Endocrine Abstracts

Introduction: Diabetes mellitus and depression are two major public health problems which can coexist and influence each other. Identification of the predictive and associated factors with depression among diabetics can facilitate the task of clinicians.

Objective: Evaluate the socio-demographic and clinical factors associated with depression among patients having diabetes mellitus (DM).

Materials and methods: A cross sectional study was conducted among 260 diabetic patients followed in the Endocrinology Department at “Taher Sfar University Hospital” in Mahdia, Tunisia. Patients with a psychiatric history were excluded at the outset. Depression was diagnosed according to DSM-V criteria and the severity determined via the Hamilton score scale.

Results: Our patients were aged between 20 and 91 years old, 62.7% of the participants in the study were women. The mean duration of the diabetic disease was of 9 years (from 1 to 50 years). Type 2 diabetes was found among 92.3% of patients. According to DSM-V diagnosis criteria, we found that 15% of our patients suffered from Major Depressive disorder (MDD). Among this group having MDD, 71.8% were female, 31% belonged to the age group 35-45 years and 53.84% were married. Matrimonial status wasn’t significantly linked to MDD but correlated with the severity of depression (P = 0.048).We also found that the majority of patients with MDD (84.6%), had at least one chronic disease in addition to diabetes and that a good proportion of them (69%) was treated with insulin. Both MDD and severity of depression were significatally linked to chronic complications of DM (p ≤ 0.001 for both). Distal neuropathy was present among 39% of patients and this complication had a significant relationship with depression (P = 0.025).

Conclusion: Our study showed that diabetic patients suffering from MDD are mostly women but since proportion of women was most important in our study, these results should be evaluated. The relationship between depressive symptoms and insulin therapy can be explained by the arduousness of the injections and the increased risk of hypoglycemia causing depressive symptoms in one hand, and in the other by the failure to reach glycemic targets via other medications among depressive patients having poor treatment compliance.The risk of depression seems to be increased in diabetic patients suffering from chronic diabetic complications and screening for depression would be necessary in this case. Other studies should be conducted to determine if early screening of depression could delay insulin therapy or help prevent diabetes complications.