Assessment of Depression Risk Factors in Type 2 Diabetics at an Outpatient Clinic of a Tertiary Hospital in North Central, Nigeria


Authors : Dr. Godwin Abah Akor; Dr. Nndunno Ashaku Akwaras; Dr. David Aondona Daniel; Dr. Laadi Swuende; Dr. Onuh Friday; Dr. Aganyi Paul

Volume/Issue : Volume 9 - 2024, Issue 7 - July


Google Scholar : https://tinyurl.com/28vnenht

Scribd : https://tinyurl.com/dycbcjf7

DOI : https://doi.org/10.38124/ijisrt/IJISRT24JUL1008

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.


Abstract : Background Depression and diabetes mellitus are health problems that affect people's quality of life. Some diabetic patients who are depressed may remain undiagnosed with the co- morbidity by Family Physicians. Hence there is need to draw physicians’ attention to curb this.  Aim/Objectives The objective of this study was to assess the prevalence and risk factors of depression among type 2 diabetic patients attending Federal Medical Centre's General Outpatient Clinic in Makurdi, Nigeria  Methodology This cross-sectional study included 238 diabetic patients over the age of 18 using the random sampling technique. Self-completed questionnaires were used to collect data, and clinical parameters such as height, weight, blood pressure, and fasting blood glucose levels were noted. The questionnaire collected information on the socio- demographic characteristics, relevant history and Becks Depression Inventory (BDI). Version 21 of the SPSS (Statistical Package for Social Sciences) was used to analyze the data. P-values of less than 0.05 were considered statistically significant in all analyses, which were carried out at a 5% significance level.  Results It was shown that 33.6% of people had depression. It was more common in people between the ages of 20 and 29 (50%) and in women than in men (39% vs. 25%). Mild depression was present in 56.3% of diabetic patients with depression. Depression was shown to be significantly correlated with BMI (p = 0.002), marital status (p = 0.034), gender (p = 0.026), and the kind of antidiabetic medicine taken (p = 0.036). Being overweight was substantially linked to a decreased risk of depression, according to multiple logistic regression analysis (aOR = 0.14, CI = 0.03-0.66, p = 0.013).  Conclusion/Recommendation A considerable number of diabetic patients exhibited depression. Physicians should maintain a high level of vigilance, monitor the behavior of individuals with diabetes, and screen them for depression. This approach can provide a foundation for further research.

References :

