Severity of depression in patients with type 1 and type 2 diabetes and its relation to the level of glycemia control and anti-depressive therapy
LR Tsutskiridze, RB Kurashvili, GR Kurashvili, MG Khelashvili, MA Nishnianidze, EL Shelestova & MG Dundua
Background and Aims: There are consistent findings about increased prevalence of depressive disorders in diabetes. The aim of the study was to reveal prevalence of depression in patients (pts) with type 1 (DM1) and type 2 (DM2) diabetes.
Materials and Methods: Totally, 157 pts with DM were questioned. To assess depression degree Becks scale was used, and 83 depressive pts (scores >10), were allocated into 2 groups (Gr.): Gr.1 (n=44)DM2 pts (m20/f24), mean age 57.5±8.4 yrs, diabetes duration 6±2 yrs, HbA1c8.8±1.3%, Gr. 2 (n=39)DM1 pts (m16/f23), mean age 30±5 yrs, diabetes duration7±2 yrs, HbA1c9.2±1.9%. Assessment scores: Gr.1(m) >55 (7 pts/35%), 3050 (8 pts/40%), ≥10 (5 pts/25%); (f) >60 (11 pts/45.8%), 3050 (8 pts/33.4%), >15 (5 pts/20.8%). Gr.2(m) >50 (8 pts/50%), 3050 (7pts/43.7%), ≥10 (1pts/6.25%); (f) >60 (12/52.2%), 3050 (8/34.8%), >20 (3/13%). 18 Gr.1 pts were treated with insulins and oral hypoglycemic agents (OHAs); 26only with OHAs. Intensive insulin therapy was used in 22 Gr.1 pts. Tianeptin 3 tablets/daily was used for depression treatment in both groups.
Results: Repeated examination at month 3 post study initiation showed: HbA1c dropped by 7.3±0.9%; P=0.000 (Gr.1), and by 6.5±0.6%; P=0.000 (Gr.2). Becks scores were: Gr.1 (m): 3040 (7 pts), 2030 (8 pts), 0 (5 pts); (f): 5060 (11 pts), 2030 (8 pts), ≥10 (5 pts). Gr.2 (m): 30-40 (8 pts), ≥20 (7 pts), 0 (1 pts); (f): 5060 (12 pts), 2025 (8 pts), ≧8 (3 pts). At entry there was no statistically evident difference in depression severity between the groups (P=0.177; P=0.537, respectively). Post treatment there was statistically evident correlation between decline in HbA1c levels and depression severity in both groups, this evidence was relevant for males and females: Gr.1(m) r=0.948, P=0.000; (f) r=0.909, P=0.000. Gr.2(m) r=0.915, P=0.000; (f) r=0.921, P=0.000.
Conclusion: We conclude: 1.There was no statistically evident difference in depression severity between the DM types. 2.There is statistically evident post-treatment correlation between glycemia control level and depression degree in both groups.