Research Article
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The Relationship Between Disease Profile and Depression and Anxiety in Patients with Diabetes Mellitus

Year 2021, Volume: 2 Issue: 1, 11 - 15, 06.03.2021
https://doi.org/10.48176/esmj.2021.9

Abstract

Introduction: Diabetes mellitus (DM) causes end-organ damage in patients, as well as directly or indirectly causing many psychological problems that can or cannot be diagnosed. Diagnosing depression in DM patients is limited because of the lack of specific diagnostic criteria and the presence of overlapping symptoms. An optimal method for detecting DM and accompanying psychiatric disorders (depression and anxiety) has not been established. The purpose of our study is to reveal the connection between the course of depression and anxiety and the control of the disease in patients with DM and to show that one of the reasons of the incompatibilities encountered in the course of DM is psychiatric disorders.
Methods: In the study, disease course and complication status, demographic characteristics and Diabetes Anxiety Depression Scale (DADS) scores of patients with type 2 DM between 01.06.2019-01.06.2020 were recorded in Eskişehir City Hospital Internal Diseases Department.
Results: The average age of the patients participating in the study was 53.1 years. 51% (n = 25) of the participants were male and 49% (n = 24) were female. When the DADS scores were evaluated; there was a statistically significant change between the first arrival median values 13 (3-35), the 2nd week values 7 (1-24) and the 6th month values 7 (2-26) (p < 0.001). However, the first controls and HbA1c values of our patients at the 6th month showed a significant decrease, and success was achieved in diabetes regulation (p < 0.001).
Conclusion: DM is a chronic and progressive metabolic disease that is common all over the world with accompanying complications. Depression and anxiety are psychiatric disorders that adversely affect the course of chronic diseases and can impair life comfort. There are studies showing that these psychiatric disorders decrease the treatment motivation of the patients, increase treatment costs and make process management difficult in case of comorbidity with DM. In our findings, it has been revealed that when DADS is administered in patients, it can be a suitable tool for evaluating the response to treatment and managing complications in the future, and scores correlated with the course of DM can be obtained.

References

  • 1. Saeedi P, Petersohn I, Salpea P, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract. 2019 Nov;157:107843.
  • 2. Rubin RR, Peyrot M. Psychological issues and treatments for people with diabetes. J Clin Psychol. 2001 Apr;57(4):457-78.
  • 3. Li C, Ford ES, Strine TW, et al. Prevalence of depression among U.S. adults with diabetes: findings from the 2006 behavioral risk factor surveillance system. Diabetes Care. 2008 Jan;31(1):105-7.
  • 4. Khan P, Qayyum N, Malik F, et al. Incidence of Anxiety and Depression Among Patients with Type 2 Diabetes and the Predicting Factors. Cureus. 2019 Mar 14;11(3):e4254.
  • 5. L Lin EH, Von Korff M, Alonso J, et al. Mental disorders among persons with diabetes--results from the World Mental Health Surveys. J Psychosom Res. 2008 Dec;65(6):571-80.
  • 6. Danaei G, Finucane MM, Lu Y, et al. National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2•7 million participants. Lancet. 2011 Jul 2;378(9785):31-40.
  • 7. Holt RI, Katon WJ. Dialogue on Diabetes and Depression: Dealing with the double burden of co-morbidity. J Affect Disord. 2012 Oct;142 Suppl:S1-3.
  • 8. Nouwen A, Winkley K, Twisk J, et al. Type 2 diabetes mellitus as a risk factor for the onset of depression: a systematic review and meta-analysis. Diabetologia. 2010 Dec;53(12):2480-6.
  • 9. Egede LE, Zheng D, Simpson K. Comorbid depression is associated with increased health care use and expenditures in individuals with diabetes. Diabetes Care. 2002 Mar;25(3):464-70.
  • 10. Ferrari AJ, Charlson FJ, Norman RE, et al. Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010. PLoS Med. 2013 Nov;10(11):e1001547.
  • 11. Gülseren L, Güiseren Ş, Hekimsoy Z, et al. Major depresif bozukluğu olan diabetes mellituslu hastalarda fluoksetin ve paroksetinin depresyon-anksiyete, yaşam kalitesi, yeti yitimi ve metabolik kontrol üzerine etkisi: Tek-kör, karşılaştırmalı bir çalışma. Klinik Psikofarmakoli Bülteni. 2001; 11 (1) :1–10.
  • 12. Korkut Y, Kayabaşı A, Onbaşı K. The relationship of depression, anxiety with the type of treatment and age of diabetes in patients with type 2 diabetes. Turkish Journal of Family Practice 2020;24(2):58-67.
  • 13. Holt RI, Katon WJ. Dialogue on Diabetes and Depression: Dealing with the double burden of co-morbidity. J Affect Disord. 2012 Oct;142 Suppl:S1-3.
  • 14. Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006 May 22;166(10):1092-7.
  • 15. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001 Sep;16(9):606-13.
  • 16. Konkan R, Şenormanci Ö, Güçlü O, et al. Validity and reliability study for the Turkish adaptation of the generalized anxiety disorder-7 (GAD-7)scale. Archives of Neuropsychiatry. 2013; 50: 53-58
  • 17. Sarı YE, Kokoglu B, Balcioglu H, et al. Turkish reliability of the patient health questionnaire-9. Biomedical Research. 2016; Special Issue: S460-S462
  • 18. Summary of Revisions: Standards of Medical Care in Diabetes-2020. Diabetes Care. 2020 Jan;43(Suppl 1):S4-S6.
  • 19. Davis WA, Bruce DG, Dragovic M, et al. The utility of the Diabetes Anxiety Depression Scale in Type 2 diabetes mellitus: The Fremantle Diabetes Study Phase II. PLoS One. 2018 Mar 15;13(3):e0194417.
  • 20. Pouwer F. Should we screen for emotional distress in type 2 diabetes mellitus? Nat Rev Endocrinol. 2009 Dec;5(12):665-71.
  • 21. Bennett CM, Guo M, Dharmage SC. HbA(1c) as a screening tool for detection of Type 2 diabetes: a systematic review. Diabet Med. 2007 Apr;24(4):333-43.
  • 22. Bajaj S, Agarwal SK, Varma A, et al. Association of depression and its relation with complications in newly diagnosed type 2 diabetes. Indian J Endocrinol Metab. 2012 Sep;16(5):759-63.
  • 23. Uysal Y, Akpınar E. Tip 2 Diyabetli Hastalarda Hastalık Algısı ve Depresyon. Cukurova Medical Journal. 2013; 38 (1): 31-40
  • 24. Knol MJ, Twisk JW, Beekman AT, et al. Depression as a risk factor for the onset of type 2 diabetes mellitus. A meta-analysis. Diabetologia. 2006 May;49(5):837-45.

