The Screening of Comorbid Depressive Disorders and Associated Risk Factors in Adult Patients with Type 2 Diabetes

Yıl: 2020 Cilt: 24 Sayı: 3 Sayfa Aralığı: 189 - 197 Metin Dili: İngilizce DOI: 10.25179/tjem.2020-73401 İndeks Tarihi: 20-10-2020

The Screening of Comorbid Depressive Disorders and Associated Risk Factors in Adult Patients with Type 2 Diabetes

Öz:
Objective: Elevated depressive symptoms and disorders affect one in fivepatients with diabetes. Current guidelines recommend screening depressionin the diabetic population. Turkey has the highest (13.7%) prevalence of diabetesin Europe. However, there are limited data about the prevalence of depressivedisorders among diabetic patients in Turkey. We aim to investigatethe prevalence of a comorbid depressive disorder in Type 2 diabetic patientswho were referred to the Endocrinology outpatient unit of a tertiary hospital.Material and Methods: All the Type 2 diabetic patients admitted to our endocrinologydepartment were consecutively included in the study. Their sociodemographics,concomitant diseases and medications, macro andmicrovascular complications, lifestyle and personal habits, and treatment regimenswere obtained by a specifically designed questionnaire. Laboratory datawere obtained from the hospital records. The Patient Health Questionnaire-9(PHQ-9), a depression screening tool, was used as a screening method fordepression. Patients with a score of 10 or above determined high risk for depressivedisorder according to PHQ-9. The scores were re-evaluated by a psychiatristto minimize the false negative and positive results.Result: A total of 460 patients with Type 2 diabetic were enrolled in this crosssectionalstudy. 18.9% (n=87) of the participants were found to have depressivedisorders according to the psychiatric evaluation done after thePHQ-9 questionnaire. Patients with depressive disorders were predominantlyfemale (69.0% vs. 55.5%; p=0.022), younger (57.2±10.5 vs. 60.0±9.5;p=0.014), had higher HbA1c (8.51±2.51 vs. 7.98±2.05; p=0.042), total cholesterol(205.6±44.2 vs. 194.2±46.0; p=0.045), LDL-cholesterol (123.1±37.8vs. 113.1±35.4; p=0.026) and non-HDL-cholesterol (158.5±41.61 vs.146.6±42.7; p=0.024). These patients had frequent neuropathy (37.3% vs.19.0%, p=0.001), they were less likely to perform exercise (31.8% vs.53.1%; p<0.001) while smoke in excess (31.4% vs. 14.3%; p<0.001). Theanalysis showed that female gender (OR=4.4; 95% CI=1.6-12.8; p=0.005)and smoking (OR=7.6; 95% CI=2.8-20.5, p<0.001) are independent determinantsof a depressive disorder. Conclusion: Approximately one-fifth of diabeticpatients had a depressive disorder, and their metabolic parameterswere worse than those without a depressive disorder. Therefore, to assess adiabetic patient from all aspects, screening for depressive disorder should bemade an indispensable part of the evaluation process.
Anahtar Kelime:

Erişkin Tip 2 Diyabet Hastalarında Depresif Bozuklukların ve İlişkili Risk Faktörlerinin Taranması

