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Abstract
Background: Depression is a common psychological disorder in diabetic patients that potentially causes non-adherence and complications. However, information regarding the prevalence and risk factor of depression in diabetic patients in Indonesia remains inconsistent.
Objective: This study is aimed to determine the prevalence of depression and its associated factors among patients with type II diabetes mellitus (T2DM) in primary public health centers.
Method: This cross-sectional study involved adult patients with T2DM in primary health centers in Sleman, Indonesia. Subjects were recruited using the purposive sampling method, and depression was assessed using the PHQ-9 questionnaire. The association between subject characteristics and depression was determined using the chi-square of Fisher’s exact test.
Results: Among 268 subjects, most of them were women, aged <60 years old, had at least 1 comorbidity, and were taking a combination of oral antidiabetics. More than half of subjects had T2DM for <5 years. The prevalence of depression among T2DM was 36.6%. Being aged ≥60 years old, having a low education level, being a provider of family, and having T2DM for 5-10 years (p<0.05) were significantly associated with depression.
Conclusion: T2DM patients aged ≥60 years old, who have a low education level, are providers of family, and have had T2DM for 5-10 years are more vulnerable to depression, thus needing more attention from healthcare providers to achieve diabetes goal therapy.
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References
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References
Abuhegazy, H., Mujairi, A., Banah, F., Agdi, Y., Elkeshishi, H., Kamel, A., Abdullah, A., & Elsheikh, M. (2022). Depression and Associated Risk Factors Among Type 2 Diabetic Patients: A Cross Sectional Study on a Convenience Sample from the Diabetic Center, Khamis Mushait; Saudi Arabia. Neuropsychiatric Disease and Treatment, 18, 1975–1984. https://doi.org/10.2147/NDT.S374752
Akhaury, K., & Chaware, S. (2022). Relation Between Diabetes and Psychiatric Disorders. Cureus, 14(10), e30733. https://doi.org/10.7759/cureus.30733
Aljohani, W., Algohani, L., Alzahrani, A., Bazuhair, M., Bawakid, A., Aljuid, L., & Al-ahdal, A. (2021). Prevalence of Depression Among Patients With Type 2 Diabetes at King Abdullah Medical City. Cureus, 13(10), e18447. https://doi.org/10.7759/cureus.18447
Almeida, O. P., McCaul, K., Hankey, G. J., Yeap, B. B., Golledge, J., Norman, P. E., & Flicker, L. (2016). Duration of Diabetes And Its Association With Depression In Later Life: The Health In Men Study (HIMS). Maturitas, 86, 3–9. https://doi.org/10.1016/j.maturitas.2016.01.003
Al-Sahouri, A., Merrell, J., & Snelgrove, S. (2019). Attitudes, Knowledge, and Perceptions of Patients Regarding Type-2 Diabetes in Jordan. Journal of Diabetes Mellitus, 9(1), 1-13. https://doi.org/10.4236/jdm.2019.91001
Aschner, P., Gagliardino, J. J., Ilkova, H., Lavalle, F., Ramachandran, A., Mbanya, J. C., Shestakova, M., Bourhis, Y., Chantelot, J.-M., & Chan, J. C. N. (2021). High Prevalence of Depressive Symptoms in Patients With Type 1 and Type 2 Diabetes in Developing Countries: Results From the International Diabetes Management Practices Study. Diabetes Care, 44(5), 1100–1107. https://doi.org/10.2337/dc20-2003
Asefa, A., Zewudie, A., Henok, A., Mamo, Y., & Nigussie, T. (2020). Depression and Its Associated Factors among Diabetes Mellitus Patients Attending Selected Hospitals in Southwest Ethiopia: A Cross-Sectional Study. Psychiatry Journal, 2020(1), 1-8. https://doi.org/10.1155/2020/6486030
Bădescu, S., Tătaru, C., Kobylinska, L., Georgescu, E., Zahiu, D., Zăgrean, A., & Zăgrean, L. (2016). The Association Between Diabetes Mellitus and Depression. Journal of Medicine and Life, 9(2), 120–125.
