Factors associated with anxiety in type 2 diabetes mellitus patients in Pakistan

Anxiety and associated factors among medical and surgical patients in Ethiopia: A systematic review and meta-analysis

BACKGROUND

Individuals diagnosed with chronic medical conditions and patients appointed to undergo surgery face various degrees of anxiety as a result of doubts related to the outcome of surgery, and the psycho-socioeconomic costs of the medical illness. This can affect the treatment process and even the outcome of patients with medical and surgical cases. Though different studies were conducted on anxiety and associated factors among medical and surgical patients in Ethiopia, the findings were found to be inconsistent and had a wide discrepancy. So, this systematic review and meta-analysis estimated the pooled effect size of anxiety among this population and guides to plan appropriate intervention at a national level.

METHODS

Studies conducted on anxiety and associated factors among medical and surgical patients in Ethiopia were included. Data was extracted using Microsoft Excel and analyzed using STATA version 11. The random-effects model was used to estimate the pooled effect size of anxiety and its determinants with 95% confidence intervals. Funnel plots and Egger's regression tests were employed to check publication bias. Sub-group and sensitivity analyses were also conducted.

RESULTS

The pooled prevalence of anxiety among medical and surgical patients in Ethiopia was found to be 48.82% with a 95% CI (42.66, 54.99). Being female[OR = 2.84(2.02, 4.01)], fear of death [OR = 2.93(1.57, 5.50)], and history of surgery[OR = 0.42(0.27, 0.065)], among surgical patients and being female[OR = 2.35(1.94, 2.850], having poor social support[OR = 2.22(1.62, 3.05)], perceived stigma[OR = 4.25(1.97, 9.18)] and family history of mental illness[OR = 1.86(1.21, 2.86)] among medical patients were significantly associated with anxiety in this systematic review and meta-analysis.

CONCLUSION AND RECOMMENDATION

The pooled prevalence of anxiety among medical and surgical patients in Ethiopia was found to be high. Therefore, it would be good for professionals to screen patients for anxiety besides managing their medical or surgical cases to detect them early and address them.

Systematic review and meta-analysis on the prevalence and associated factors of depression among hypertensive patients in Ethiopia

BACKGROUND

Identifying individuals at increased risk for depression allows for earlier intervention and treatment, ultimately leading to better outcomes and potentially preventing severe symptoms. However, to date, no systematic reviews or meta-analyses have estimated the prevalence of depression among hypertensive patients. Thus, this review was initiated to determine the prevalence and factors associated with depression among patients with hypertension in Ethiopia.

METHODS

Multiple databases, such as PubMed, African Journals Online, the Cochrane Library, and Google Scholar, were used to ensure wider coverage of relevant studies. The data extracted from Microsoft Excel were imported into STATA version 11 (Stata Corp LLC, TX, USA) for further analysis. The pooled prevalence of depression was estimated using a random effects model. To evaluate statistical heterogeneity, the Cochrane Q test and I2 statistic were used.

RESULTS

The random effect model indicated that the pooled prevalence of depression in 12 studies conducted in Ethiopia was 32.43% (95% CI: 25.18, 39.67%). Being female (POR = 2.41; 95% CI: 1.89, 3.07, I2 = 17.7%, P = 0.302), having comorbid illnesses (POR = 3.80; 95% CI: 2.09, 6.90, I2 = 81%, P = 0.005), having poor blood pressure control (POR = 3.58; 95% CI: 2.51, 5.12, I2 = 0.0%, P = 0.716), having a family history of depression (POR = 3.43; 95% CI: 1.98, 5.96, I2 = 62.6%, P = 0.069), being single (POR = 2.30; 95% CI: 1.35, 3.99, I2 = 48.0%, P = 0.146) and having poor social support (POR = 4.24; 95% CI: 1.29, 13.98, I2 = 95.8%, P<0.001) were positively associated with depression among hypertensive patients.

CONCLUSION

Overall, the results of our review showed that depression affects a significant number of Ethiopians who have hypertension. Being female, being single, having comorbidities, having poor blood pressure control, having a family history of depression, and having poor social support were factors associated with depression among patients with hypertension. For those who are depressed, improving the psycho-behavioral treatment linkage with the psychiatric unit can result in improved clinical outcomes.

TRIAL REGISTRATION

Prospero Registration number: CRD42024498447. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024498447.

Depression and anxiety in patients with diabetes in a Moroccan region

AIMS

To estimate prevalence of anxiety and depression in patients with diabetes mellitus and identify their determinants.

METHODS

A cross-sectional study was conducted at Hassan II University-Hospital of Fes in 2019-2020. Anxiety and depression were measured by using the Hospital Anxiety and Depression Scale (HADS). Multivariate analysis by logistic regression was used to determine factors associated with depression and anxiety, adjusting for confounding factors. All statistical analyses were conducted using EPIINFO7.

