CC BY-NC-ND 4.0 · Journal of Social Health and Diabetes 2015; 03(02): 095-101
DOI: 10.4103/2321-0656.152806
Original Article
NovoNordisk Education Foundation

Psychological health of caregivers of individuals with type 2 diabetes mellitus: A cross-sectional comparative study

Pankaj Jorwal
Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
,
Rohit Verma
1   Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
,
Yatan Pal Singh Balhara
2   Department of Psychiatry, National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
› Author Affiliations
Further Information

Publication History

Publication Date:
22 November 2018 (online)

Abstract

Introduction: The quality-of-life in individuals with diabetes is also dependent upon the quality of family relationships and general well-being of caregivers because the patient depends on them to uphold in the community. Only limited studies have assessed the psychological health of caregivers to individuals with diabetes. Aims and Objective: The current study aims at comparison of depression and anxiety levels among patients with diabetes and their caregivers. Materials and Methods: Fifty consecutive patients-care giver dyads of subjects having type 2 diabetes were recruited at an out-patient clinic of medicine at a tertiary care center. The dyads were assessed using a semi-structured proforma for the socio-demographic details and for anxiety and depression levels using the Hospital Anxiety and Depression Scale (HADS). The data were analyzed using SPSS version 17.0. Correlation analysis was performed for multiple variables including blood glucose profile. Results: The mean duration of illness (4.93 ΁ 3.53 years) and blood glucose parameters were not found to be associated to depressive or anxiety symptoms. Depressive and anxiety disorder was observed in 24% and 44% of patients and 10% and 18% of caregivers, respectively. Patients had significantly more HADS anxiety (HADS-A) scale scores than caregivers but not for HADS depression (HADS-D) scale. Female patients were found to be having more HADS-D scores than male patients (P = 0.02), but were not significantly different from caregivers. HADS-A scores were comparable among male and female gender in intragroup as well as intergroup comparison for patient and caregiver groups. Conclusion: Diabetes mellitus affects the psychological health of not only the patients but as well as the family caregivers and patients tend to be more anxious than the caregivers. Furthermore, it was seen that women with diabetes had higher rates of depression than their male counterparts.