Öz:
Amaç: Depresif bozukluk ve artmış depresif durumlar her beş diyabet hastasından birini etkilemektedir. Güncel rehberler, diyabetik popülasyonda depresif semptom ve bozuklukların taranmasını önermektedir. Türkiye, Avrupa’da en yüksek (%13,7) diyabet prevalansına sahip ülke konumundadır. Bununla birlikte, Türkiye’de diyabet hastaları arasında depresif bozukluğun sıklığı hakkında kısıtlı veri bulunmaktadır. Biz bu çalışma ile bir üçüncü basamak Endokrinoloji polikliniğine başvuran Tip 2 diyabetik hasta popülasyonunda eşlik eden depresif bozukluk prevalansını saptamayı amaçladık. Gereç ve Yöntemler: Endokrinoloji polikliniğine başvuran tüm tip 2 diyabet hastaları ardışık olarak çalışmaya dâhil edildi. Katılımcıların sosyodemografik özellikleri, eşlik eden hastalıkları ve uygulanan tedaviler, makro ve mikro komplikasyonlar, yaşam tarzı ve kişisel alışkanlıkları hazırlanan sorgu formu ile kayıt altına alındı. Laboratuvar verileri hastane bilgi sisteminden alındı. Depresif bozukluk taraması için “Patient Health Questionnaire-9 (PHQ-9)” depresyon tarama aracı kullanıldı. PHQ-9 puanı 10 ve üzeri olan hastalar, depresif bozukluk açısından yüksek riskli olarak değerlendirildi ve olası yanlış negatif-pozitif sonuçları en aza indirgemek amacıyla bir psikiyatri uzmanı tarafından yeniden değerlendirildi. Bulgular: Çalışmaya toplam 460 Tip 2 diyabet hastası dâhil edildi. PHQ-9 skorları ve akabinde yapılan psikiyatri değerlendirmesi sonrası hastaların %18,9 (n=87)’unda depresif bozukluk saptandı. Depresif bozukluk saptanan hastalar ağırlıklı olarak kadın cinsiyette (%69,0’a karşı %55,5; p=0,022), daha genç yaşta (57,2±10,5’e karşı 60,0±9,5; p=0,014), daha yüksek HbA1c (8,51±2,51’e karşı 7,98±2,05; p=0,042), total kolesterol (205,6±44,2’ye karşı 194,2±46,0; p=0,045), LDL kolesterol (123,1±37,8’e karşı 113,1±35,4; p=0,026) ve non-HDL-kolesterol (158,5±41,61’e karşı 146,6±42,7; p=0,024) seviyelerine sahip idi. Ek olarak, bu hastalarda nöropati daha sık (%37,3’e karşı %19,0, p=0,001), egzersiz yapma oranları daha düşük (%31,8’e karşı %53,1; p<0,001) ve sigara içme sıklığı daha yüksek (%31,4’e karşı %14,3; p<0,001) idi. Kadın cinsiyette olmak (OR=4,4; %95 GA=1,6-12,8; p=0,005) ve sigara içmek (OR=7,6; %95 GA=2,8-20,5; p<0,001) depresif bozukluğa sahip olmanın bağımsız öngördürücüleri idi. Sonuç: Diyabetik hastaların yaklaşık beşte birinde depresif bozukluk mevcuttu ve metabolik parametreleri depresif bozukluk olmayanlara göre daha kötü idi. Bu nedenle, bir diyabet hastasını kapsamlı bir şekilde değerlendirebilmek için depresif bozukluk taraması hasta değerlendirmesinin ayrılmaz bir parçası olarak uygulanmalıdır.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA Demirci I, haymana c, Sonmez A, bolu a, gülsoy kirnap n, DEMİR O, Meric C, GÜVEN OYSUL F, Aydogdu A, Ersöz Gulcelik N, Azal O (2020). The Screening of Comorbid Depressive Disorders and Associated Risk Factors in Adult Patients with Type 2 Diabetes. , 189 - 197. 10.25179/tjem.2020-73401
Chicago Demirci Ibrahim,haymana cem,Sonmez Alper,bolu abdullah,gülsoy kirnap nazli,DEMİR ORHAN,Meric Coskun,GÜVEN OYSUL Fahrettin,Aydogdu Aydogan,Ersöz Gulcelik Nese,Azal Omer The Screening of Comorbid Depressive Disorders and Associated Risk Factors in Adult Patients with Type 2 Diabetes. (2020): 189 - 197. 10.25179/tjem.2020-73401
MLA Demirci Ibrahim,haymana cem,Sonmez Alper,bolu abdullah,gülsoy kirnap nazli,DEMİR ORHAN,Meric Coskun,GÜVEN OYSUL Fahrettin,Aydogdu Aydogan,Ersöz Gulcelik Nese,Azal Omer The Screening of Comorbid Depressive Disorders and Associated Risk Factors in Adult Patients with Type 2 Diabetes. , 2020, ss.189 - 197. 10.25179/tjem.2020-73401
