Depressive comorbidity in type 2 Diabetes: Prevalence and associated factors

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Published Mar 10, 2026
https://doi.org/10.62438/tunismed.v104i01.5434
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Vol. 104 No. 01 (2026): Tunis Med Jan 2026

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Hind Mhalla
Department of Outpatient Clinic and Functional Explorations, National Institute of Nutrition and Food Technology of Tunis, Tunis, Tunisia
Marwa Ben Mbarek
Research Laboratory “Vulnerability to mental health”, Faculty of Medecine of Monastir, University of Monastir, Monastir, Department of Psychiatry, Fattouma Bourguiba University Hospital, Monastir, Tunisia
Kamilia Ounaissa
Department of Outpatient Clinic and Functional Explorations, National Institute of Nutrition and Food Technology of Tunis, Tunis, Tunisia
Imen Betbout
Research Laboratory “Vulnerability to mental health”, Faculty of Medecine of Monastir, University of Monastir, Monastir, Department of Psychiatry, Fattouma Bourguiba University Hospital, Monastir, Tunisia
Amjed Ben Haouala
Research Laboratory “Vulnerability to mental health”, Faculty of Medecine of Monastir, University of Monastir, Monastir, Department of Psychiatry, Fattouma Bourguiba University Hospital, Monastir, Tunisia
Ferid Zaafrane
Research Laboratory “Vulnerability to mental health”, Faculty of Medecine of Monastir, University of Monastir, Monastir, Department of Psychiatry, Fattouma Bourguiba University Hospital, Monastir, Tunisia
Chiraz Amrouche
Department of Outpatient Clinic and Functional Explorations, National Institute of Nutrition and Food Technology of Tunis, Tunis, Tunisia
Badii Amamou
Research Laboratory “Vulnerability to mental health”, Faculty of Medecine of Monastir, University of Monastir, Monastir, Department of Psychiatry, Fattouma Bourguiba University Hospital, Monastir, Tunisia
Ahmed Mhalla
Research Laboratory “Vulnerability to mental health”, Faculty of Medecine of Monastir, University of Monastir, Monastir, Department of Psychiatry, Fattouma Bourguiba University Hospital, Monastir, Tunisia

Abstract

Background: The comorbidity diabetes depression is frequent and would have a synergistic effect. Depression is underdiagnosed in diabetology consultations.


Methods: This was a cross-sectional study that included 102 outpatients with type 2 Diabetes mellitus (T2DM) recruited during April and May 2019. A pre-established form was filled out from the interview of the patients and the medical file review. Depression, Therapeutic adherence, self-esteem, temperament, satisfaction of treatment, quality of life and physical activity were assessed by validated questionnaires.


Results: The average age of the patients was 53.4± 8.5 years, sex-ratio was 0.7. 76.5% have exhibited depressive symptoms; 51% of the patients have had moderate to severe depression. Depression was associated with female gender (p=0.04) and psychiatric family history (p=0.01). Patients with depression have had significantly higher HbA1c levels (p=0.05) and significantly lower HDL-C levels (p=0.05). Regarding psychosocial factors, depression was associated with low self-esteem (p= 0.005) and significantly higher scores of depressive (p=0.002) and cyclothymic (p=0.003) temperaments. Depression was also associated with significantly lower treatment satisfaction (p=0.01) and poor quality of life. In multivariate study, factors independently associated with depression were female gender, low HDL-C, quality of life score without diabetes and low self-esteem score.


Conclusion: This study showed, despite limitations, that depression is frequent in patients with T2DM and was associated with several sociodemographic, anamnestic, clinical and psychological characteristics.


 

Keywords:

Type 2 diabetes, Depression, Blood glucose control, Quality of life, Self-esteem, Treatment satisfaction

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