycaemic control.SettingA tertiary diabetic referral clinic in Gaborone, Botswana.MethodA sample of 260 randomly selected patients with DM was recruited in this cross-sectional study. Socio-demographic and clinical characteristics of the patients were collected using a case report form. Depression was evaluated using the Patient Health Questionnaire (PHQ)-9 scale. Multivariate regression analysis was used to determine factors significantly associated with depression.ResultsThe mean age (standard deviation [s.d.]) of study participants was 58.4 (11.8) years, and the majority, 160/260 (61.5%), were females. The prevalence of depression was 30.4% and significantly associated with female sex (adjusted odds ratio [AOR] = 5.529, p-value = 0.004), three or more diabetes-related hospitalisations (AOR = 3.886, p-value = 0.049) and inversely associated with systolic blood pressure (SBP) ≥ 140 mmHg (AOR = 0.11, p-value = 0.001).ConclusionDepression is a common problem among patients with DM in our setting. Routine screening of depression in diabetic patients to enable early detection and treatment is recommended.
Highlights
Diabetes mellitus (DM) is an important public health concern with a high prevalence of co-existing medical conditions.[1]
The choice of this clinic makes it appropriate for this study given that it serves as a main tertiary clinic for diabetes in Botswana, and findings are likely to represent the population of DM that is difficult to treat in Botswana
The Patient Health Questionnaire (PHQ)-9 categorised a slightly greater proportion of patients with major depression than the Beck’s Depression Inventory (BDI)-II. These results indicate that despite both tools not being validated in this setting they can both be used to screen for depression among patients with DM in Botswana
Summary
Diabetes mellitus (DM) is an important public health concern with a high prevalence of co-existing medical conditions.[1]. Poor selfcare (e.g. lack of adherence to lifestyle recommendations and glucose monitoring) is driven by depression and contributes to poor glycaemic control and diabetic complications over time.[8,9]. A recent meta-analysis of 248 studies by Khaledi et al revealed a significant association between depression and diabetes with a worldwide prevalence of comorbid major depressive disorder at 28%.10. Older meta-analysis and global studies have shown rates of major depressive disorder at 12% and depressive symptoms at 15%–35% among individuals with DM.[8,9,11,12]. Despite the fact that poor self-care practices among patients with DM contribute to poor glycaemic control over http://www.sajpsychiatry.org. Depression is one of the commonest co-existing medical conditions among patients with diabetes mellitus (DM).
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