Trivedi Ojaswini, Raghuveer Pracheth
Department of Epidemiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India.
J Educ Health Promot. 2024 Oct 28;13:398. doi: 10.4103/jehp.jehp_127_24. eCollection 2024.
Diabetes is linked with depression, but screening rates for depression are low, indicating a need for periodic assessments among those with diabetes. The study aimed to determine depression prevalence and associated factors in persons with type 2 diabetes mellitus (T2DM) in an urban primary care setting of Karnataka, as well as implementation challenges in depression screening for persons with T2DM as perceived by healthcare providers.
A mixed-methods study was performed for 6 months in 2022-2023 at an Urban Primary Health Centre (UPHC) in Bengaluru. The sample size was calculated to be 110, and convenience sampling was applied to select persons with T2DM. The participants were screened for depression using Patient Health Questionnaire-9. Key informant interviews were performed among various health care providers of the UPHC. Data were captured using EpiCollect Version 5.0. Univariate logistic regression was performed to find the factors associated with depression.
Of the 110 participants, 60 (54.5%) screened positive for depression. Men had 0.474 (95% Confidence Intervals-CI: 0.126, 1.782) lesser odds of depression when compared with women ( = 0.269). Those with comorbidities had 1.975 more odds (95% CI: 0.538, 7.252) when compared with absence of comorbidities ( = 0.305). Statistically significant associations were not found with any of the factors. Key facilitators for screening were willingness to implement screening, empathetic attitude, and awareness of mental health, whereas the challenges included lack of training in mental health assessment and patient reluctance to adhere to treatment due to stigma.
The study found that 54.5% of persons with T2DM seeking heath care at the UPHC screened positive for depression. Several challenges in implementing depression screening for T2DM in primary care settings were noted.
糖尿病与抑郁症有关，但抑郁症的筛查率较低，这表明需要对糖尿病患者进行定期评估。本研究旨在确定卡纳塔克邦城市初级保健机构中2型糖尿病（T2DM）患者的抑郁症患病率及相关因素，以及医疗服务提供者所认为的T2DM患者抑郁症筛查中的实施挑战。
2022年至2023年期间，在班加罗尔的一家城市初级卫生中心（UPHC）进行了为期6个月的混合方法研究。计算得出样本量为110，并采用便利抽样法选取T2DM患者。使用患者健康问卷-9对参与者进行抑郁症筛查。对UPHC的各类医疗服务提供者进行了关键信息访谈。数据使用EpiCollect 5.0版本进行收集。进行单因素逻辑回归以找出与抑郁症相关的因素。
在110名参与者中，60名（54.5%）抑郁症筛查呈阳性。与女性相比，男性患抑郁症的几率低0.474（95%置信区间-CI：0.126，1.782）（P = 0.269）。与无合并症者相比，有合并症者患抑郁症的几率高1.975倍（95% CI：0.538，7.252）（P = 0.305）。未发现与任何因素存在统计学上的显著关联。筛查的关键促进因素包括实施筛查的意愿、同理心态度和心理健康意识，而挑战包括缺乏心理健康评估培训以及患者因耻辱感而不愿坚持治疗。
该研究发现，在UPHC寻求医疗保健的T2DM患者中，54.5%的抑郁症筛查呈阳性。注意到在初级保健机构中对T2DM患者实施抑郁症筛查存在若干挑战。
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