A high prevalence of depression among diabetic patients at a teaching hospital in Western Saudi Arabia

OBJECTIVE: To determine the prevalence of depression among diabetic patients followed at the outpatient department of King Abdul-Aziz University Hospital, Jeddah, Kingdom of Saudi Arabia (KSA).

METHODS: A cross-sectional study was conducted at King Abdul-Aziz University Hospital, Jeddah, KSA, between September 2002 and June 2003. Demographic features, marital status, smoking, presence of hypertension, hyperlipidemia, and other chronic illnesses were registered for both diabetic and non-diabetic groups. For diabetic patients, detailed information (duration of diabetes mellitus (DM), its type and treatment, glycemic control, presence of microvascular and macrovascular complications) were recorded. Depression was assessed by interviewing patients using the Beck depression inventory scale. Relation between depression and different variables was studied, analyzed and compared statistically in both groups.

RESULTS: A total of 400 patients were studied (200 diabetic, 200 non-diabetic patients). Depression prevalence among diabetic patients was 34% in comparison with 13% among non-diabetic patients (p<0.001). Statistically significant relation was found between depression and duration of DM (11 versus 9 years), poor glycemic control; glycosylated hemoglobin (10% versus 9%) with p values of 0.03 and 0.04. Macrovascular complications and retinopathy were higher among depressed diabetics (64% and 54%) compared to non-depressed diabetics (43%, and 34%) (p=0.004, p=0.007). Hyperlipidemia and hypertension were found to be higher among depressed diabetics (69% and 63%) compared to non-depressed diabetics (50% and 42%), (p=0.01, p=0.006).

CONCLUSION: Depression is more common among diabetics than non-diabetics in this population. It was higher among diabetics with long duration of DM, poor glycemic control, macrovascular complications, retinopathy, hyperlipidemia and hypertension.