Prevalence and factors associated with depression among type 2 diabetic patients in a tertiary care centre in Cameroon

CaHReF 20116, Yaoundé Conges hall, 23 – 26 August 2016 , PL098

Depression, a condition commonly associated with chronic illnesses is the most common psychiatric disorder in diabetic patients. It has been shown to significantly impact both management and disease outcome. Unfortunately most Cameroonians do not seek help for mental distress.

To investigate the prevalence and determinants of depression in type 2 diabetic patients and determining the influence of depression on medication adherence and attainment of treatment targets.
This was a cross sectional study involving 177 type 2 diabetic patients in the outpatient diabetic unit of the Douala General Hospital. Data were collected using a semi-structured questionnaire. Depression and adherence to treatment were assessed using the 9-Item-Patient Health Questionnaire (PHQ-9) and 8-Item Morisky medication adherence scale respectively. Data were analysed using Epi-info version 7 and Statistical significance set at p < 0.05. Logistic regression analysis was done to identify independent associations.

We included 177 type 2 diabetic patients. Of these about a third of them were depressed; 29.4% (95% CI: 22.8 – 36.7). In bivariate analysis determinants of depression identified were; age > 48 years (OR: 0.29, 95% CI: 0.08 – 1.00; P=0.040), physical inactivity (OR: 0.48, 95% CI: 0.29 – 0.98; P=0.043), major life event, pill burden [≥5 medication types and ≥7 tablets/day], nephropathy (OR: 2.41, 95% CI: 1.15 – 5.10; P=0.019) and neuropathy. In multivariate analysis neuropathy (OR: 3.25, 95% CI: 1.47 – 7.19; P=0.004) and major life event (OR: 8.38, 95% CI: 2.79 – 25.15; P<0.001) were independently associated with depression. Depression was independently associated with non adherence to medication (OR: 0.17, 95% CI: 0.07 – 0.40; P<0.001). Depression was associated with HbA1c > 7% (OR: 0.40, 95% CI: 0.20 – 0.81; P=0.010) but was not associated with FBS > 120 or < 80mg/dl, B.P > 130/80mmHg, TG > 150mg/dl, LDLc > 100mg/dl nor HDLc < 50mg/dl.

Depression is common among Cameroonian type 2 diabetic patients with major life event and neuropathy identified as independent risk factors. Depression is independently associated with non adherence to medication and associated with poor glycaemic control. Large scale studies are required to substantiate these findings

Depression, diabetes, prevalence, determinants, adherence, disease outcome