AMA Demirci I,haymana c,Sonmez A,bolu a,gülsoy kirnap n,DEMİR O,Meric C,GÜVEN OYSUL F,Aydogdu A,Ersöz Gulcelik N,Azal O The Screening of Comorbid Depressive Disorders and Associated Risk Factors in Adult Patients with Type 2 Diabetes. . 2020; 189 - 197. 10.25179/tjem.2020-73401
Vancouver Demirci I,haymana c,Sonmez A,bolu a,gülsoy kirnap n,DEMİR O,Meric C,GÜVEN OYSUL F,Aydogdu A,Ersöz Gulcelik N,Azal O The Screening of Comorbid Depressive Disorders and Associated Risk Factors in Adult Patients with Type 2 Diabetes. . 2020; 189 - 197. 10.25179/tjem.2020-73401
IEEE Demirci I,haymana c,Sonmez A,bolu a,gülsoy kirnap n,DEMİR O,Meric C,GÜVEN OYSUL F,Aydogdu A,Ersöz Gulcelik N,Azal O "The Screening of Comorbid Depressive Disorders and Associated Risk Factors in Adult Patients with Type 2 Diabetes." , ss.189 - 197, 2020. 10.25179/tjem.2020-73401
ISNAD Demirci, Ibrahim vd. "The Screening of Comorbid Depressive Disorders and Associated Risk Factors in Adult Patients with Type 2 Diabetes". (2020), 189-197. https://doi.org/10.25179/tjem.2020-73401
APA Demirci I, haymana c, Sonmez A, bolu a, gülsoy kirnap n, DEMİR O, Meric C, GÜVEN OYSUL F, Aydogdu A, Ersöz Gulcelik N, Azal O (2020). The Screening of Comorbid Depressive Disorders and Associated Risk Factors in Adult Patients with Type 2 Diabetes. Turkish Journal of Endocrinology and Metabolism, 24(3), 189 - 197. 10.25179/tjem.2020-73401
Chicago Demirci Ibrahim,haymana cem,Sonmez Alper,bolu abdullah,gülsoy kirnap nazli,DEMİR ORHAN,Meric Coskun,GÜVEN OYSUL Fahrettin,Aydogdu Aydogan,Ersöz Gulcelik Nese,Azal Omer The Screening of Comorbid Depressive Disorders and Associated Risk Factors in Adult Patients with Type 2 Diabetes. Turkish Journal of Endocrinology and Metabolism 24, no.3 (2020): 189 - 197. 10.25179/tjem.2020-73401
MLA Demirci Ibrahim,haymana cem,Sonmez Alper,bolu abdullah,gülsoy kirnap nazli,DEMİR ORHAN,Meric Coskun,GÜVEN OYSUL Fahrettin,Aydogdu Aydogan,Ersöz Gulcelik Nese,Azal Omer The Screening of Comorbid Depressive Disorders and Associated Risk Factors in Adult Patients with Type 2 Diabetes. Turkish Journal of Endocrinology and Metabolism, vol.24, no.3, 2020, ss.189 - 197. 10.25179/tjem.2020-73401
AMA Demirci I,haymana c,Sonmez A,bolu a,gülsoy kirnap n,DEMİR O,Meric C,GÜVEN OYSUL F,Aydogdu A,Ersöz Gulcelik N,Azal O The Screening of Comorbid Depressive Disorders and Associated Risk Factors in Adult Patients with Type 2 Diabetes. Turkish Journal of Endocrinology and Metabolism. 2020; 24(3): 189 - 197. 10.25179/tjem.2020-73401
Vancouver Demirci I,haymana c,Sonmez A,bolu a,gülsoy kirnap n,DEMİR O,Meric C,GÜVEN OYSUL F,Aydogdu A,Ersöz Gulcelik N,Azal O The Screening of Comorbid Depressive Disorders and Associated Risk Factors in Adult Patients with Type 2 Diabetes. Turkish Journal of Endocrinology and Metabolism. 2020; 24(3): 189 - 197. 10.25179/tjem.2020-73401
IEEE Demirci I,haymana c,Sonmez A,bolu a,gülsoy kirnap n,DEMİR O,Meric C,GÜVEN OYSUL F,Aydogdu A,Ersöz Gulcelik N,Azal O "The Screening of Comorbid Depressive Disorders and Associated Risk Factors in Adult Patients with Type 2 Diabetes." Turkish Journal of Endocrinology and Metabolism, 24, ss.189 - 197, 2020. 10.25179/tjem.2020-73401
ISNAD Demirci, Ibrahim vd. "The Screening of Comorbid Depressive Disorders and Associated Risk Factors in Adult Patients with Type 2 Diabetes". Turkish Journal of Endocrinology and Metabolism 24/3 (2020), 189-197. https://doi.org/10.25179/tjem.2020-73401