Elsevier

Comprehensive Psychiatry

Volume 53, Issue 8, November 2012, Pages 1169-1173
Comprehensive Psychiatry

Prevalence of psychiatric disorders in patients with diabetes types 1 and 2

https://doi.org/10.1016/j.comppsych.2012.03.011Get rights and content

Abstract

Background

Diabetes mellitus, classified into types 1 and 2, is a chronic disease that shows high comorbidity with psychiatric disorders. Insulin-dependent patients show a higher prevalence of psychiatric disorders than do patients with type 2 diabetes.

Methods

This research involved the participation of 200 subjects divided into 2 groups: 100 patients with diabetes type 1 and 100 patients with diabetes type 2. This study used the Mini International Neuropsychiatric Interview for the identification of psychiatric disorders.

Results

Of the 200 participants, 85 (42.5%) were found to have at least 1 psychiatric disorder. The most prevalent disorders were generalized anxiety disorder (21%), dysthymia (15%), social phobia (7%), current depression (5.5%), lifelong depression (3.5%), panic disorder (2.5%), and risk of suicide (2%). Other disorders with lower prevalence were also identified. The groups showed a statistically significant difference in the presence of dysthymia, current depression, and panic disorder, which were more prevalent in patients with diabetes type 1.

Conclusion

The high prevalence of psychiatric disorders in diabetic patients points to the need for greater investment in appropriate diagnostic evaluation of patients that considers mental issues. The difference identified between the groups shows that preventive measures and therapeutic projects should consider the specific demands of each type of diabetes.

Introduction

Diabetes mellitus is a chronic disease that may begin in childhood (type 1) or can appear in adulthood (type 2). Individuals with chronic diseases have twice the likelihood of having mood and anxiety disorders compared with healthy people [1], [2]. The prevalence of psychiatric disorders in diabetic patients may reach 84% for mood disorders and 80% for anxiety [2] disorders. The direct relationship between these disorders is truth [3]. One study found that, among the patients evaluated, the 55% of patients who used psychotropic drugs had better-controlled hypoglycemia [4].

Research on 3675 patients with various chronic diseases identified incidences of major depression (odds ratio [OR], 23.45), secondary bipolar disorder (OR, 15.54), and dysthymia (OR, 15.12) [5]. Among hospitalized diabetic patients, the incidence of depression varied from 9% to 16%, and the relation to pain was significant [5]. In 160 participants, 36% of whom met the diagnostic features of major depression and 33% reported chronic pain [6].

Studies of diabetes type 2 have shown that high glucose may contribute to anxiety and depression [7]. Comparative research on mental health among diabetic subjects (n = 42) and nondiabetic subjects (n = 42) from 17 countries found an OR of 1.38 for depression and dysthymia (95% confidence interval, 1.15-1.16) and an OR of 1.20 for generalized anxiety disorders (GADs), panic/agoraphobia, and posttraumatic stress disorder (95% CI, 1.01-1.42).

Diabetes is a chronic disease with comorbid mood disorders and anxiety [8]. A meta-analysis of studies conducted for 10 years on chronic depressive disorders concluded that dysthymia has a prevalence between 3% and 6% compared with cyclothymia and may result from social and economic conditions. These conditions are present in chronic diseases that may cause pain, such as arthritis and diabetes mellitus [9].

This study aims to investigate the prevalence of psychiatric disorders in diabetic patients, comparing groups of patients with diabetes types 1 and 2.

Section snippets

Methodology

The sample of this cross-sectional observational study consisted of outpatients from a public health clinic with diagnoses of diabetes mellitus who were under the medical supervision of an endocrinologist. The sample are composed of male and female participants, and the data collected were age, marital status, religion, occupation, education, use of psychotropic, and if they had children.

Participants included 200 patients who were divided into 2 groups of the same size. The first group was

Results

Descriptive data from participants diagnosed as having diabetes types 1 and 2, including sex, age, education, occupation, religion, children, and the use of psychotropic drugs, are shown in Table 1. The groups are similar, and no statistically significant differences were found between the groups for these variables.

Table 2 shows the total number of patients with diabetes who presented each of the psychiatric disorders identified in the sample, with percentages in decreasing order. Of the 200

Discussion

The 2 groups of patients with diabetes types 1 and 2 were similar in age, sex, religion, education, marital status, occupation, number of children, and even the use of psychotropic drugs. No statistically significant difference was found in any of the comparisons between groups for the same variables.

Of the 200 participants who answered the MINI, 85 (42.5%) had a psychiatric disorder. The most prevalent disorder was GAD (21%), followed by dysthymia (15%), social phobia (7%), current depression

Conclusion

In addition to the signs and symptoms of anxiety and depression, most patients with diabetes mellitus present with psychiatric disorders. Both the physiological changes in the chronic course of the disease—weight gain, pain, hypertension, heart disease, loss of motor skills, or blindness—directly affect the emotional state. Similarly, the reactions and symptoms of psychiatric disorders can interfere with the glucose rates of diabetic patients.

The most prevalent psychiatric disorders among

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