Depression, anxiety and stress symptoms among diabetics in Malaysia: a cross sectional study in an urban primary care setting

Abstract

BackgroundDiabetes mellitus is a highly prevalent condition in Malaysia, increasing from 11.6% in 2006 to 15.2% in 2011 among individuals 18 years and above. Co-morbid depression in diabetics is associated with hyperglycemia, diabetic complications and increased health care costs. The aims of this study are to determine the prevalence and predictors of depression, anxiety and stress symptoms in Type II diabetics attending government primary care facilities in the urban area of Klang Valley, Malaysia.MethodsThe study was cross sectional in design and carried out in 12 randomly selected primary care government clinics in the Klang Valley, Malaysia. A total of 2508 eligible consenting respondents participated in the study. The Depression, Anxiety and Stress Scale (DASS) 21 questionnaire was used to measure depression, anxiety and stress symptoms. Data was analyzed using the SPSS version 16 software using both descriptive and inferential statistics.ResultsThe prevalence of depression, anxiety and stress symptoms among Type II diabetics were 11.5%, 30.5% and 12.5% respectively. Using multiple logistic regression, females, Asian Indians, marital status (never married, divorced/widowed/separated), a family history of psychiatric illness, less than 2 years duration of diabetes and current alcohol consumption were found to be significant predictors of depression. For anxiety, unemployment, housewives, HbA1c level of more than 8.5%, a family history of psychiatric illness, life events and lack of physical activity were independent risk factors. Stress was significantly associated with females, HbA1c level of more than 8.5%, presence of co-morbidity, a family history of psychiatric illness, life events and current alcohol consumption. For depression (adjusted OR 2.8, 95% CI 1.1; 7.0), anxiety (adjusted OR 2.4, 95% CI 1.1;5.5) and stress (adjusted OR 4.2, 95% CI 1.8; 9.8), a family history of psychiatric illness was the strongest predictor.ConclusionWe found the prevalence of depression, anxiety and stress symptoms to be high among Type II diabetics, with almost a third being classified as anxious. Screening of high risk Type II diabetics for depression, anxiety and stress symptoms in the primary care setting is recommended at regular intervals.

Psychological health and menopause-specific quality of life of Malaysian women with type 2 diabetes

“…Despite the high prevalence of diabetes in the general population in Malaysia (Institute for Public Health, 2011;Zanariah et al, 2010), only a few cohort or case-control studies are available on this topic. These studies support the hypotheses that people with diabetes are more likely to have depression or anxiety symptoms than people who do not have diabetes (Kaur et al, 2013;Subramaniam et al, 2009). Some authors have also suggested that depression and anxiety symptoms are significantly higher in postmenopausal women compared to premenopausal women (Saqsoz et al, 2001).…”

“…Similarly, anxiety (31.8% versus 33.3%) and depression symptoms (20.9% versus 20.8%) as measured by the psychosocial domain of MENQOL were also similar for both groups, suggesting that attainment of menopausal status did not increase or decrease the psychological burden in participating women. A recent study in Malaysia (2013) found a relatively higher prevalence of depression and anxiety symptoms among people with diabetes (Kaur et al, 2013). This may be a result of differences in the screening instrument, the age groups (less than 35 and more than 75 years), and the inclusion of male participants.…”

“…Logistic regression was used to investigate the relationship between: psychological conditions (depression and anxiety symptoms) and diabetes, and menopausal symptoms and diabetes. The potential confounders and risk factors were identified on the basis of their association with outcomes and on the basis of a priori knowledge ( b Hasan et al, 2013;Kaur et al, 2013;Smith et al, 2013). Multiple logistic regressions were then used to assess the relationship, after adjustment for other potential confounding variables.…”

“…Bahrain (2008) (Almawi et al, 2008;Kaur et al, 2013). This may be attributed to inadequate or inefficient coping skills for managing diabetes shortly after diagnosis.…”

Relação dos sintomas e fases do estresse com características sociodemográficas e clínicas de pessoas com diabetes mellitus tipo 2

“…As DCNTs constituem grave problema de saúde pública, tanto em países ricos quanto nos de média e baixa renda, contudo estes últimos são os mais afetados, tendo em vista o escasso oferecimento de políticas públicas que modifiquem os determinantes sociais de saúde (MS, 2008 O estresse em pessoas com DM tende a estar presente desde o início da doença e em todo o seu curso (ORTIZ et al, 2011), uma vez que possuir uma doença crônica significa apresentar possíveis limitações ou incapacidades físicas (KAUR et al, 2013;ORTIZ et al, 2011;NASCIMENTO et al, 2010;CHAMORRO;MARTINEZ;TOMÁS, 2002). Dessa maneira, as pessoas podem sentir-se desanimadas com o plano terapêutico, preocupadas com o controle glicêmico e complicações, bem como apresentar dificuldades na proposição de metas concretas para o tratamento (ZULMAN et al, 2012).…”