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Abstract
Objectives: To determine the prevalence of major depressive disorder and its association with socio-demographic and clinical factors in patients with type 2 diabetes mellitus.
Methods: This was a cross-sectional study of patients with type 2 diabetes mellitus who attended the hospital-based primary care clinics at the University Malaya Medical Centre, Kuala Lumpur, Malaysia. The patients were interviewed using the Mini-International Neuropsychiatric Interview to diagnose depression based on the DSM-IV criteria. The socio-demographic and clinical data were obtained by interviewing the patients and subsequently verified against their respective case notes.
Results: A total of 204 patients were recruited. The prevalence of major depressive disorder was 15.7%. Major depressive disorder was significantly associated with younger age of patients (mean ± standard deviation, 57.8 ± 15.1 years, p = 0.04), younger age at diagnosis of diabetes mellitus (46.2 ± 13.0 years, p = 0.01), having secondary education (p = 0.02), and having a history of depression (p = 0.002). Multivariate analysis showed that current age (p = 0.04), duration of diabetes mellitus (p = 0.04), age at diagnosis of diabetes mellitus (p = 0.01), and secondary education (p = 0.01) were significant factors.
Conclusions: The prevalence of major depressive disorder was high among patients with type 2 diabetes mellitus. Screening of patients with type 2 diabetes mellitus for depression should be performed periodically or routinely, especially in the primary care setting.
Key words: Depressive disorder, major; Diabetes mellitus; Malaysia; Prevalence; Socioeconomic factors
Introduction
Diabetes mellitus (DM) is a chronic and debilitating disease that affects millions of people globally. Its prevalence is rising in many countries and it is recognised as a global epidemic of the 21st century that is rapidly becoming rampant. According to the International Diabetes Federation, the global prevalence of DM is estimated to increase from 6.6% in 2010 to 7.8% by 2030. This represents an increase in number of diabetics from 285 million to an estimated 438 million people worldwide over 20 years.1 In Malaysia, a rising trend in the incidence of DM is also seen. The Third National Health and Morbidity Survey in 2006 showed that the overall prevalence of DM (known and newly diagnosed) was 11.6%,2 compared with 8.3% in the Second National Health and Morbidity Survey 10 years earlier.3...