Nisreen Fouzi Altoughar¹*, Hesham Ben Masaud², Ahlam Masaud Ellafi³, Safa Sharfudeen⁴, Tawfik Besheya⁵ and Manar Alabani⁶

¹Qasser Ben Ghashier Health Center, Tripoli, Libya
²Airport Road Polyclinic, Tripoli, Libya
³Histology and Genetics Department, Faculty of Medicine, University of Tripoli, Libya
⁴Parasitology Department, Faculty of Medicine, University of Tripoli, Libya
⁵Clinical Skills Department, Faculty of Medicine, University of Tripoli, Libya
⁶Alhani Polyclinic, Tripoli, Libya

*Corresponding Author: Nisreen Fouzi Altoughar, Qasser Ben Ghashier Health Center, Tripoli, Libya.

Received: December 26, 2023; Published: January 11, 2024

Abstract

Background: Diabetic patients have a relatively high prevalence of depressive symptoms, and self-harm thoughts often complicate their emotional disturbances. The risk factors of the comorbidity of depression and diabetes should be taken into consideration to decrease problems arising because of the comorbidity of these two conditions.

Objectives: This study was undertaken to determine the prevalence of depression and its severity among diabetic patients and correlate it with sociodemographic, lifestyle, and clinical characteristics.

Materials and Methods: A cross-sectional study was conducted from January 2020 to October 2022. The study included 400 patients with Type 1 and Type 2 diabetes attending diabetic clinics in primary health care centers in Tripoli-Libya of both sexes; the sample excluded pregnant women and those with advanced complications. The patients were assessed for depression using the Patient Health Questionnaire-9. The relationship between depression, diabetic control, and sociodemographic characteristics was analyzed using Chi-square and ANOVA analyses, which estimated the significant factors that were dependently associated with depression.

Results: The sample study included 400 participants; the study reveals that 30.5% of diabetic patients reported depressive symptoms; 15% had moderate depression; 10% had moderately severe depression; and 5.5% had severe depression. There was a statistically significant relation between depression and female gender, married patient, house ownership, poor drug adherence, diabetic complications, especially in the eye, poor diet control, physical inactivity, sleep disturbance, self-harm ideation, and difficulty dealing with ordinary life.

Conclusion: The study found that 30.5% of diabetic patients attending primary health care centers in 2020 in Tripoli were depressed.