  1. E.O Ogboghodo, E. Osadiaye and T. Omosun-Fadal, “Depression and suicidal ideation among young persons in Benin City, Edo State: An assessment of prevalence and risk factors”, J Mental Health Hum Behav, vol 23 pp 93-98, 2018
  2. Aluh DO, Anyachebelu OC, Anosike C, Anizoba EL. Mental health literacy: what do Nigerian adolescents know about depression? Int J Ment Health Syst; 12: pp 1-8, 2018.
  3. World Health Organisation, global report on diabetes. Geneva 2016. Accessed on   30th August 2019.
  4. WHO, mh GAP intervention guide for mental, neurological and substance use disordersin non-specialized health settings. 2010.http://whqlibdoc.who.int/publications/ 2010/9789241548069_eng.pdf.Accessed 10/03/17.
  5. J. Mbanya , A. Motala, E. Sobngwi, F. Assah and S. Enoru, “Diabetes in sub-Saharan Africa”, Lancet, vol 375, issue 9733, pp 2254 –2266, 2010.
  6. O. Oguejiofor, C. Odenigbo and C. Onwukwe, “Diabetes in Nigeria: Impact, challenges, future directions” Endocrinol Metab Synd, vol 3, pp 130-141, 2014.
  7. D.H. Tesfa, T.R. Yosef and T.S. Nigussie “Prevalence of depression among type 2 diabetic outpatients in black Lion General Specialised Hospital Addis Ababa, Ethiopia” Depression Research and Treatment, vol, 2015, pp 1-8, 2015.
  8. K.C Tan, G.C. Chan, H. Eric, A.L. Maria, M.J. Norliza and B.H. Oun et al, “Depression anxiety and stress among patients with diabetes in primary care: A cross- sectional study” Malays Fam Physician, vol 10 (2), pp 9-21, 2015.
  9. T.A. Ibrahim, O.A. Olawole, B.J. Ahmed, A.A. Abdullateef, A.O Sunday and K.1. Mary “Current clinical coding practices and implementation of ICD-10 in Africa: A Survey of Nigerian hospitals”, Am J of Health Res, vol 3(1), pp 38-46, 2015.
  10. B. Bayani, S. Yousefi, M. Bayani, M. Shirmohammadi, A. Alimoradi and H. Falsoleiman “Depression and anxiety in a cardiovascular out-patient clinic: a descriptive study”. Iran JPsychiatr, vol 6 (3) pp 125-127, 2011.
  11. J. Shi, Y. Zhang, F. Liu, Y. Li, J. Wang and J. Flint et al, “Associations of education attainment, occupation, social class and major depressive disorder among Han Chinese women” PLoS One. vol (1), pp 1-7, 2019.
  12. O. Olibamoyo, A. Adewuya, B. Ola, O. Coker and O. Atilola, “Prevalence and correlates of depression among Nigerian stroke survivors”, S Afr J Psychiatr, vol 25 pp 1-7, 2019.
  13. M.A. Salinero-Fort, P. Gómez-Campelo and F.J. San Andrés-Reboll et al, “Prevalence of depression in patients with type 2 diabetes mellitus in Spain (the DIADEMA Study): results from the MADIABETES cohort”, Br Med J, vol 8(9) pp 1-11, 2018.
  14. N. Nanayakkara, A. Pease, S. Ranasinha, R. Sanjeeva, W. Natalie, A. Sofianos and S. Jane et al, “Depression and diabetes distress in adults with type 2 diabetes: results from the Australian National Diabetes Audit (ANDA)”, Sci Rep, vol 8 (1) pp 1-8, 2016.
  15. L. Chaoyang, S.F. Earl, W.S Tara and H.M Ali, “Prevalence of depression among U.S. adults with diabetes: Findings from the 2006 behavioral risk factor surveillance system”. Diabetes Care vol 31(1), pp 105-107, 2008
  16. Batholomew C, Samuel K E, Carl DA, Charles G and Marvin A.  “Severe disability and self-reported depression and anxiety among persons living with Type 2 diabetes in Canada” J Afff Disord Rep vol (16) pp 1-10, 2024.
  17. C. Tovilla-Zárate, I. Juárez-Rojop, Y. Peralta Jimenez, M.A, Jiménez, S. Vázquez and D. Bermúdez-Ocaña, et al “Prevalence of anxiety and depression among outpatients with type 2 diabetes in the Mexican population”, PLoS ONE, vol 7(5), pp 1-7, 2012.
  18. Madkhali JM, Hakami AA, Dallak AH, Hakami RM, Yatimi AA, Hamdi ME et al. Prevalence and Associated Factors of Depression among Patients with Diabetes at Jazan Province, Saudi Arabia: A Cross-Sectional Study. Psychiatry J.vol (2019) pp 1-6, 2019.
  19. R. Rezia, A. Islam and S.M. Shariful Islam “Depressive symptoms among participants with type 2 diabetes in Southeast Asia: A systematic review” J Diabetol, vol 9, pp 19-24, 2018.
  20. D.K. Zahra, L. Janet and M.M. Sibtain “Prevalence of depression and associated factors among diabetic patients in an outpatient diabetes clinic” Psychiatry J, ID 2083196, pp 1-6, 2019.
  21. O.J. Bawo, O.O. Joyce and G. Eze, “Depression among patients with diabetes mellitus in a Nigerian teaching hospital” S Afri J Psychi, 16(2), pp 61-64, 2010.
  22. A.A. Sabir, S. Balarabe S, A.A. Sani, S.A.  Isezuo, K.S. Bello, A.O. Jimoh and S.O. Iwuala “Prevalence of diabetes mellitus and its risk factors among the suburban population of Northwest Nigeria” Sahel Med J, vol 20, pp 168-172, 2017.
  23. S.V. Bădescu, C. Tătaru and L.  Kobylinska, “The association between diabetes mellitus and depression” J Med Life, vol 9(2), pp 120–125, 2016.
  24. Di Florio, K.  Putnam and M. Altemus, “The impact of education, country, race and ethnicity on the self-report of postpartum depression using the Edinburgh Postnatal Depression Scale”, Psychol Med, vol 47(5), pp 787–799, 2017.
  25. Obadeji A, Oluwole LO, Dada MU, Ajiboye AS, Kumolalo BF, Solomon OA. Assessment of Depression in a Primary Care Setting in Nigeria using the PHQ-9. J Family Med Prim Care.;4(1) pp 30–34, 2015.
