Department of Nursing Management, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Office of the Chief Nursing Officer, Ministry of Health Zanzibar, Zanzibar, Tanzania.
PLoS One. 2023 Apr 17;18(4):e0284566. doi: 10.1371/journal.pone.0284566. eCollection 2023.
Depression is one of the mental illnesses that cause disability worldwide, and is a significant contributor to the global burden of diseases. Although depression is reported among patients with diabetes in high-income countries, it remains undetected or undiagnosed in low and middle-income countries. This article describes the prevalence of depression and its associated factors among patients with diabetes in Zanzibar, United Republic of Tanzania.
A cross-sectional study design was conducted at Mnazi Mmoja Referral Hospital (MMRH). A simple random sampling method was used to select the potential participants. Depressive symptoms were assessed using Patient Health Questionnaire-9(PHQ-9). Data were coded and analyzed using SPSS 23.0. A Chi-square test was performed to obtain the association between depression and socio-demographic, medical and psychological factors. A P-value of <0.05 with a 95% confidence interval was used to determine the significant associations between the variables. Also, multiple logistic regression was performed with the factors with P-value <0.2 to ascertain the confounding factors.
A total of 267 patients with diabetes responded to the questionnaire of which 142 (53.2%) were males. The mean age of participants was 50 years and a standard deviation of ±14. The overall prevalence of depression in this study was 73%. The specific type of depression among diabetic patients varied from severe (8%) to mild depression (30%). Respondents who had difficulties in adhering to the treatment regimen (AOR = 5.7: 95% CI, 2.11-15.18, p = 0.001), feeling angry or stressed (AOR = 4.4: 95% CI, 2.44-8.10, p<0.001), and had diabetic retinopathy (AOR = 2.8: 95% CI, 1.45-5.28, p = 0.002) had symptoms of depression. Furthermore, respondents who had diabetic foot ulcers (AOR = 0.1: 95% CI, 0.04-0.49, p = 0.003) and impotence for male patients (AOR = 0.4: 95% CI, 0.20-0.68, p = 0.002) were 0.1 and 0.4 times less likely to have depression respectively.
The majority of patients with diabetes have symptoms of depression. Adherence to the treatment regimen, diabetic retinopathy, feeling angry or stressed, impotence and diabetic foot ulcer were associated with depression. Thus, early screening of depression among patients with diabetes is crucial to enhance self-management and good health outcomes.
抑郁症是导致全球残疾的精神疾病之一，也是全球疾病负担的重要原因。尽管在高收入国家的糖尿病患者中报告了抑郁症，但在中低收入国家，抑郁症仍未被发现或诊断。本文描述了坦桑尼亚联合共和国桑给巴尔岛糖尿病患者中抑郁症的患病率及其相关因素。
采用横断面研究设计，在 Mnazi Mmoja 转诊医院（MMRH）进行。采用简单随机抽样方法选择潜在参与者。使用患者健康问卷-9（PHQ-9）评估抑郁症状。使用 SPSS 23.0 对数据进行编码和分析。采用卡方检验评估抑郁与社会人口统计学、医学和心理因素之间的关系。采用 95%置信区间的 P 值<0.05 来确定变量之间的显著关联。还对 P 值<0.2 的因素进行了多因素逻辑回归，以确定混杂因素。
共有 267 名糖尿病患者对问卷做出了回应，其中 142 名（53.2%）为男性。参与者的平均年龄为 50 岁，标准差为±14。本研究中抑郁症的总体患病率为 73%。糖尿病患者的具体抑郁类型从重度（8%）到轻度抑郁（30%）不等。在坚持治疗方案方面有困难的受访者（OR = 5.7：95%CI，2.11-15.18，p = 0.001）、感到愤怒或压力（OR = 4.4：95%CI，2.44-8.10，p<0.001）和患有糖尿病视网膜病变（OR = 2.8：95%CI，1.45-5.28，p = 0.002）的受访者出现抑郁症状的可能性更大。此外，患有糖尿病足溃疡的受访者（OR = 0.1：95%CI，0.04-0.49，p = 0.003）和男性患者阳痿（OR = 0.4：95%CI，0.20-0.68，p = 0.002）的可能性分别降低了 0.1 倍和 0.4 倍。
大多数糖尿病患者都有抑郁症状。坚持治疗方案、糖尿病视网膜病变、愤怒或压力、阳痿和糖尿病足溃疡与抑郁有关。因此，早期筛查糖尿病患者的抑郁症状对于提高自我管理和改善健康结果至关重要。