Diyabetes Mellituslu Hastalarda Hastalık Profili ile Depresyon ve Anksiyete İlişkisi

Year 2021, Volume: 2 Issue: 1, 11 - 15, 06.03.2021
https://doi.org/10.48176/esmj.2021.9

Abstract

Giriş: Diyabetes Mellitus (DM) hastalarda uç organ hasarı oluşturmasının yanı sıra tanı konulabilen veya konulamayan birçok psikolojik probleme doğrudan veya dolaylı yolla sebep olabilir. DM hastalarında depresyon tanısını koymak, spesifik tanı kriterlerindeki eksiklik ve örtüşen semptomların varlığı nedeniyle sınırlamalara uğramaktadır. DM ve ona eşlik eden psikiyatrik bozuklukların (depresyon ve anksiyete) saptanmasında optimal bir yöntem ortaya konmamıştır. Çalışmamızın amacı; DM’li hastalarda eşlik eden depresyon ve anksiyetenin seyri ile hastalığın kontrolü arasındaki bağlantıyı ortaya çıkartmak ve DM seyrinde karşılaşılan uyumsuzlukların sebeplerinden birinin de psikiyatrik bozukluklar olduğunu göstermektir.
Yöntemler: Çalışmada Eskişehir Şehir Hastanesi İç Hastalıkları bölümünde, 01.06.2019 - 01.06.2020 tarihleri arasında Tip 2 DM tanılı hastaların hastalık seyri ve komplikasyon durumları, demografik özellikleri ve Diyabet Anksiyete Depresyon Skalası (DADS) skorları kaydedildi.
Bulgular: Araştırmaya katılan hastaların yaş ortalaması 53,1 yıldı. Katılımcıların %51’i (n = 25) erkek, %49’u (n = 24) kadındı. DADS skorları değerlendirildiğinde; ilk geliş değeri 13 (3-35), 2. hafta değeri 7 (1-24) ve 6. ay değeri 7 (2-26) arasındaki değişimde istatistiksel olarak anlamlı azalma saptandı (p < 0,001). Bununla birlikte hastalarımızın ilk kontrolleri ve 6. aydaki HbA1c değerleri de anlamlı ölçüde azalma göstererek diyabet regülasyonunda başarı sağlandı (p < 0,001).
Sonuç: DM, eşlik ettiği komplikasyonlar ile tüm dünyada yaygın görülen, kronik ve ilerleyici bir metabolik hastalıktır. Depresyon ve anksiyete ise kronik hastalıkların seyrini kötü etkileyen ve yaşam konforunu bozabilen psikiyatrik bozukluklardır. Sözü geçen psikiyatrik bozuklukların DM ile birlikteliği durumunda, hastaların tedavi motivasyonunu düşürdüğünü, tedavi maliyetlerini arttırdığı ve süreç yönetimini zorlaştırdığını gösteren çalışmalar mevcuttur. Bulgularımızda, DADS hastalarda uygulandığında, tedaviye yanıtın değerlendirilmesinde ve ilerisi için komplikasyon yönetiminde uygun bir araç olabileceği, DM seyri ile korele skorlar elde edilebileceği ortaya çıkmıştır.