  26. C. Lunghi, J. Moisan, J.P. Grégoire, and L. Guénette, “Incidence of depression and associated factors in patients with type 2 diabetes in Quebec, Canada: A population-based cohort study” Medicine (Baltimore), vol 95 (21): pp 1-10, 2016.
  27. T.M. Agbir, M.D. Audu, T.O Adebowale and S.G. Goar, “Depression among medical outpatients with diabetes”, Ann Afr Med, 9, pp 5-10, 2010.
  28. A.A. El Mahalli. Prevalence and predictors of depression among type 2 diabetes mellitus outpatients in eastern province, Saudi Arabia. Int J Health Sci. vol 9(2) pp 119–126, 2015.
  29. Coker, L.  Okonkwo, Y.A. Kuyinu YA, Adedokun and A. Mohammed, “A Screening for Psychiatric Symptoms in a general outpatient clinic in Lagos, Nigeria: The need for psychiatric evaluation” J Behavioural Health, vol 3, pp 225-229, 2014.
  30. W.M. Sweileh, H.M. Abu-Hadeed, S.W. Al-Jabi and H.Z. Saed “Prevalence of depression among people with type 2 diabetes mellitus: a cross-sectional study in Palestine” BMC Public Health, vol 14, pp 163-174, 2014.
  31. S.L Floriana, M.W Leonore, F.B. Paul, T. Stijnen, C. Pim and W.J. Brenda et al., “Overweight, obesity, and Depression; A systematic review and meta-analysis of longitudinal studies” Arch Gen Psychiatry, vol 67(3) pp 220-229, 2010.
  32. H. Luo, J. Li, Q. Zhang, P. Cao, X. Ren and A.  Fang, et al., “Obesity and the onset of depressive symptoms among middle-aged and older adults in China: evidence from the CHARLS” BMC Public Health, vol 18(1), pp 909-918, 2018.
  33. X. Xiang and R. An “Obesity and onset of depression among U.S. middle-aged and older Adults” Journal of Psychosomatic Research, vol 78(3), pp 242-248, 2015.
  34. S.M. Strauss, M.T. Rosedale and D.M. Rindskopf. “Predictors of depression among adult women with diabetes in the United States. An analysis using national health and nutrition Examination Survey Data From 2007 to 2012” Diabetes Educ, vol 42(6), pp 728-738, 2016.
  35. Kuo SY, Lin KM, Chen CY, Chuang YL, Chen WJ. Depression trajectories and obesity among the elderly in Taiwan. Psychol Med 2011; 41:1665-1676.
  36. M.O.  Araoye, “Research methodology with statistics for health and social sciences. Ilorin: Nathadex”, pp 115– 122, 2004.
  37. J. Gordon, “Beck Depression Inventory” Occup Med, vol 66(2), pp 174-175, 2016.
  38. How to take Anthropometric Measurements. Available at http://www.thl.fi/publications/ehrm/product2/partiii5.ht. accessed 15/11/ 2018.
  39. D. Sahu and M. Bhaskaran, “Palpatory method of measuring diastolic blood pressure”, Anaesthesiol Clin Pharmacol, 26(4), pp 528–530, 2010.
  40. Park CY, Kim SY, Gil JW, Park MH, Park JH, Kim Y. Depression among Korean adults with type 2 diabetes mellitus: Ansan-Community-based epidemiological study. Osong Public Health Res Perspect. 6(4): pp 224-232, 2015.
  41. C.E. Ekpenyong, U.P. Akpan, J.O. Ibu and G. Nyebuk “Gender and age specific prevalence and associated risk factors of type 2 diabetes mellitus in Uyo metropolis south eastern Nigeria”, Diabetol Croat, vol 41(1) pp 17-28, 2012.
  42. K. Deassalegn, W. Yemataw and Z. Atinku t, “Comorbidity of depression and diabetes mellitus in University of Gondar Referral Hospital, Gondar, Ethiopia” Nurs Health Care Int J, vol 2(4), pp 1-12, 2018.
  43. M.C. Thomas “Type 2 diabetes and heart failure: challenges and solutions” Curr Cardiol Rev, vol 12(3), pp249–255, 2016.
  44. F. Kiani and N. Hesabi “The relationship between religious belief of the diabetic patient and depression in a diabetic clinic in Iran “J Relig Health, vol 56(4) pp 1311-1316, 2017.
  45. A.S. Aminu, V. Chandrasekaran and S. Nair, “Depression among patients with diabetes: A community-based study in South India” J Med Sci, vol 37 pp 237-244, 2017.
  46. J. Akpalu, E. Yorke, J. Ainuson-Quampah, W. Balogun and K. Yeboah “Depression and glycaemic control among type 2 diabetes patients: a cross-sectional study in a tertiary healthcare facility in Ghana”, BMC Psychiatry, vol 18(1) pp 357-364, 2018.
  47. S, Ramkisson, B.J.  Pillay and B. Sartorius, “Anxiety, depression and psychological well-being in a cohort of South African adults with Type 2 diabetes mellitus” S Afr J Psychiatr, vol 22(1) pp 1-9, 2016.
  48. K. K. Hall, J. Tambekou, L. Penn, A. Camara, N.M Balde and E. Sobngwi “Association between depression, glycaemic control and the prevalence of diabetic retinopathy in a diabeticpopulation in Cameroon” S Afr J Psychiatr, vol 23, pp 983-990, 2017.
  49. Palizgir M, Bakhtiari M, Esteghamati A. Association of Depression and Anxiety with Diabetes Mellitus Type 2 Concerning Some Sociological Factors. Iran Red Med J. 15(8): pp 644-648,2013.
  50. M.N. Igwe, R.  Uwakwe, C.A. Ahanotu, G.M. Onyema, M.O. Bakare and A.C.  Ndukuba. “Factors associated with depression and suicide among patients with diabetes mellitus and essential hypertension in a Nigerian Teaching Hospital” J Afr Health Sci, vol 13 (1) pp  68-77, 2013.
  51. Lam MS, Fitzpatrick AL, Shrestha A, Karmacharya BM, Koju RP, Rao D. Determing the prevalence of and risk factors for depressive symptoms among adults in Nepal: findings from the Dhulikhel Heart Study. Int J Non-Commun Dis. Vol (2): pp 18-26, 2017.
  52. Sunny AK. Depression among people living with type 2 diabetes in an urbanizing community of Nepal. Plos One. 14(6): pp 1-11, 2019.

