Depression and suicidal ideation among individuals with type-2 diabetes mellitus, a cross-sectional study from an urban slum area of Karachi, Pakistan

Abstract

BackgroundSuicidal thoughts and depression are associated with patients with diabetes, especially patients with low socioeconomic backgrounds and prolonged illness.ObjectiveWe aimed to estimate suicidal thoughts and depression among patients with type 2 diabetes (T2D) in the slums of Karachi.MethodsThis cross-sectional study was conducted across 38 locations in the slums of Karachi to understand depression, suicidal thoughts, and other supporting factors of depression associated with T2D. The three-item Oslo Social Support Scale, the Patient Health Questionnaire-9 (PHQ-9) scale, and the Ask Suicide Screening Questions were used to screen the patients.ResultsA total of 504 study participants were interviewed, with a response rate of 98%. The prevalence of depression among patients with diabetes was 30.83%, and suicidal ideation was 20.39%. In the final multivariate analysis, being socioeconomically poor, physically disabled, and having poor social support were independent predictors of depression.ConclusionDiabetes, low socioeconomic level, a lack of social support, and physical disability were all linked to depression. Therefore, trained health providers should conduct an early depression-focused routine screening for patients with diabetes.

Psychological resilience mediates the relationship between diabetes distress and depression among persons with diabetes in a multi-group analysis

“…This finding further aligns with prior research that found high rate of depressive symptoms individual with T1D, which were linked to their diabetes related distress 24 . Finally, it in an agreement with the finding by Younes et al study found higher levels of diabetes distress were highly correlated with depressive symptoms, with distress and depression both being significant predictors of one another individual with T1D 38 .…”

“…In the Type 1 diabetes subgroup, the relationship between diabetes distress and depression was significant and more pronounced. This suggests that individuals with Type 1 diabetes may be particularly vulnerable to the psychological consequences of diabetes distress, consistent with prior studies indicating high rates of depressive symptoms in this population 24 , 36 , 38 . The finding also in accordance with the study by Stahl-Pehe, et al that showed a significant association between diabetes distress and depression among adults with T1D 37 .…”

“…Studies show higher depression rates in both types, with Type 2 diabetes patients particularly at risk due to poor glycemic control 27 , 35 . Research also highlights the significant link between diabetes distress and depression, especially during challenging times like the COVID-19 lockdown 24 , 36 – 38 . Diabetes distress and depression pose considerable challenges, particularly in Type 2 diabetes, affecting patients' mental health and quality of life 15 , 39 – 46 .…”

Is a sedentary lifestyle a leading causal factor of obesity and distress in type 2 diabetes? A cross-sectional study in low-socioeconomic areas of Karachi, Pakistan

“…43 One study also reported that the slum adult population having diabetes shows depression related to diabetes, and some of them show suicidal ideation to get rid of their diabetes life. 44 In addition, several past studies confirm that an inactive lifestyle plays a leading role in developing T2D among the majority of the population. [41][42][43] Low socioeconomic status, low income and illiteracy are also associated with a sedentary lifestyle.…”

Eating Disorders and Suicidal Ideation in Morbid and Non-morbid Type 2 Diabetes Mellitus: A Cross-sectional Study

“…In our study, patients with Nephropathy, Retinopathy, or Diabetic Foot were considered as the morbid group, whereas their criteria were broader. Sharif et al studied 504 T2DM patients in Karachi, Pakistan (21), and posited that elevated fasting blood sugar (FBS) levels, urban residence, physical disability, and limited social support are risk factors for depression and suicidal ideation. Our study found a significant link between HbA1c levels and suicidal ideation in both groups.…”