Prevalence of depression among diabetic patients attending the Armed Forces Hospital, Southern Region, Saudi Arabia: A prospective cross-sectional study.

ABSTRACT

Background: Depression associated with diabetes is one of major obstacles in diabetic patient management. This study aims to determine the prevalence of depression and its associated risk factors among diabetic patients of both types (I and II). Materials and Methods: A cross-sectional analytical study was conducted at Armed Forces Hospital, Southern Region, Kingdom of Saudi Arabia, among adult diabetic patients attending the diabetic center. An interview-validated questionnaire was utilized to collect data. It consists of three main parts demographic data, diabetic assessment tool, and patient health questionnaire-9. Results: A total of 386 diabetic patients were included. The age of them ranged between 17 and 95 years with an arithmetic mean of 53.4 years and a standard deviation of ± 18.2 years. Almost two-thirds (62.2%) were males. The prevalence of depression among diabetic patients was 48.2%, mostly of mild (31.4%) or moderate severity (12.7%). Multivariate logistic regression analysis revealed that female diabetic patients were at almost double-fold risk of developing depression compared to males [adjusted odds ratio (AOR) =2.73, 95% confidence interval (CI) 1.70-4.38], P < 0.001. Also, type II diabetic patients were at almost double-fold risk of developing depression compared to type I diabetic patients (AOR = 2.07, 95% CI 1.16-3.67), P = 0.013. Patients with history of any social issue with the family, relatives, or friends were at about three-fold risk of developing depression compared to those without such history (AOR = 3.45, 95% CI 2.11-5.66), P < 0.001. Patients who reported compliance to diet were at higher risk for developing depression compared to their peers (AOR = 2.57, 95% CI 1.25-5.28), P = 0.010, while those compliant to physical activity about 150 min/week or more were at significant lower risk to develop depression (AOR = 0.56, 95% CI 0.35-0.89), P = 0.015. Patients with nephropathy or neuropathy were more likely to have depression compared to their counterparts (AOR = 2.52. 95% CI 1.33-4.80, P = 0.005 and AOR = 1.80, 95% CI 1.11-2.90, P = 0.016, respectively). Conclusion: Depression is a very prevalent problem affecting diabetic patients, particularly those of type II, female patients, and those with nephropathy or neuropathy. Therefore, regular screening of diabetic patients for depression and referral of severe cases to psychiatric care are highly warranted.