Keywords: Diabetes Mellitus (DM); Depression

References

1. Kharroubi AT and Darwish HM. “Diabetes mellitus: the epidemic of the century”. World Journal of Diabetes6 (2015): 850.
2. Power AC., et al. “Harrison’s Principles of Internal Medicine”. 17^th McGraw Hills Medical, New York. (2008): 2304-2475.
3. International Diabetes Federation. IDF Diabetes, 10^th Eds; International Diabetes Federation: Brussels, Belgium (2021).
4. Adili F., et al. “Diabetic patients: psychological aspects”. Annals of the New York Academy of Sciences 1084 (2006): 329-349.
5. Eaton WW. “Epidemiologic evidence on the comorbidity of depression and diabetes”. Journal of Psychosomatic Research4 (2002): 903-906.
6. Engidaw NA., et al. “Prevalence of depression and its associated factors among patients with diabetes mellitus at Tirunesh-Beijing general hospital, Addis Ababa, Ethiopia”. BMC Public Health266 (2020).
7. WJ Katon. “The Comorbidity of Diabetes Mellitus and Depression”. American Journal of Medicine11 (2008): S8-S15.
8. Moussavi S., et al. “Depression, chronic diseases, and decrements in health: results from the World Health Surveys”. Lancet 370 (2007): 851-858.
9. Ismail MFS., et al. “Prevalence of Depression and Predictors of Glycemic Control among Type 2 Diabetes Mellitus Patients at Family Medicine Clinic, Suez Canal University Hospital Egypt”. World Family Medicine Journal/Middle East Journal of Family Medicine 2 (2019): 4-13.
10. Zheng Y., et al. “Global aetiology and epidemiology of type 2 diabetes mellitus and its complications”. Nature Reviews Endocrinology. Nature Publishing Group 14 (2018): 88-98.
11. Kroenke K., et al. “The PHQ-9: Validity of a brief depression severity measure”. Journal of General Internal Medicine 9 (2001): 606-613.
12. “Internet-Delivered Cognitive Behavioural Therapy for Major Depression and Anxiety Disorders: A Health Technology Assessment”. Ontario Health Technology Assessment Series6 (2021): 1-199.
13. Chew BH., et al. “Diabetes-Related distress, depression and Distress-Depression among adults with type 2 diabetes mellitus in Malaysia”. PLoS One3 (2016).
14. Al-Qadhi W., et al. “Adult depression screening in Saudi primary care: Prevalence, instrument and cost”. BMC Psychiatry1 (2014): 1-9.
15. World health organization WHO. Classification of Diabetes Mellitus 2019 Classification of diabetes mellitus (2019)‏.
16. Bensbaa S., et al. “Clinical assessment of depression and type 2 diabetes in Morocco: Economical and social components”. The Journal of Neurosciences in Rural Practice 3 (2014): 250-253.
17. Ahmed A., et al. “Prevalence of Depression among Diabetic Patients in Makkah”. Egyptian Journal of Hospital Medicine 1 (2018): 2243-2249.
18. Ellouze F., et al. “Depression in Tunisian type 2 diabetic patients: prevalence and association to glycemic control and to treatment compliance”. Tunisie Médicale, La3 (2017): 210-214.
19. Al-Amer RM., et al. “Depression among adults with diabetes in Jordan: Risk factors and relationship to blood sugar control”. Journal of Diabetes Complications4 (2014): 247-252.
20. Belhadj H., et al. “Validation of the Tunisian version of the patient health questionnaire (PHQ-9)”. European PsychiatryS1 (2017): S523-S523.
21. Agbir TM., et al. “Depression among medical outpatients with diabetes: A cross-sectional study at Jos University Teaching Hospital, Jos, Nigeria”. Annals of African Medicine1 (2010): 5-10.
22. Ilori HT and Ajetunmobi OA. “Cross-Sectional Study of Impact of Social Support on Depression among Type 2 Diabetics in a Secondary Health Care Facility in Southwest Nigeria”. Journal of Advances in Medicine and Medical Research 2 (2019): 1-8.
23. PHQ-9 Meta-Analysis: How Accurate is this Questionnaire for Depression Screening? - The ObG Project (2019).
24. Sun N., et al. “Sociodemographic, clinical, and psychosocial factors associated with depression among type 2 diabetic outpatients in Black Lion General Specialized Hospital”. BMJ Open 6.8 (2016): e012540.
25. Cols-Sagarra C., et al. “Prevalence of depression in patients with type 2 diabetes attended in primary care in Spain”. Prime Care Diabetes5 (2016): 369-375.
26. Habtewold TD., et al. “Sociodemographic, clinical, and psychosocial factors associated with depression among type 2 diabetic outpatients in Black Lion General Specialized Hospital, Addis Ababa, Ethiopia: A cross-sectional study”. BMC Psychiatry1 (2016): 103.
27. Mukeshimana M and Chironda G. “Depression and Associated Factors Among the Patients with Type 2 Diabetes in Rwanda”. Ethiopian Journal of Health Sciences 6 (2019): 709-718.
28. Sweileh WM., et al. “Prevalence of depression among people with type 2 diabetes mellitus: A cross sectional study in Palestine”. BMC Public Health1 (2014): 163.
