Objective: To explore specific psychiatric comorbidity among type II DM patients with poor and good glycemic control.
Method: One hundred four patients with type II DM attending outpatient department of the Endocrinology Unit of Süleyman Demirel University Medical Faculty were included in this study. Patients were divided into two groups according to HbA1c level: >7% defined group 1 with poor glycemic control (n=40), and <7% defined group 2 with good glycemic control (n=64). All patients were assessed using a semi structured sociodemographic data form, the Structured Clinical Interview for DSM-IV-Clinical Version (SCID-I/CV), Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS) and the Minimental State Examination Scale.
Results: The prevalence rate of psychiatric disorders were as follows: major depressive disorder 67.5%, dysthymic disorder 10.0%, generalized anxiety disorder 7.5%, obsessive compulsive disorder 5%, social phobia 2.5% and nicotine dependence 5% in group 1 patients; and major depressive disorder 43.8%, dysthymic disorder 10.9%, paranoid disorder 3.1%, obsessive compulsive disorder 6.3%, social phobia 4.7%, generalized anxiety disorder 6.3%, nicotine dependence 9.4% and alcohol dependence 3.1% in group 2 patients. Major depressive disorder frequency was significantly higher in group1 patients than group 2 patients. HDRS and HARS scores were significantly higher in group 1 patients than in group 2 patients. Significant positive correlations were found between HDRS, HARS scores, number of depressive episodes and the level of HbA1c in the diabetic patients.
Conclusion: Major depressive disorder was more frequent in diabetic patients with poor glycemic control than in those with good glycemic control. There was a strong association between level of HbA1c and depression and anxiety symptom level.