References

  • 1. Saeedi P, Petersohn I, Salpea P, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract. 2019 Nov;157:107843.
  • 2. Rubin RR, Peyrot M. Psychological issues and treatments for people with diabetes. J Clin Psychol. 2001 Apr;57(4):457-78.
  • 3. Li C, Ford ES, Strine TW, et al. Prevalence of depression among U.S. adults with diabetes: findings from the 2006 behavioral risk factor surveillance system. Diabetes Care. 2008 Jan;31(1):105-7.
  • 4. Khan P, Qayyum N, Malik F, et al. Incidence of Anxiety and Depression Among Patients with Type 2 Diabetes and the Predicting Factors. Cureus. 2019 Mar 14;11(3):e4254.
  • 5. L Lin EH, Von Korff M, Alonso J, et al. Mental disorders among persons with diabetes--results from the World Mental Health Surveys. J Psychosom Res. 2008 Dec;65(6):571-80.
  • 6. Danaei G, Finucane MM, Lu Y, et al. National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2•7 million participants. Lancet. 2011 Jul 2;378(9785):31-40.
  • 7. Holt RI, Katon WJ. Dialogue on Diabetes and Depression: Dealing with the double burden of co-morbidity. J Affect Disord. 2012 Oct;142 Suppl:S1-3.
  • 8. Nouwen A, Winkley K, Twisk J, et al. Type 2 diabetes mellitus as a risk factor for the onset of depression: a systematic review and meta-analysis. Diabetologia. 2010 Dec;53(12):2480-6.
  • 9. Egede LE, Zheng D, Simpson K. Comorbid depression is associated with increased health care use and expenditures in individuals with diabetes. Diabetes Care. 2002 Mar;25(3):464-70.
  • 10. Ferrari AJ, Charlson FJ, Norman RE, et al. Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010. PLoS Med. 2013 Nov;10(11):e1001547.
  • 11. Gülseren L, Güiseren Ş, Hekimsoy Z, et al. Major depresif bozukluğu olan diabetes mellituslu hastalarda fluoksetin ve paroksetinin depresyon-anksiyete, yaşam kalitesi, yeti yitimi ve metabolik kontrol üzerine etkisi: Tek-kör, karşılaştırmalı bir çalışma. Klinik Psikofarmakoli Bülteni. 2001; 11 (1) :1–10.
  • 12. Korkut Y, Kayabaşı A, Onbaşı K. The relationship of depression, anxiety with the type of treatment and age of diabetes in patients with type 2 diabetes. Turkish Journal of Family Practice 2020;24(2):58-67.
  • 13. Holt RI, Katon WJ. Dialogue on Diabetes and Depression: Dealing with the double burden of co-morbidity. J Affect Disord. 2012 Oct;142 Suppl:S1-3.
  • 14. Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006 May 22;166(10):1092-7.
  • 15. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001 Sep;16(9):606-13.
  • 16. Konkan R, Şenormanci Ö, Güçlü O, et al. Validity and reliability study for the Turkish adaptation of the generalized anxiety disorder-7 (GAD-7)scale. Archives of Neuropsychiatry. 2013; 50: 53-58
  • 17. Sarı YE, Kokoglu B, Balcioglu H, et al. Turkish reliability of the patient health questionnaire-9. Biomedical Research. 2016; Special Issue: S460-S462
  • 18. Summary of Revisions: Standards of Medical Care in Diabetes-2020. Diabetes Care. 2020 Jan;43(Suppl 1):S4-S6.
  • 19. Davis WA, Bruce DG, Dragovic M, et al. The utility of the Diabetes Anxiety Depression Scale in Type 2 diabetes mellitus: The Fremantle Diabetes Study Phase II. PLoS One. 2018 Mar 15;13(3):e0194417.
  • 20. Pouwer F. Should we screen for emotional distress in type 2 diabetes mellitus? Nat Rev Endocrinol. 2009 Dec;5(12):665-71.
  • 21. Bennett CM, Guo M, Dharmage SC. HbA(1c) as a screening tool for detection of Type 2 diabetes: a systematic review. Diabet Med. 2007 Apr;24(4):333-43.
  • 22. Bajaj S, Agarwal SK, Varma A, et al. Association of depression and its relation with complications in newly diagnosed type 2 diabetes. Indian J Endocrinol Metab. 2012 Sep;16(5):759-63.
  • 23. Uysal Y, Akpınar E. Tip 2 Diyabetli Hastalarda Hastalık Algısı ve Depresyon. Cukurova Medical Journal. 2013; 38 (1): 31-40
  • 24. Knol MJ, Twisk JW, Beekman AT, et al. Depression as a risk factor for the onset of type 2 diabetes mellitus. A meta-analysis. Diabetologia. 2006 May;49(5):837-45.
There are 24 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Research Articles
Authors

