Major depressive disorder and generalized anxiety disorder among the patients with diabetes mellitus

Abstract

IntroductionDiabetes mellitus is a chronic disorder characterized by impaired metabolism of glucose and other energy-yielding fuels as well as by the late development of vascular and neurological complication. 1 DM may present with characteristic or classical symptoms such as polydipsia, polyuria, polyphagia, loss of weight, fatigue, blurring of vision etc. Diabetic subjects are at an increased risk of atherosclerotic changes affecting the vessels leading to cardiovascular, cerebrovascular and peripheral vascular diseases. Several pathogenetic processes are involved in the development of diabetes. The autoimmune destruction of the beta cells of the islets of Langerhans of the pancreas results in insulin deficiency. DM is a major global public health problem which is increasing dramatically in developing countries. 2 The prevalence of DM worldwide is estimated to be around 200 million people, more than 5% of the adult population globally. 3 Several factors contribute in type 2 DM pathogenesis, including environmental and lifestyle factors. 4,5 In modern life suffering from diabetes mellitus has become an integral part for many. Not only the genetic inheritance but also the environmental factors and lifestyle we lead in this era also can cause diabetes in people. Among the many additional complications which coincide with DM, depression, anxiety, tension and stress are most commonly under-detected. 6 This is that a growing body of literature has reported that patients with diabetes are almost twice as suffer from anxiety and depression as the general population. 7,8 To our knowledge, insufficient studies had conducted regarding psychiatric morbidities among diabetic patients in our country and no study had conducted in North zone of Bangladesh. So the objective of the study was to evaluate the proportion of MDD and GAD among the patients suffering from Diabetes mellitus as well as to identify the socio-demographic characteristics of patients in this area. This study will give baseline information about psychiatric co-morbidity among the diabetic patients. Among them 18 (22.5%) were suffering from MDD and 11 (13.7%) were suffering from GAD. It was shown that both MDD and GAD were higher among female patients. So physicians should pay attention to rule out psychiatric disorders in patients with DM.

Psychiatric disorders in diabetes mellitus patients attending a tertiary health institution in north-eastern Nigeria

“…19 However, the prevalence rate for depression in this study is much higher than the rate of 9.6% for depression reported among DM patients by Issa et al using Composite International Diagnostic Interview (CIDI), though the rate of 10.4% reported for anxiety disorder in their study is slightly higher than the rate in this study. 23 Similarly, rates of 22.5% for MDD and 13.7% for GAD was found among DM patients in Bangladesh via a clinical interview using DSM-5 diagnostic criteria by Monzur et al 24 The higher proportion of females in this study compared to that by Issa et al and Monzur et al may be a plausible explanation for the higher rate of depression reported in this study as literature has revealed that females with DM are more likely to develop depression than their male counterparts. 19 In other studies, using screening instruments, Gul & Bali reported a much higher prevalence rates of 43% and 30% for depression and anxiety in DM patients attending outpatient clinic in India using Amritsar Depressive inventory (ADI) and Hamilton Anxiety Rating Scale (HARS) respectively.…”