Despite adequate treatment for diabetes, it is estimated that 15%- 20% of people with diabetes are struggling with a moderate to severe form of depression daily. Little is known about depression in diabetes in East Africa, particularly in Tanzania. The study is aimed at determining the prevalence of depression and associated factors among patients with diabetes. A descriptive cross-sectional study was carried out at the diabetes clinic of Muhimbili National Hospital. The 9-item Patient Health Questionnaire (PHQ 9) scale was used to assess presence of depressive symptoms among diabetes patients at the clinic. In addition, patient's sociodemographic and clinical characteristics were obtained and analysed for their association with depression. A total of 353 participants were recruited, of whom 229 (64.9%) patients were female and 156 (44.2%) were aged between 41 and 60 years. The overall prevalence of depression among diabetes patients at the diabetes clinic was 87%. Most (56.7%) had minimal depression, 22.1% had mild depression, and 8.2% had moderate depression. None had severe depression. Factors independently associated with a diagnosis of mild to moderate depression were being on insulin therapy and being a current smoker. There was a high prevalence of depression in this diabetic population. Majority of patients had minimal depression but about 30% had either mild or moderate depression. A holistic approach that focuses on the identification and management of depression among patients with diabetes is recommended.
Abstract Electroconvulsive Therapy (ECT) is a treatment that steals medical attention and the public. Memory disturbance after ECT is a special consideration for the Food and Drugs Administration (FDA) of the United States to classify ECT, whether it belongs to class III (high risk). Psychiatrists or anesthesiologists (who are experienced with ECT) tend to change this classification, while neurologists, psychologists, biostatistics experts, and public representatives agree to maintain ECT status in class III. Contrary to unexpected effects, ECT can induce a transition in severe melancholic patients and suicide to normal functioning humans, after other treatments have failed. With the aim of balancing effectiveness and safety, this paper provides modern evidence of the benefits and risks of ECT.
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