Association between depression and diabetes amongst adults in Bangladesh: a hospital based case-control study

METHODS: A matched case-control study was conducted among 591 consecutive patients with diabetes attending a tertiary hospital in Dhaka and 591 controls matched for age, sex and area of residence without diabetes not related with the index-case. Depression was measured using the Patient Health Questionnaire-9. Multivariate logistic regression was performed to examine the association between depression and diabetes. RESULTS: The mean age (±standard deviation) of the participants was 50.4 ± 11.4 years, with a male to female ratio of 43:57. The prevalence of depression was 45.2% and 19.8% among cases and controls, respectively. In the multivariate analysis, mild as well as moderate to severe depression were significantly associated with diabetes and independent of sociodemographic factors and co-morbidity (adjusted odds ratio (OR) = 2.0, 95% confidence interval (CI) = 1.4-2.9 and adjusted OR = 6.4, 95% CI = 3.4-12.3; P < 0.001 for both). CONCLUSION: The high prevalence and strong association of depression in individuals with diabetes in Bangladesh suggests that depression should be routinely screened for patients with diabetes at the clinics and that management strategies adequate for resource-poor settings need to be developed. Further research to determine the pathophysiological role of depression in the development of diabetes is merited.