Chen, B., Zhang, X., Xu, X., Lv, X., Yao, L., Huang, X., Guo, X., Liu, B., Li, Q., & Cui, C. (2013). Diabetes Education Improves Depressive State In Newly Diagnosed Patients With Type 2 Diabetes. Pakistan Journal of Medical Sciences, 29(5), 1147–1152.
Dian, C. N., Effendy, E., & Amin, M. M. (2022). The Validation of Indonesian Version of Patient Health Questionnaire-9. Open Access Macedonian Journal of Medical Sciences, 10(T7), 193–198.
Didoné, L. S., Jesus, I. T. M. de, Santos-Orlandi, A. A., Pavarini, S. C. I., Orlandi, F. de S., Costa-Guarisco, L. P., Gratão, A. C. M., Gramany-Say, K., Cominetti, M. R., Gomes, G. A. de O., & Zazzetta, M. S. (2020). Factors Associated With Depressive Symptoms In Older Adults In Context of Social Vulnerability. Revista Brasileira De Enfermagem, 73(1), 1-7. https://doi.org/10.1590/0034-7167-2019-0107
Dziurkowska, E., & Wesolowski, M. (2021). Cortisol as a Biomarker of Mental Disorder Severity. Journal of Clinical Medicine, 10(21), 1-17. https://doi.org/10.3390/jcm10215204
Engidaw, N. A., Wubetu, A. D., & Basha, E. A. (2020). Prevalence of Depression and Its Associated Factors Among Patients With Diabetes Mellitus At Tirunesh-Beijing General Hospital, Addis Ababa, Ethiopia. BMC Public Health, 20(1), 1-7. https://doi.org/10.1186/s12889-020-8360-2
Fottrell, E., Ahmed, N., Shaha, S. K., Jennings, H., Kuddus, A., Morrison, J., Akter, K., Nahar, B., Nahar, T., Haghparast-Bidgoli, H., Khan, A. K. A., Costello, A., & Azad, K. (2018). Diabetes Knowledge and Care Practices Among Adults In Rural Bangladesh: A Cross-Sectional Survey. BMJ Global Health, 3(4), 1-11. https://doi.org/10.1136/bmjgh-2018-000891
Holt, R. I. G., Groot, M. de, & Golden, S. H. (2014). Diabetes and Depression. Current Diabetes Reports, 14(6), 491. https://doi.org/10.1007/s11892-014-0491-3
Hsu, Y.-L., Su, D.-H., & Kuo, S.-C. (2020). Health Literacy and Depression In Women With Type 2 Diabetes Mellitus. Clinics, 75, e1436. https://doi.org/10.6061/clinics/2020/e1436
Jung, A., Du, Y., Nübel, J., Busch, M. A., Heidemann, C., Scheidt-Nave, C., & Baumert, J. (2021). Are Depressive Symptoms Associated With Quality of care In Diabetes? Findings From A Nationwide Population-Based Study. BMJ Open Diabetes Research and Care, 9(1), 1-11. https://doi.org/10.1136/bmjdrc-2020-001804
Karlin, N. J., Weil, J., & Felmban, W. (2016). Aging in Saudi Arabia: An Exploratory Study of Contemporary Older Persons’ Views About Daily Life, Health, and the Experience of Aging. Gerontology and Geriatric Medicine, 2, 1-9. https://doi.org/10.1177/2333721415623911
Kessing, L. V., Rytgaard, H. C., Ekstrøm, C. T., Knop, F. K., Berk, M., & Gerds, T. A. (2020). Antidiabetes Agents and Incident Depression: A Nationwide Population-Based Study. Diabetes Care, 43(12), 3050–3060. https://doi.org/10.2337/dc20-1561
King, T. L., Shields, M., Byars, S., Kavanagh, A. M., Craig, L., & Milner, A. (2020). Breadwinners and Losers: Does the Mental Health of Mothers, Fathers, and Children Vary by Household Employment Arrangements? Evidence From 7 Waves of Data From the Longitudinal Study of Australian Children. American Journal of Epidemiology, 189(12), 1512–1520. https://doi.org/10.1093/aje/kwaa138
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9. Journal of General Internal Medicine, 16(9), 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x
