Context: Type 2 diabetes mellitus doubles the odds of suffering from depressive illness. Objectives: The
present prospective randomized controlled study aimed to estimate the prevalence of anxiety and depressive
disorders among a consecutive group of patients with type 2 non obese diabetes and assess its impact on glycemic
control. Subjects and Methods: We selected 200 consecutive adult patients with type 2 non obese diabetes
mellitus. Patients were divided into 2 groups according to HbA1c level: >7% defined group1 with poor glycemic
control (n=140) and ≤7% defined group2 with good glycemic control (n=60). All patients were assessed using semi
structured Sociodemographic data form, Hospital Anxiety Depression Scale, The Mini Mental State Examination
and Mini international Neuropsychiatric Interview (MINI). Results: Anxiety and depressive scores (HAD) were
significantly higher in group 1 patients than in group 2 .The prevalence rate of psychiatric disorders were as follow:
major depressive disorders 30.7%, dysthymic disorders 15.7% generalized anxiety disorder 10.7%, panic disorder
with or without agoraphobia 10%, social anxiety disorder10%, obsessive compulsive disorder 5.7%, post traumatic
stress disorder 5(3.6%) in group1 patients and major depressive disorder 18.3%, dysthymic disorder 11.7%,
generalized anxiety disorder 8.3%,panic disorder with or without agoraphobia 6.7% social anxiety disorder 6.7%,
obsessive compulsive disorder 5%, post traumatic stress disorder 3.3% in group2 patients .Correlation coefficient
were computed among hospital anxiety depressive scores (HAD) and HbA1c level, where significant positive
correlation was found between these scores and HbA1c level in the diabetic patients indicating the negative impact
of depressive and anxiety disorders on glycemic control among diabetics. Conclusion: Anxiety and depressive
disorders were significantly more frequent in patients with poor glycemic control (more than one third) than in those
with good glycemic control. There was a strong association between HbA1c and depressive and anxiety symptoms.
The presence of depressive symptoms was associated with a significant worsening of glycemic control. |
