Depression and Its Biochemical, Immuno-hematological, and Behavioral Predictors among Adult Type 2 Diabetic Patients in Sheik Hassan Yabare Comprehensive Specialized Hospital, Jigjiga, Ethiopia, 2022

Abstract

Introduction: Globally, there exist alarming rise of type 2 diabetes mellitus (T2DM) prevalence, with the highest rate of increment observed in developing countries including Ethiopia. The disease has multi-dimensional burden ranging from physical and mental to socio-economical consequence. While most of these burden had due consideration, the mental health impact of the disease such as depression is often unnoticed, undiagnosed or untreated. More importantly, depression is known to have higher likelihood of occurrence in patients with T2DM. Hence, measuring the prevalence of depression and its socio economic, behavioral, biochemical such as HgbA1c, and immune hematological such as Systemic Immune-inflammation Index (SII) predictors remained critical undertaking. Objective: The aim of the present study was to determine the prevalence of depression and its biochemical, immuno-hematological, socio-economic, and behavioral predictors among adult type 2 diabetic patients at SHY- Comprehensive Specialized Hospital, Jigjiga, Ethiopia, 2022. Methods: A hospital-based cross-sectional study was conducted using systematic random sampling method. Patient Health Questionnaire (PHQ9) was used to assess depression. Glycemic control was measured using glycated hemoglobin (HgA1c). Then complete blood count was done to calculate SII. The data was entered to Epidata version 4.6 for data entry and then exported to SPSS-Version 26 for analysis. Multiple logistic regressions with backward elimination method was performed. A p-value of < 0.05 with 95% CI was taken as statistically significant. Results: A total of 263 participants were included with 94.6% response rate. More than half 134 (51%) of the respondents were males. The overall prevalence of depression was 47.1% (95% CI= 41.1, 53.2). Majority 66 (25.1%) had mild depression, followed by 44 (16.7%) moderate, 9 (3.4%) moderately severe, and 5 (1.9%) severe depression. A multivariable logistic regression analysis indicated that poor glycemic control (AOR= 1.93; 95% CI= 1.05, 3.53), high SII (AOR= 2.76; 95% CI= 1.55, 4.91), DM complication (AOR= 2.02; 95% CI= 1.09, 3.74), current Khat chewers (AOR= 2.83; 95% CI= 1.41, 5.68), ex-Khat chewers (AOR= 4.12; 95% CI= 1.88, 9.12), female sex (AOR= 2.68; 95% CI= 1.50, 4.80) and DM duration of 5-10 years since diagnosis (AOR= 2.29; 95% CI= 1.21, 4.34), were identified independent predictors of depression. Conclusion: There was high prevalence of depression among T2DM patients on follow up at SHY CSH. As well, glycemic control, SII, complication, Khat chewing, female sex, and DM duration were identified as predictors of depression. Therefore, the concerned stakeholders should work towards blood sugar control, control of systemic inflammation and promotion of healthy behavior particularly among female and those who were ill for longer period.