Kuehner, C. (2017). Why Is Depression More Common Among Women Than Among Men? The Lancet Psychiatry, 4(2), 146–158. https://doi.org/10.1016/S2215-0366(16)30263-2
Lunghi, C., Zongo, A., Moisan, J., Grégoire, J.-P., & Guénette, L. (2017). The Impact of Incident Depression On Medication Adherence In Patients With Type 2 Diabetes. Diabetes & Metabolism, 43(6), 521–528. https://doi.org/10.1016/j.diabet.2017.07.003
Mokoagow, M. I., Pitawati, D., Arisandy, D. N., Magfira, N., Palupi, P. I., Nasarudin, J., Epriliawati, M., & Kshanti, I. A. (2022). Factors Associated with Depression among Type 2 Diabetes Mellitus Patients at a Tertiary Hospital during the COVID-19 Pandemic. Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal), 17(4), 257-263. https://doi.org/10.21109/kesmas.v17i4.6301
Moshomo, T., Rivera, Y. P., Boshe, J., & Rwegerera, G. M. (2022). The Prevalence of Depression and Its Associated Factors Among Patients With Diabetes Mellitus Attending A Tertiary Clinic In Gaborone, Botswana. The South African Journal of Psychiatry: SAJP: The Journal of the Society of Psychiatrists of South Africa, 28, 1-10. https://doi.org/10.4102/sajpsychiatry.v28i0.1647
Nabila, K. A., Kusumawati, M., & Megawati, G. (2022). Knowledge and Perception of Diabetes Mellitus among Patients with Type 2 Diabetes Mellitus in Five Public Health Centers in Karawang, West Java, Indonesia. Althea Medical Journal, 9(1), 12-18. https://doi.org/10.15850/amj.v9n1.2287
Naviganuntana, Y., Kerdcharoen, N., & Rawdaree, P. (2022). Factors Associated with Depressive Symptoms in Elderly Individuals Living in Urban Communities. Psychology Research and Behavior Management, 15, 855–864. https://doi.org/10.2147/PRBM.S348782
Nene, B., Delao, K., Vargas, Mandal, J., Tan, V., Geonzon, J., Tinapay, A., Espanillo, M., & Tirol, S. (2023). The Psychological Well-Being of Breadwinners in Selected Families of a Third-Class Municipality: A Literature Review, 8, 2595–2601.
Nouwen, A., Adriaanse, M. C., van Dam, K., Iversen, M. M., Viechtbauer, W., Peyrot, M., Caramlau, I., Kokoszka, A., Kanc, K., de Groot, M., Nefs, G., Pouwer, F., & Consortium, the E. D. in D. (EDID) R. (2019). Longitudinal Associations Between Depression and Diabetes Complications: A Systematic Review and Meta-Analysis. Diabetic Medicine, 36(12), 1562–1572. https://doi.org/10.1111/dme.14054
Patria, B. (2022). The Longitudinal Effects of Education On Depression: Finding From The Indonesian National Survey. Frontiers in Public Health, 10, 1-7. https://doi.org/10.3389/fpubh.2022.1017995
Putri, C. A., Anissa, M., & Mahatma, G. (2023). Gambaran Tingkat Depresi Pada Pasien Diabetes Melitus Tipe 2 di Puskesmas Tanjung Pinang Tahun 2022. Scientific Journal, 2(5), 1-9. https://doi.org/10.56260/sciena.v2i5.103
Qusaibi, B. A., Mosli, H., Kattan, W., Fadel, H., Alariefy, A., Almalki, B., Bahkali, L., Alzubaidi, A., AlQusaibi, B., Mosli, H., Kattan, W., Fadel, H., Alariefy, A. A., Almalki, B., Sr, L. H. B., & Alzubaidi, A. (2022). Depression Among Patients With Type 2 Diabetes Mellitus at King Abdulaziz University Hospital (KAUH): A Cross-Sectional Study. Cureus, 14(6). https://doi.org/10.7759/cureus.25990
Saleh, R., Maryunis, & Murtini. (2020). Gambaran Tingkat Kecemasan, Depresi, dan Stres pada Penderita Diabetes Mellitus. Window of Nursing Journal, 1(2), 87–97. https://doi.org/10.33096/won.v1i2.255
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