The Effect of Diabetes Mellitus on the Presentation of Depression in a Primary Care Population
- 1. Consultant of Family, Community Medicine and Medical Education, KSA
- 2. Faculdade de Ciências Médicas, NOVA Medical School Universidade Nova de Lisboa, Portugal
Abstract
Background: Depression is a common disorder with more than 300 million people worldwide. The comorbidity of depression and diabetes has a high
prevalence rate. Collaborative care in diabetes should include screening for depression and patients with depression should be screened for diabetes for
better patients care outcome.
Objective: To identify the effect of diabetes mellitus on the depression presentations in the primary-care centers.
Method: A case-control study was conducted at 11 PHC centers during April-May, 2017. Out of 185 patients who fulfill the study criteria, 74 who had
depression with co-morbid with diabetes formed the Case-sample, 111 depressed patients not co-morbid formed the Control sample.
PHQ-9 used as the diagnostic tool for depression. The satisfaction level and patients’ file were assessed and explored the diagnosed and missed cases
by the PHC doctors. Data were analyzed using SPSS version 20. Odds ratios (OR) demonstrated with their 95% confidence intervals (CI) and P–value < 0.05.
Results: Comorbid depression and diabetes have a significantly high mean of TG and HbA1c. Physical activity and sleep pattern were better among
comorbid cases. At the same time, they were unsatisfied with their care in the PHC centers. Most of the depressant patients were missed by their PHC doctors
(74%), that worse when the patients had comorbid with diabetes (85%) with significantly different (p-value=0.005).
Conclusion: In diabetic patients, depression is mostly missed by the PHC physicians. Therefore, depression should be predicted in diabetic patients
particularly, uncontrolled diabetes, unsatisfied patients. integrated depression management in diabetic care is necessary to improve clinical outcomes and
reduce the burden of illness