Department of Community Nursing, Faculty of Nursing, The University of Jordan, Amman, Jordan.
J Diabetes Complications. 2011 Jul-Aug;25(4):247-52. doi: 10.1016/j.jdiacomp.2011.03.001. Epub 2011 May 20.
The aims of this study were to estimate the prevalence of undiagnosed depression among adults with diabetes mellitus in Jordan and to determine the factors that may indicate the presence of depression and to examine the relationship between depression and blood sugar control among Jordanian subjects with diabetes.
A systemic random sample of 649 type 1 and type 2 diabetic patients aged 18-75 years was selected during the period from July 2009 to January 2010. A prestructured questionnaire was used for collecting the information about sociodemographic data and clinical characteristics. Depression was evaluated using the Patients' Health Questionnaire-8 (PHQ-8). A PHQ-8 score ≥10 has been recommended as a cutoff point for depression. Self-care management behaviors and barrier to adherence were collected. Weights and heights were measured. Glycated hemoglobin was abstracted from each patient directly after the interview.
Of the 649, 128 (19.7) have depression according to the PHQ-8 scores. According to the multivariate analysis, females are more likely to develop depression than males with [odds ratio (OR), 1.91; P=001] and low-educated people versus educated people (OR, 3.09; P≤.002). Being on insulin treatment also has a significant association with depression (OR, 3.31; P=.001). Not following eating plans as recommended by dietitians, lacking self-monitoring blood glucose and increased barriers to adherence scale scores were also associated with depression among the subjects with diabetes.
The prevalence of depression among Jordanian subjects with type 1 and type 2 diabetes is high compared with some developed countries. This was associated with gender, educational level, insulin treatment, low self-management behaviors and increased barriers to adherence. This result shows the urgent need to include the routine screening of depression during outpatient visit, which might help prevention, early detection and management of depression.
本研究旨在评估约旦成年糖尿病患者中未确诊抑郁症的患病率，并确定可能提示抑郁症存在的因素，以及探讨抑郁与约旦糖尿病患者血糖控制之间的关系。
在 2009 年 7 月至 2010 年 1 月期间，采用系统随机抽样方法选取了 649 名 18-75 岁的 1 型和 2 型糖尿病患者。使用预先设计的问卷收集社会人口统计学数据和临床特征信息。采用患者健康问卷-8（PHQ-8）评估抑郁情况。PHQ-8 评分≥10 被推荐为抑郁的截断值。收集自我护理管理行为和遵医障碍。测量体重和身高。在访谈结束后直接从每位患者处提取糖化血红蛋白值。
根据 PHQ-8 评分，649 例患者中有 128 例（19.7%）患有抑郁症。多变量分析显示，女性比男性更容易患抑郁症（比值比 [OR]，1.91；P=0.01），受教育程度低的人比受教育程度高的人更容易患抑郁症（OR，3.09；P≤0.002）。接受胰岛素治疗也与抑郁显著相关（OR，3.31；P=0.001）。未按营养师推荐的饮食计划进食、缺乏自我监测血糖以及遵医障碍量表评分增加与糖尿病患者的抑郁有关。
与一些发达国家相比，约旦 1 型和 2 型糖尿病患者的抑郁患病率较高。这与性别、教育程度、胰岛素治疗、低自我管理行为和遵医障碍增加有关。这一结果表明，迫切需要在门诊就诊时常规筛查抑郁，这可能有助于预防、早期发现和管理抑郁。
