Clinical assessment of depression and type 2 diabetes in Morocco: Economical and social components

Abstract

Background: The global prevalence of diabetes is increasing worldwide. In Morocco, diabetes and depression are major public health problems, requiring improvement in their care. Diabetes and depression are associated with morbidity and early mortality. This association contributes to raising the risk of the complications that occur, while causing higher suffering to patients, as also an increased cost toward healthcare. Aim: This study aims to assess the prevalence of depression in patients with type 2 diabetes (T2D), and identify the main risk factors for depression in this category of diabetic patients. Patients and Methods: Type 2 diabetic patients and older than 18 years of age were recruited. The exclusion criteria included being type 1 diabetic, pregnant woman, hospitalized patients, a history of neurological disorders, such as, stroke, infectious episidodes, and history of psychiatric disorders. The individual patient data was collected through individual and confidential interviews lasting 30 minutes, at the end of the diabetology consultation, by the same diabetologist, trained to use the psychometric scales that were needed. The Moroccan–Arabic version of the Beck diagnostic scale of depression was used. Patients assessed with depressive disorders were reviewed in a specialized psychiatric consultation. The statistical analysis was achieved by using SPSS package (version 17). We retained a threshold P value of 0.05. Settings and Design: A cross-sectional study was conducted that included adults with type 2 diabetes. The depression diagnosis was performed using the Arabic version of the Beck Depression scale. Statistical Analysis: We included 142 patients with type 2 diabetes, with an average age of 56.26 years. The prevalence of depression was 33.1%. The risk factors recognized for depression were, lack of social security, hypertension, and a history of type 2 diabetes of more than five years. Results and Conclusions: In this study, we have focused on the frequent association of ‘Type 2 diabetes and depression’ and the risk of mutual aggravation of both pathologies that might require multidisciplinary healthcare, as well as, improvement in the risk factors of depression through improved access to healthcare, with the extension of social security. The stability of the healthcare personnel involved in the treatment of both chronic diseases, including diabetes and hypertension screening, should also be considered for better management of psychiatric complications.

Risk and protective factors of co-morbid depression in patients with type 2 diabetes mellitus: a meta analysis

“…This was consistent with two of included studies [15,26] and a study conducted in Jazan area [30]. However, other studies contradicted to this finding where the prevalence of depression was found significantly related to the duration of diabetes [31]. This could be attributed to the differences in culture or long experience and adaptation gained in dealing with diabetes complications.…”

Depression and Its Predictors among Diabetes Mellitus Patients Attending Treatment in Hawassa University Comprehensive Specialized Hospital, Southern Ethiopia

“…In our study among those with poor social support, 51.7% had depression (AOR = 3:68). But the study done in Journal of Diabetes Research 2014 in Morocco indicated that from those who had no social support (security), 43.3% had depression [22]. The higher result in this study may be due to low social support for DM patient in the community, absence of social support in the hospital, and low educational status of the participants to be aware about the disease and its process.…”

Detection and prevalence of depression among adult type 2 diabetes mellitus patients attending non-communicable diseases clinics in Lilongwe, Malawi

“…In contrast to our study, several studies in other African countries have shown higher prevalence of depression among T2DM patients. A study in Morocco found that patients with T2DM had higher prevalence of major depression (33.1%) [ 41 ] while studies in South Africa found and in Egypt found 46% and 32% respectively [ 39 ]. Similarly a systematic review conducted in Ethiopia showed that the prevalence of depression among T2DM patients was 39.73% [ 42 ].…”