 
  • References

  • 1 World Health Organization. The Global Burden of Disease: 2004 Update. Geneva, Switzerland: World Health Organization; 2008
  • 2 Gupta R, Misra A. Type 2 diabetes in India: Regional disparities. Br J Diab Vasc Dis 2007; 7: 12-16
  • 3 Kruse J, Schmitz N, Thefeld W. German National Health Interview and Examination Survey. On the association between diabetes and mental disorders in a community sample: Results from the German National Health Interview and Examination Survey. Diabetes Care 2003; 26: 1841-1846
  • 4 Bouwman V, Adriaanse MC, van ‘t Riet E. Snoek FJ, Dekker JM, Nijpels G. Depression, anxiety and glucose metabolism in the general dutch population: The new Hoorn study. PLoS One 2010; 5: e9971
  • 5 Nouwen A, Winkley K, Twisk J, Lloyd CE, Peyrot M, Ismail K. et al. Type 2 diabetes mellitus as a risk factor for the onset of depression: A systematic review and meta-analysis. Diabetologia 2010; 53: 2480-2486
  • 6 Brod M. Quality of life issues in patients with diabetes and lower extremity ulcers: Patients and care givers. Qual Life Res 1998; 7: 365-372
  • 7 Awadalla AW, Ohaeri JU, Al-Awadi SA, Tawfiq AM. Diabetes mellitus patients′ family caregivers′ subjective quality of life. J Natl Med Assoc 2006; 98: 727-736
  • 8 Awadalla AW, Ohaeri JU, Tawfiq AM, Al-Awadi SA. Subjective quality of life of outpatients with diabetes: Comparison with family caregivers′ impressions and control group. J Natl Med Assoc 2006; 98: 737-745
  • 9 Anaforoglu I, Ramazanogullari I, Algün E, Kutanis R. Depression, anxiety and quality of life of family caregivers of patients with type 2 diabetes. Med Princ Pract 2012; 21: 360-365
  • 10 El-Mallakh P, Yates BE, Adkins S. Family caregiving for adults with schizophrenia and diabetes mellitus. Issues Ment Health Nurs 2013; 34: 566-577
  • 11 Cunningham NR, Vesco AT, Dolan LM, Hood KK. From caregiver psychological distress to adolescent glycemic control: The mediating role of perceived burden around diabetes management. J Pediatr Psychol 2011; 36: 196-205
  • 12 Miller CK, Davis MS. The influential role of social support in diabetes management. Top Clin Nutr 2005; 20: 157-165
  • 13 Cole I, Chesla CA. Interventions for the family with diabetes. Nurs Clin North Am 2006; 41: 625-639 vii.
  • 14 Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983; 67: 361-370
  • 15 Herrmann C. International experiences with the hospital anxiety and depression scale: A review of validation data and clinical results. J Psychosom Res 1997; 42: 17-41
  • 16 Verma R, Sharma S, Balhara YP, Mathur S. Anxiety and depression among caregivers of patients with Neurological Illness. Delhi Psychiatry J 2011; 14: 120-123
  • 17 Balhara YP, Verma R, Sharma S, Mathur S. A study of predictors of anxiety and depression among stroke patient-caregivers. J Midlife Health 2012; 03: 31-35
  • 18 Raval A, Dhanaraj E, Bhansali A, Grover S, Tiwari P. Prevalence & determinants of depression in type 2 diabetes patients in a tertiary care centre. Indian J Med Res 2010; 132: 195-200
  • 19 Balhara YP, Sagar R. Correlates of anxiety and depression among patients with type 2 diabetes mellitus. Indian J Endocrinol Metab 2011; 15: S50-S54
  • 20 Aina Y, Susman JL. Understanding comorbidity with depression and anxiety disorders. J Am Osteopath Assoc 2006; 106 (05) (Suppl. 02) S9-S14
  • 21 Collins MM, Corcoran P, Perry IJ. Anxiety and depression symptoms in patients with diabetes. Diabet Med 2009; 26: 153-161
  • 22 Kaur G, Tee GH, Ariaratnam S, Krishnapillai AS, China K. Depression, anxiety and stress symptoms among diabetics in Malaysia: A cross sectional study in an urban primary care setting. BMC Fam Pract 2013; 14: 69
  • 23 Khuwaja AK, Lalani S, Dhanani R, Azam IS, Rafique G, White F. Anxiety and depression among outpatients with type 2 diabetes: A multi-centre study of prevalence and associated factors. Diabetol Metab Syndr 2010; 2: 72
  • 24 Tovilla-Zárate C, Juárez-Rojop I, Peralta JimenezY, Jiménez MA, Vázquez S, Bermúdez-Ocaña D. et al. Prevalence of anxiety and depression among outpatients with type 2 diabetes in the Mexican population. PLoS One 2012; 7: e36887