RESULTS

A total of 243 diabetics were included in the study. The average age of the participants was 48.07±14.25 years, 58% were females and 72% were diagnosed with diabetes type II. The prevalence of depressive symptoms and anxiety symptoms was (18, 1%, CI_95%=(13-23)) and (29.6%, CI_95%=(24-35)), respectively. The prevalence of depression and anxiety was higher among women than man and increases with increasing duration of the disease. In multivariate analysis, illiterates (OR=3.19, CI_95%=(1.46-6.98)), those with depression (OR=3.61, CI_95%=(1.78-7.32)), and type 1 diabetics (OR=3.22, CI_95%=(1.44-7.21)) are a higher risk of developing anxiety. Depression was associated with older age (OR=2, 65, CI_95%=(1, 14-6, 14)), use of insulin (OR=3.77 CI_95%=(1.50-9.44)) and anxiety symptoms (OR=4, 27, CI_95%=(2, 05-8, 91)).

CONCLUSION

High prevalence of depressive and anxiety symptoms in diabetics suggests consideration of psychological aspect in implementation of diabetes managing program.

Factors for Social Stressors Among Type 2 Diabetics Versus Non-Diabetics Using the Hamilton Depression Rating Scale

Objective This study aimed to evaluate different factors of social stressors among people with type II diabetes versus non-diabetics by using the Hamilton Depression Rating Scale (HAM-D). Methodology This case-control study was done for one year at Ziauddin University Hospital, Karachi, Pakistan. Diagnosed patients with type II diabetes between 25 and 60 years were included as cases and age-related healthy individuals as controls. Participants on any psychotropic medications, neurodegenerative disorders, or on chemotherapy were excluded. Hamilton Rating Scale for Depression (HRDS-17) was used for recording depressive symptoms. The Statistical Package for the Social Sciences (SPSS) version 26.0 (IBM Corp., Armonk, NY) was used for data analysis. The frequency was calculated for descriptive statistics and depression scores (HRDS-17). A significance level of 0.05 was considered. Results A total of 272 patients were divided into two groups, with 136 patients in the group with diabetes and 136 participants in the control group. The mean age among people with diabetes was 55.13±9.10 years and among non-diabetics was 43.25±12.97 years (p<0.001). The mean duration of illness in people with diabetes was 8.51±7.57 years and in non-diabetics, it was 6.73±4.42 years (p=0.018). The mean social rating in people with diabetes was 164.0±155.60 and in non-diabetics, it was 124.75±99.02 (p=0.014). Insomnia, both in the early and middle part of the night affecting work activities, hypochondriasis, and loss of weight, was significantly present among diabetics as compared to controls (p<0.05). Conclusion Most diabetics reported a significant effect on the quality of life based on social rating and health-care expenditure. They experienced depressive symptoms more frequently than non-diabetics. Insomnia in the middle of the night affected work and activities; hypochondriasis and weight loss were found to be substantially higher among patients with diabetes than in controls.

Factors Associated with Anxiety and Depression among Diabetes, Hypertension, and Heart Failure Patients at Dessie Referral Hospital, Northeast Ethiopia

Background

Anxiety and depression are common in patients with diabetes, hypertension, and heart failure. However, they are usually unrecognized and untreated especially in developing countries. Identifying factors associated with anxiety and depression is helpful for early screening and management.

Objective

This study is aimed at assessing factors associated with anxiety and depression among diabetes, hypertension, and heart failure patients at Dessie Referral Hospital, Northeast Ethiopia.

Methods

An institutional-based cross-sectional study was conducted in Dessie Referral Hospital from February 22, 2019 to April 6, 2019. A total of 404 diabetic, hypertension, and heart failure patients were included through systematic sampling technique. The data were collected by face-to-face interview. After data collection, the data were cleaned and presented with text, graphs, and tables. Multivariable binary logistic regression was deployed to identify factors at a P value of < 0.05.

Result

A total of 384 patients participated with a 94.8% response rate. Among these, 32% and 5.73% of them had anxiety and depression, respectively. Patients who did not read and write develop anxiety 7.89 times more likely compared with those whose educational status is diploma and above (AOR: 7.89; 95% CI: 3.08-20.26; P = 0.001). Patients who took substances like chat, cigarette, shisha, hashish, and alcohol develop anxiety 2.56 times more likely compared with their counterparts (AOR: 2.56; 95% CI: 1.05–6.23; P = 0.038). Patients whose level of physical activity is inactive develop depression 24 times more likely than patients who did a health-enhancing physical activity. Patients who are widowed develop depression 5 times more likely compared with married patients. Conclusion and Recommendations. Low educational level, being single and widowed, substance use, poor perception towards prognosis of illness, and monthly income were factors associated with anxiety. On the other hand, being single and unable to do physical activity were statistically associated with depression. Patients with low educational level and monthly income should be screened and supported for anxiety. Health care providers should provide advice to patients about the importance of physical activity to prevent depression.