Kamrul-Hasan A B, Palash-Molla M, Mainul-Ahsan M, Gaffar A J, Asaduzzaman M, Saifuddin M, Rahman M S, Akter F, Rahman H, Talukder S K, Islam M, Chanda P K, Siddiqui N I, Selim S
Dr Abul Bashar Mohammad Kamrul Hasan, Assistant Registrar, Department of Endocrinology, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh; E-mail:
Mymensingh Med J. 2019 Jan;28(1):23-30.
Depression is a common comorbidity of type 2 diabetes mellitus (T2DM) which adversely affects diabetes management and outcome. Identifying and treating comorbid depression may improve diabetes care. This cross-sectional study was conducted in several tertiary hospitals throughout Bangladesh from July 2017 to April 2018. Nine hundred (900) adult patients with T2DM aging ≥25 years having diabetes for at least 6 months and equal numbers of non-diabetic otherwise healthy controls were recruited from the outpatient departments of these centers. Depression was assessed in all consenting patients and controls by administering the Bangla (local language) version of the PRIME-MD Patient Health Questionnaire (PHQ-9); participants obtaining a score of 5 or more were labeled to have depression. Depression was present in 60.3% of T2DM patients and in 29.4% of controls. Statistically significant difference was found in age, marital status, occupation, body mass index (BMI), waist circumference, systolic blood pressure (BP), diastolic BP and PHQ-9 score between diabetic and non-diabetic subjects (<0.001). T2DM subjects had 4.71-fold higher odds of depression in comparison to the controls (95% CI: 3.76-5.90; p<0.001). Age ≥50 years, unmarried status, years of schooling ≤10 years, underweight, abdominal obesity, and hypertension appeared to be the significant predictors of depression in the study subjects. In T2DM subjects, diabetes in the family members, the presence of other comorbidities, diabetic complications, diabetes duration >5 years, insulin use, using insulin syringe for injection, albuminuria and CKD were the important predictors of depression. Our study found higher prevalence and risk of depression in T2DM patients than their non-diabetic counterparts. T2DM patients should be screened for depression in order to achieve and maintain the treatment goals.
抑郁症是2型糖尿病（T2DM）常见的合并症，会对糖尿病的管理和预后产生不利影响。识别并治疗合并的抑郁症可能会改善糖尿病护理。这项横断面研究于2017年7月至2018年4月在孟加拉国各地的几家三级医院进行。从这些中心的门诊部招募了900名年龄≥25岁、患糖尿病至少6个月的成年T2DM患者，以及数量相等的非糖尿病健康对照者。通过使用PRIME-MD患者健康问卷（PHQ-9）的孟加拉语（当地语言）版本对所有同意参与的患者和对照者进行抑郁症评估；得分5分及以上的参与者被标记为患有抑郁症。T2DM患者中抑郁症的患病率为60.3%，对照者中为29.4%。糖尿病患者和非糖尿病患者在年龄、婚姻状况、职业、体重指数（BMI）、腰围、收缩压（BP）、舒张压和PHQ-9得分方面存在统计学显著差异（<0.001）。与对照组相比，T2DM患者患抑郁症的几率高4.71倍（95%CI：3.76-5.90；p<0.001）。年龄≥50岁、未婚、受教育年限≤10年、体重过轻、腹部肥胖和高血压似乎是研究对象中抑郁症的重要预测因素。在T2DM患者中，家庭成员患糖尿病、存在其他合并症、糖尿病并发症、糖尿病病程>5年、使用胰岛素、使用胰岛素注射器注射、蛋白尿和慢性肾脏病是抑郁症的重要预测因素。我们的研究发现，T2DM患者抑郁症的患病率和风险高于非糖尿病患者。应筛查T2DM患者是否患有抑郁症，以实现并维持治疗目标。