Anıl Uçan This is me 0000-0001-8771-6121

Ebru Özden Yılmaz 0000-0002-1984-2481

Cafer Balcı This is me 0000-0002-1478-1106

Cevahir Dinçtürk This is me 0000-0001-5105-6985

Publication Date March 6, 2021
Published in Issue Year 2021 Volume: 2 Issue: 1

Cite

APA Uçan, A., Özden Yılmaz, E., Balcı, C., Dinçtürk, C. (2021). Diyabetes Mellituslu Hastalarda Hastalık Profili ile Depresyon ve Anksiyete İlişkisi. Eskisehir Medical Journal, 2(1), 11-15. https://doi.org/10.48176/esmj.2021.9
AMA Uçan A, Özden Yılmaz E, Balcı C, Dinçtürk C. Diyabetes Mellituslu Hastalarda Hastalık Profili ile Depresyon ve Anksiyete İlişkisi. Eskisehir Med J. March 2021;2(1):11-15. doi:10.48176/esmj.2021.9
Chicago Uçan, Anıl, Ebru Özden Yılmaz, Cafer Balcı, and Cevahir Dinçtürk. “Diyabetes Mellituslu Hastalarda Hastalık Profili Ile Depresyon Ve Anksiyete İlişkisi”. Eskisehir Medical Journal 2, no. 1 (March 2021): 11-15. https://doi.org/10.48176/esmj.2021.9.
EndNote Uçan A, Özden Yılmaz E, Balcı C, Dinçtürk C (March 1, 2021) Diyabetes Mellituslu Hastalarda Hastalık Profili ile Depresyon ve Anksiyete İlişkisi. Eskisehir Medical Journal 2 1 11–15.
IEEE A. Uçan, E. Özden Yılmaz, C. Balcı, and C. Dinçtürk, “Diyabetes Mellituslu Hastalarda Hastalık Profili ile Depresyon ve Anksiyete İlişkisi”, Eskisehir Med J, vol. 2, no. 1, pp. 11–15, 2021, doi: 10.48176/esmj.2021.9.
ISNAD Uçan, Anıl et al. “Diyabetes Mellituslu Hastalarda Hastalık Profili Ile Depresyon Ve Anksiyete İlişkisi”. Eskisehir Medical Journal 2/1 (March 2021), 11-15. https://doi.org/10.48176/esmj.2021.9.
JAMA Uçan A, Özden Yılmaz E, Balcı C, Dinçtürk C. Diyabetes Mellituslu Hastalarda Hastalık Profili ile Depresyon ve Anksiyete İlişkisi. Eskisehir Med J. 2021;2:11–15.
MLA Uçan, Anıl et al. “Diyabetes Mellituslu Hastalarda Hastalık Profili Ile Depresyon Ve Anksiyete İlişkisi”. Eskisehir Medical Journal, vol. 2, no. 1, 2021, pp. 11-15, doi:10.48176/esmj.2021.9.
Vancouver Uçan A, Özden Yılmaz E, Balcı C, Dinçtürk C. Diyabetes Mellituslu Hastalarda Hastalık Profili ile Depresyon ve Anksiyete İlişkisi. Eskisehir Med J. 2021;2(1):11-5.