Depression and Diabetes in High-Risk Urban Population of Pakistan

ABSTRACT

Objective: To determine the prevalence of depressive symptoms among subjects with high-risk of diabetes as assessed by a pre-defined questionnaire in an urban city of Pakistan. Depressive symptoms were also assessed in people with newly diagnosed diabetes along with its determinants. Materials and Methods: High risk subjects were identified by a pre-defined questionnaire which included positive family history of DM, age > 30 yrs, obese or over weight, decreased intake of fruit and vegetables in diet etc. Amongst them 1,825 subjects agreed for OGTT. 1,246 subjects gave consent for the assessment of depressive symptoms. Depressive symptoms were assessed by using the Montgomery Asberg Depression Rating Scale (MADRS). Results: Depressive symptoms were present in 7.4% of the subjects at a rating of ≥ 13 on the MADRS. Mean age of all the subjects was 42 ± 9.4 years while mean BMI was 26.3 ± 5.1 kg/m2. The prevalence of depression was significantly higher in subjects with newly diagnosed diabetes compared to subjects without diabetes (13% vs 6%; p < 0.01). Females were found to be more depressed than males (15.5% vs 3.6%; p < 0.001). Female gender, being financially dependent, and having diabetes were found to be independent risk factors for depression controlling for potential confounding factors. Conclusion: A significantly high percentage of depression, assessed by MADRS was found in subjects with newly diagnosed diabetes as compared to subjects without diabetes. It is of the essence that psychiatric attention may be necessary to be incorporated in diabetes care both for prevention and treatment.