Background Depression and diabetes mellitus are health problems that affect people's quality of life. Some diabetic patients who are depressed may remain undiagnosed with the co- morbidity by Family Physicians. Hence there is need to draw physicians’ attention to curb this.  Aim/Objectives The objective of this study was to assess the prevalence and risk factors of depression among type 2 diabetic patients attending Federal Medical Centre's General Outpatient Clinic in Makurdi, Nigeria  Methodology This cross-sectional study included 238 diabetic patients over the age of 18 using the random sampling technique. Self-completed questionnaires were used to collect data, and clinical parameters such as height, weight, blood pressure, and fasting blood glucose levels were noted. The questionnaire collected information on the socio- demographic characteristics, relevant history and Becks Depression Inventory (BDI). Version 21 of the SPSS (Statistical Package for Social Sciences) was used to analyze the data. P-values of less than 0.05 were considered statistically significant in all analyses, which were carried out at a 5% significance level.  Results It was shown that 33.6% of people had depression. It was more common in people between the ages of 20 and 29 (50%) and in women than in men (39% vs. 25%). Mild depression was present in 56.3% of diabetic patients with depression. Depression was shown to be significantly correlated with BMI (p = 0.002), marital status (p = 0.034), gender (p = 0.026), and the kind of antidiabetic medicine taken (p = 0.036). Being overweight was substantially linked to a decreased risk of depression, according to multiple logistic regression analysis (aOR = 0.14, CI = 0.03-0.66, p = 0.013).  Conclusion/Recommendation A considerable number of diabetic patients exhibited depression. Physicians should maintain a high level of vigilance, monitor the behavior of individuals with diabetes, and screen them for depression. This approach can provide a foundation for further research.

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