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Prevalence of Depressive and Anxiety Symptoms in Adults with Type 2 Diabetes, Peshawar, KPK, Pakistan

Hasan A, Zia S*, Amanullah Y, Nisa F, Maracy M, Hasan Z

Introduction: Diabetes is a known cause of, disability, morbidity, premature death and increased health-system costs. Previous research has shown that there is high prevalence of depression in patients with type 2 diabetes as compared to people without diabetes but there is a lack of data for Pakistan.

Objective: To determine the presence of depressive and anxiety symptoms in adults with type 2 diabetes and without diabetes.

Methods: A questionnaire-based descriptive cross-sectional study was carried out at AIMS Sugar Hospital, Hayatabad, Peshawar, Pakistan, 2018-2019. We used Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder (GAD-7) scale for data collection, on a consecutive sample of patients.

Results: A total of 1157 subjects were interviewed face to face, to fill PHQ-9 and GAD-7 questionnaires in Pashto (locally spoken language). More than three quarters (77%) of the study population had known type 2 diabetes and 23% (264) were healthy individuals. Of the 1157 subjects, 893 (55%) were males and 264 (45%) were females. The mean (S.D.) age of study participants was 46.2 ± 14.1years (range 25-74 years). Both, PHQ- 9 and GAD-7 score, showed high prevalence of mild (34% vs. 12%, moderate (17% vs. 5%) and moderately severe/severe (8% vs. 5%) depression, symptoms and mild (25% vs. 13%), moderate (19% vs. 6%) and severe (8.6% vs. 4.5%) anxiety symptoms in diabetes group as compared to control group. We found that females in diabetes group were more likely to have depressive symptoms as compared to male patients (p<0.01, Pearson Chi Square test). Increasing age (>50 years of age) was not associated with depressive and anxiety symptoms as compared to younger age (<50 years of age) in both control and diabetes group (P=0.3181and P=0.431, respectively,). Similarly, we did not find any statistical association between duration of diabetes and severity of depressive and anxiety symptoms (P=0.561).

Conclusion: High prevalence of depressive and anxiety symptoms were reported by patient with diabetes and female gender was more affected than males. The psychosocial wellbeing of patient with diabetes should be taken into consideration during their consultation and need regular monitoring of depressive illness and anxiety disorder in primary healthcare settings in Pakistan.