29. Alajmani DSA., et al. “Prevalence of undiagnosed depression in patients with type 2 diabetes”. Frontiers in Endocrinology Frontiers Media S.A (2019): 259.
30. Abdelwahid HA and Al-Shahrani SI. “Screening of depression among patients in family medicine in southeastern Saudi Arabia”. Saudi Medical Journal (2011).
31. Tovilla-Zárate C., et al. “Prevalence of anxiety and depression among outpatients with type 2 diabetes in the Mexican population”. PLoS One5 (2012).
32. Mohamed R., et al. “A study on depression among patient with type 2 diabetes mellitus in North-Eastcoast Malaysia”. International Journal of Collaborative Research on Internal Medicine and Public Health (2012).
33. Lustman PJ and Clouse RE. “Depression in diabetic patients: The relationship between mood and glycemic control”. Journal of Diabetes and its Complications (2005).
34. Khuwaja AK., et al. “Anxiety and depression among outpatients with type 2 diabetes: A multi-centre study of prevalence and associated factors”. Diabetology and Metabolic Syndrome1 (2010).
35. Akena D., et al. “The association between depression, quality of life, and the health care expenditure of patients with diabetes mellitus in Uganda”. Journal of Affective Disorders 174 (2015): 7-12.
36. Briganti CP., et al. “Association between diabetes mellitus and depressive symptoms in the Brazilian population”. Revista de Saúde Pública 1 (2019).
37. Fairall L., et al. “Collaborative care for the detection and management of depression among adults receiving antiretroviral therapy in South Africa: Study protocol for the CobALT randomised controlled trial”. Trials 1 (2018): 1-18.
38. Sharafeddin A and Arocho I. “The Socioemotional Implications of the Public Housing Built Environment on Children: Comparison between Playground Areas in Public Housing in the USA and Libya”. Proc., First Scientific Conference in Libya/Violence Against Children, Tripoli University, Tripoli, Libya (2017).
39. Sharafeddin A and Arocho I. “Toward Sustainable Public Housing, A Comparison of Social Aspects in Public Housing in the United States and Libya”. Habitat International 122 (2022): 102513.
40. Al-Khaledi M., et al. “Diabetes Self-Management: A Key to Better Health-Related Quality of Life in Patients with Diabetes”. Medical Principles and Practice4 (2018): 323-331.
41. Nasser J., et al. “Prevalence of depression among People with Diabetes Attending Diabetes Clinics at Primary Health Settings in the Kingdom of Bahrain”. Bahrain Medical Bulletin 31 (2009).
42. Sebbani M., et al. “Prévalence du diabète de type 2 et facteurs associés au cours de la depression”. Encephale1 (2014): 9-14.
43. Mapa-Tassou C., et al. “Economic Impact of Diabetes in Africa”. Current Diabetes Reports. Current Medicine Group LLC 19 (2019): 80-84.
44. Alhunayni NM., et al. “Prevalence of Depression among Type-II Diabetic Patients Attending the Diabetic Clinic at Arar National Guard Primary Health Care Center, Saudi Arabia”. Psychiatry Journal (2020): 1-7.
45. AhathamilkAbdullah D., et al. “Depression and anxiety among hypertensive and diabetic primary health care patients: Could patients’ perception of their diseases control be used as a screening tool?” Saudi Medical Journal 6 (2017): 6218.
46. Myers AK., et al. “Brief report: Depression and history of suicide attempts in adults with new-onset Type 2 Diabetes”. Psychoneuroendocrinology (2013).
47. F-T and JL S. “Lifetime prevalence of suicidal ideation in a representative sample of Canadians with Type 1 diabetes”. Diabetes Research and Clinical Practice (2009).
48. Han SJ., et al. “Increased risk of suicidal ideation in Korean adults with both diabetes and depression”. Diabetes Research and Clinical Practice (2013).
49. Bot M., et al. “Differential associations between depressive symptoms and glycaemic control in outpatients with diabetes”. Diabetic Medicine (2013).
50. Ceretta LB., et al. “Increased prevalence of mood disorders and suicidal ideation in type 2 diabetic patients”. Acta Diabetology (2012).
51. Elamoshy R., et al. “Risk of Depression and Suicidality among Diabetic Patients: A Systematic Review and Meta-Analysis”. Journal of Clinical Medicine11 (2018): 445.
52. E MN., et al. “Factors associated with depression and suicide among patients with diabetes mellitus and essential hypertension in a Nigerian teaching hospital”. African Health Sciences1 (2013): 68-77.

Citation

Citation: Nisreen Fouzi Altoughar.,et al. “Prevalence and Determinants of Depression Among the Diabetic Libyan Patients in Primary Health Care Centers During 2020".Acta Scientific Pharmaceutical Sciences 8.2 (2024): 22-34.

Copyright

Copyright: © 2024 Nisreen Fouzi Altoughar.,et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.