Psychosocial correlation between diabetes mellitus and depression: a primary care study from a low income country

Abstract

Background and aims. Systematic reviews and meta-analyses show an association between diabetes and depression. It is a major public health issue, as depression is generally associated with poor outcome of chronic illnesses, including diabetes and contributes to the high economic burden of health care costs. The purpose of this study is to explore the correlation between depression and diabetes in order to develop adequate interventions. The primary aim was to examine the prevalence of depression, social stress, health related quality of life, and social support among patients with diabetes attending primary care.
Material and methods. This was a cross-sectional study conducted in participating primary care clinics in Karachi. All patients with diabetes attending these primary care clinics were invited to participate in the study. Patients with prior diagnosis of major depression, psychotic disorder, or substance abuse disorder, were excluded. Full confidentiality of the data collected was ensured to all the study participants and all interviews were completed only after obtaining informed consent. We used several questionnaires (socio-demographic, clinical, Patient Health Questionnaire - PHQ-9, self-report questionnaire EQ-5D, Life Events Checklist) and scales (7 items Generalized Anxiety Disorder - GAD-7, 3 items - Oslo-3 scale).
Results and conclusion. Our results show that the rates of depression in adult patients with diabetes in Pakistan are high. The patients with diabetes who have depression reported higher social stress, poorer health related quality of life compared to the non depressed diabetic patients.