Distress and depression among patients with diabetes mellitus: prevalence and associated factors: a cross‐sectional study
Diabetes is a multifactorial disease and has great impact on the patients’ psychological well–being. Diabetes Distress negatively impacts a patient’s self-care behaviour and therefore knowledge about the prevalence of DD and associated factors is prudent. There are several psychological scales for assessment of distress like PAID scale, DDS17, Kessler psychological distress scale, Social avoidance and distress scale. Selecting the best and specific scale plays an important role to make the statistics closer to the real prevalence and severity of DD. Mahtab Niroomand and colleagues carried out study titled “Distress and depression among patients with diabetes mellitus: prevalence and associated factors: a cross‐sectional study” published in Journal of Diabetes & Metabolic Disorders.
Objective:
To validate the internal consistency of the Persian version of the DDS-17 questionnaire and to investigate the prevalence of DD and depression and possible relevant factors in the Iranian population.
Methods:
A cross-sectional study on 820 diabetes patients in Tehran, Iran between January and June 2017. Patients filled out a demographic and health survey, DDS-17, BDI-II and SDSCA. DDS-17 consist of emotional burden, and physician, regimen, and interpersonal related distress. The correlation between DDS subscales and association between DDS and BDI-II or SDSCA scores were assessed using SPSS.
Findings:
The Persian version of DDS-17 is a useful tool in assessing DD among Iranian patient with diabetes is indicated by excellent internal consistency and each subscale had excellent correlation with total DDS.
HbA1c level was the most useful predictor of DDS score. DDS severity had significant relationship with socioeconomic level, type of DM, type of treatment, glycemic control status, diabetic complication, depression level, and range of age and BMI.
In addition, the occurrence of diabetic complications, increasing patients’ age, and increasing BMI can increase DD because of an increase in morbidity and additional limitations in the patients’ personal life.
DD has significant association with age, BMI, BP, duration of the DM, interval of clinical examinations and laboratory results.
Patients with high DD had higher levels of HbA1c and LDL, and DD was more frequent among females, those with low income, and those with a history of retinopathy or neuropathy.
In the present study, majority of diabetes patients had high DD based on the DDS-17.
Limitations:
It is a cross-sectional study and thus cannot determine the cause and effect of the relationship between DD and its associated factors. The results may not be applicable to the general diabetes population. Incomplete data due to the large number of missing and biased answers on the questionnaires. The involvement of family members and patient’s adherence to treatment plans was not evaluated in this study.
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