  • 25 de Groot M, Doyle T, Hockman E, Wheeler C, Pinkerman B, Shubrook J. et al. Depression among type 2 diabetes rural Appalachian clinic attendees. Diabetes Care 2007; 30: 1602-1604
  • 26 Abdulbari B, Al-Hamaq AO, Dafeeah EE. High prevalence of depression, anxiety and stress symptoms among diabetes mellitus patients. Open Psychiatr J 2011; 5: 5-12
  • 27 Iype T, Shaji SK, Balakrishnan A, Charles D, Varghese AA, Antony TP. Cognition in type 2 diabetes: Association with vascular risk factors, complications of diabetes and depression. Ann Indian Acad Neurol 2009; 12: 25-27
  • 28 Perveen S, Otho MS, Siddiqi MN, Hatcher J, Rafique G. Association of depression with newly diagnosed type 2 diabetes among adults aged between 25 to 60 years in Karachi, Pakistan. Diabetol Metab Syndr 2010; 2: 17
  • 29 Almawi W, Tamim H, Al-Sayed N, Arekat MR, Al-Khateeb GM, Baqer A. et al. Association of comorbid depression, anxiety, and stress disorders with Type 2 diabetes in Bahrain, a country with a very high prevalence of Type 2 diabetes. J Endocrinol Invest 2008; 31: 1020-1024
  • 30 Egede LE, Zheng D, Simpson K. Comorbid depression is associated with increased health care use and expenditures in individuals with diabetes. Diabetes Care 2002; 25: 464-470
  • 31 Mirza I, Jenkins R. Risk factors, prevalence, and treatment of anxiety and depressive disorders in Pakistan: Systematic review. BMJ 2004; 328: 794
  • 32 Roupa Z, Koulouri A, Sotiropoulou P, Makrinika E, Marneras X, Lahana I. et al. Anxiety and depression in patients with type 2 diabetes mellitus, depending on sex and body mass index. Health Sci J 2009; 03: 32-40
  • 33 Van Tilburg MA, McCaskill CC, Lane JD, Edwards CL, Bethel A, Feinglos MN. et al. Depressed mood is a factor in glycemic control in type 1 diabetes. Psychosom Med 2001; 63: 551-555
  • 34 Ciechanowski PS, Katon WJ, Russo JE, Hirsch IB. The relationship of depressive symptoms to symptom reporting, self-care and glucose control in diabetes. Gen Hosp Psychiatry 2003; 25: 246-252
  • 35 Surwit RS, van Tilburg MA, Parekh PI, Lane JD, Feinglos MN. Treatment regimen determines the relationship between depression and glycemic control. Diabetes Res Clin Pract 2005; 69: 78-80
  • 36 De la Roca-Chiapas JM, Hernández-González M, Candelario M, Villafaña MdeL, Hernández E, Solorio S. et al. Association between depression and higher glucose levels in middle-aged Mexican patients with diabetes. Rev Invest Clin 2013; 65: 209-213
  • 37 Katon WJ, Von Korff M, Lin EH, Simon G, Ludman E, Russo J. et al. The pathways study: A randomized trial of collaborative care in patients with diabetes and depression. Arch Gen Psychiatry 2004; 61: 1042-1049
  • 38 van der Ven NC, Hogenelst MH, Tromp-Wever AM, Twisk JW, van der Ploeg HM, Heine RJ. et al. Short-term effects of cognitive behavioural group training (CBGT) in adult Type 1 diabetes patients in prolonged poor glycaemic control. A randomized controlled trial. Diabet Med 2005; 22: 1619-1623
  • 39 Georgiades A, Zucker N, Friedman KE, Mosunic CJ, Applegate K, Lane JD. et al. Changes in depressive symptoms and glycemic control in diabetes mellitus. Psychosom Med 2007; 69: 235-241
  • 40 Lim JW, Zebrack B. Caring for family members with chronic physical illness: A critical review of caregiver literature. Health Qual Life Outcomes 2004; 2: 50
  • 41 Rorer E. United Hospital Fund Study Finds Changes in Nation′s Health Care System Place Daunting New Burdens on 25 Million Unpaid Family Caregivers Who Provide Nearly $ 200 Billion in Essential Services. New York: 1998
  • 42 Figley CR. Treating Stress in Families. New York: Brunner/Mazel; 1989
  • 43 Han B, Haley WE. Family caregiving for patients with stroke. Review and analysis. Stroke 1999; 30: 1478-1485
  • 44 Haley WE, LaMonde LA, Han B, Burton AM, Schonwetter R. Predictors of depression and life satisfaction among spousal caregivers in hospice: Application of a stress process model. J Palliat Med 2003; 6: 215-224
  • 45 Li TC, Lee YD, Lin CC, Amidon RL. Quality of life of primary caregivers of elderly with cerebrovascular disease or diabetes hospitalized for acute care: Assessment of well-being and functioning using the SF-36 health questionnaire. Qual Life Res 2004; 13: 1081-1088