article · BMC Psychiatry
Depression frequently co-occurs with type 2 diabetes, yet evidence from non-Western settings remains limited. An investigation among 264 adult type 2 diabetes outpatients at Black Lion General Specialized Hospital in Addis Ababa, Ethiopia, assessed the prevalence of depressive symptoms and associated influences using the nine-item Patient Health Questionnaire. Depressive symptoms were identified in 44.7 percent of participants. Multivariate analysis revealed several key factors strongly linked to depression. Patients experiencing three or more diabetic complications faced a more than threefold increase in risk, whilst diabetic nephropathy nearly tripled the odds. Psychosocial factors also played a substantial role: poor social support and negative life events were both associated with more than double the likelihood of depression. Additionally, low monthly family income was linked to elevated risk. The high burden highlights an urgent need for early clinical diagnosis and prompt treatment strategies.
Depression significantly complicates chronic illness, yet mental health comorbidities often go unrecognised in non-Western healthcare settings. Understanding that nearly half of studied diabetes outpatients experience depression, driven by complications, poverty, and weak social support, demonstrates the critical necessity for integrated physical and mental healthcare. Healthcare providers can use these findings to identify vulnerable diabetic patients earlier and provide holistic treatment that addresses both physical complications and mental wellbeing.
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BACKGROUND: Depression is a common comorbidity among patients with type 2 diabetes. There are several reports supporting a bidirectional association between depression and type 2 diabetes. However, there is limited data from non-western countries. Therefore, the aim of this study was to assess the sociodemographic, clinical, and psychosocial factors associated with co-morbid depression among type 2 diabetic outpatients presenting to Black Lion General Specialized Hospital, Addis Ababa, Ethiopia. METHODS: This institution based cross-sectional study design was conducted on a random sample of 276 type 2 diabetic outpatients. Type 2 diabetes patients were evaluated for depression by administering a validated nine-item Patient Health Questionnaire (PHQ-9). Risk factors for depression among type 2 diabetes patients were identified using multiple logistic regression analysis. RESULT: In total, 264 study participants were interviewed with a response rate of 95.6%. The prevalence of depression was 44.7%. In the multivariate analysis, the statistically significant risk factors for depression were monthly family income ≤ 650 (p-value = 0.056; OR = 2.0; 95% CI = 1.01, 4.2), presence of ≥3 diabetic complications (p-value = 0.03; OR = 3.3; 95% CI = 1.1, 10.0), diabetic nephropathy (p-value = 0.01; OR = 2.9; 95% CI = 1.2, 6.7), negative life events (p-value = 0.01; OR = 2.4; 95% CI = 1.2, 4.5), and poor social support (p-value = 0.001; OR = 2.7; 95% CI = 1.5, 5.0). CONCLUSION: This study demonstrated that depression is a common co-morbid health problem with a prevalence rate of 44.7%. The presence of diabetic complications, low monthly family income, diabetic nephropathy, negative life event, and poor social support were the statistically significant risk factors associated with depression. We presume that the burden of mental health especially depression is high in the population with type 2 diabetes mellitus co-morbidity. Therefore, specific attention is needed to diagnose early and treat promptly.
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DOI: 10.1186/s12888-016-0809-6
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