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Chaturvedi SK, Manche Gowda S, Ahmed HU, Alosaimi FD, Andreone N, Bobrov A, Bulgari V, Carrà G, Castelnuovo G, de Girolamo G, Gondek T, Jovanovic N, Kamala T, Kiejna A, Lalic N, Lecic-Tosevski D, Minhas F, Mutiso V, Ndetei D, Rabbani G, Somruk S, Srikanta S, Taj R, Valentini U, Vukovic O, Wölwer W, Cimino L, Nouwen A, Lloyd C, Sartorius N. More anxious than depressed: prevalence and correlates in a 15-nation study of anxiety disorders in people with type 2 diabetes mellitus. Gen Psychiatr 2019; 32:e100076. [PMID: 31552386 PMCID: PMC6738670 DOI: 10.1136/gpsych-2019-100076] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 07/11/2019] [Accepted: 07/14/2019] [Indexed: 01/02/2023] Open
Abstract
Background Anxiety disorder, one of the highly disabling, prevalent and common mental disorders, is known to be more prevalent in persons with type 2 diabetes mellitus (T2DM) than the general population, and the comorbid presence of anxiety disorders is known to have an impact on the diabetes outcome and the quality of life. However, the information on the type of anxiety disorder and its prevalence in persons with T2DM is limited. Aims To assess the prevalence and correlates of anxiety disorder in people with type 2 diabetes in different countries. Methods People aged 18–65 years with diabetes and treated in outpatient settings were recruited in 15 countries and underwent a psychiatric interview with the Mini-International Neuropsychiatric Interview. Demographic and medical record data were collected. Results A total of 3170 people with type 2 diabetes (56.2% women; with mean (SD) duration of diabetes 10.01 (7.0) years) participated. The overall prevalence of anxiety disorders in type 2 diabetic persons was 18%; however, 2.8% of the study population had more than one type of anxiety disorder. The most prevalent anxiety disorders were generalised anxiety disorder (8.1%) and panic disorder (5.1%). Female gender, presence of diabetic complications, longer duration of diabetes and poorer glycaemic control (HbA1c levels) were significantly associated with comorbid anxiety disorder. A higher prevalence of anxiety disorders was observed in Ukraine, Saudi Arabia and Argentina with a lower prevalence in Bangladesh and India. Conclusions Our international study shows that people with type 2 diabetes have a high prevalence of anxiety disorders, especially women, those with diabetic complications, those with a longer duration of diabetes and poorer glycaemic control. Early identification and appropriate timely care of psychiatric problems of people with type 2 diabetes is warranted.
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Affiliation(s)
- Santosh K Chaturvedi
- Department of Psychiatry, National Institute of Mental Health and Neuro-Sciences, Bangalore, India
| | - Shayanth Manche Gowda
- Department of Psychiatry, National Institute of Mental Health and Neuro-Sciences, Bangalore, India
| | - Helal Uddin Ahmed
- Child Adolescent and Family Psychiatry, National Institute of Mental Health, Dhaka, Bangladesh
| | - Fahad D Alosaimi
- Department of Psychiatry, King Saud University, Riyadh, Saudi Arabia
| | | | - Alexey Bobrov
- National Research Centre for Psychiatry and Narcology, Moscow, Russia
| | - Viola Bulgari
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | | | | | - Tomasz Gondek
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | | | - Thummala Kamala
- Samatvam Endocrinology Diabetes Center and Jnana Sanjeevini Diabetes Hospital and Medical Center, Bangalore, India
| | | | | | | | - Fareed Minhas
- Center for Global Mental Health, Rawalpindi, Pakistan
| | | | | | - Golam Rabbani
- Child Adolescent and Family Psychiatry, National Institute of Mental Health, Dhaka, Bangladesh
| | | | - Sathyanarayana Srikanta
- Samatvam Endocrinology Diabetes Center and Jnana Sanjeevini Diabetes Hospital and Medical Center, Bangalore, India
| | - Rizwan Taj
- Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | - Umberto Valentini
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | - Wolfgang Wölwer
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Düsseldorf, Dusseldorf, Germany
| | | | - Arie Nouwen
- Department of Psychiatry, National Institute of Mental Health and Neuro-Sciences, Bangalore, India.,Child Adolescent and Family Psychiatry, National Institute of Mental Health, Dhaka, Bangladesh.,Department of Psychiatry, King Saud University, Riyadh, Saudi Arabia.,IRCCS Ospedale Sacro Cuore Don Calabria, Negrar, Italy.,National Research Centre for Psychiatry and Narcology, Moscow, Russia.,IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,University of Milano-Bicocca, Bicocca, Italy.,Department of Psychology, Catholic University, Milan, Italy.,Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland.,Institute of Mental Health, Belgrade, Serbia.,Samatvam Endocrinology Diabetes Center and Jnana Sanjeevini Diabetes Hospital and Medical Center, Bangalore, India.,University of Lower Silesia, Wroclaw, Poland.,Center for Global Mental Health, Rawalpindi, Pakistan.,University of Nairobi, Nairobi, Kenya.,Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Pakistan Institute of Medical Sciences, Islamabad, Pakistan.,Department of Psychiatry and Psychotherapy, Medical Faculty, University of Düsseldorf, Dusseldorf, Germany.,ProConsult, Owings Mills, Maryland, USA
| | - Cathy Lloyd
- Department of Psychiatry, National Institute of Mental Health and Neuro-Sciences, Bangalore, India.,Child Adolescent and Family Psychiatry, National Institute of Mental Health, Dhaka, Bangladesh.,Department of Psychiatry, King Saud University, Riyadh, Saudi Arabia.,IRCCS Ospedale Sacro Cuore Don Calabria, Negrar, Italy.,National Research Centre for Psychiatry and Narcology, Moscow, Russia.,IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,University of Milano-Bicocca, Bicocca, Italy.,Department of Psychology, Catholic University, Milan, Italy.,Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland.,Institute of Mental Health, Belgrade, Serbia.,Samatvam Endocrinology Diabetes Center and Jnana Sanjeevini Diabetes Hospital and Medical Center, Bangalore, India.,University of Lower Silesia, Wroclaw, Poland.,Center for Global Mental Health, Rawalpindi, Pakistan.,University of Nairobi, Nairobi, Kenya.,Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Pakistan Institute of Medical Sciences, Islamabad, Pakistan.,Department of Psychiatry and Psychotherapy, Medical Faculty, University of Düsseldorf, Dusseldorf, Germany.,ProConsult, Owings Mills, Maryland, USA
| | - Norman Sartorius
- Department of Psychiatry, National Institute of Mental Health and Neuro-Sciences, Bangalore, India.,Child Adolescent and Family Psychiatry, National Institute of Mental Health, Dhaka, Bangladesh.,Department of Psychiatry, King Saud University, Riyadh, Saudi Arabia.,IRCCS Ospedale Sacro Cuore Don Calabria, Negrar, Italy.,National Research Centre for Psychiatry and Narcology, Moscow, Russia.,IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,University of Milano-Bicocca, Bicocca, Italy.,Department of Psychology, Catholic University, Milan, Italy.,Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland.,Institute of Mental Health, Belgrade, Serbia.,Samatvam Endocrinology Diabetes Center and Jnana Sanjeevini Diabetes Hospital and Medical Center, Bangalore, India.,University of Lower Silesia, Wroclaw, Poland.,Center for Global Mental Health, Rawalpindi, Pakistan.,University of Nairobi, Nairobi, Kenya.,Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Pakistan Institute of Medical Sciences, Islamabad, Pakistan.,Department of Psychiatry and Psychotherapy, Medical Faculty, University of Düsseldorf, Dusseldorf, Germany.,ProConsult, Owings Mills, Maryland, USA
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