Depression, anxiety, and associated factors in patients with diabetes: evidence from the anxiety, depression, and personality traits in diabetes mellitus (ADAPT-DM) study
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Abstract
BACKGROUND: Depression and anxiety are common psychiatric complications affecting patients with diabetes mellitus. However, data on the prevalence of depression, anxiety, and associated factors among Malaysian diabetic patients is scarce. The Anxiety, Depression, and Personality Traits in Diabetes Mellitus (ADAPT-DM) study aimed to determine the prevalence of depression and anxiety, and their associated factors in the Malaysian diabetic population. METHODS: This cross-sectional study recruited 300 diabetic patients via convenience sampling from the Endocrine outpatient clinic of Universiti Kebangsaan Malaysia Medical Centre, a tertiary referral healthcare facility in Kuala Lumpur. Socio-demographic characteristics and clinical history were obtained from each participant. The Generalised Anxiety Disorder-7 (GAD-7) was administered to assess anxiety symptoms, the Beck Depression Inventory (BDI) to assess depressive symptoms, the Big Five Inventory (BFI) to evaluate personality traits, and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) to measure quality of life (QOL). Stepwise multiple logistic regression analyses were performed to determine the association between various factors, and depression and anxiety. RESULTS: The prevalence of depression was 20% (n = 60) while anxiety was 9% (n = 27). Co-morbid depression (adjusted odds ratio [OR] = 9.89, 95% confidence interval [CI] = 2.63-37.14, p = 0.001) and neuroticism (adjusted OR = 11.66, 95% CI = 2.69-50.47, p = 0.001) increased the odds of developing anxiety, while conscientiousness (adjusted OR = 0.45, 95% CI = 0.23-0.80, p = 0.004) and greater psychological-related QOL (adjusted OR = 0.47, 95% CI = 0.29-0.75, p = 0.002) were protective. Co-morbid anxiety (adjusted OR = 19.83, 95% CI = 5.63-69.92, p < 0.001) increased the odds of depression, while older age (adjusted OR = 0.96, 95% CI = 0.93-0.98, p = 0.002), social relationship-related QOL (adjusted OR = 0.84, 95% CI = 0.71-.0.99, p = 0.047), and physical health-related QOL (adjusted OR = 0.69, 95% CI = 0.58-0.83, p < 0.001) were protective. CONCLUSIONS: The study findings signify the need to screen for co-morbid depression and anxiety, as well as personality traits and QOL, and to include psychosocial interventions when planning a multidisciplinary approach to managing diabetes.
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A higher degree of quality of life in all domains predicts lower odds of depression.
“On the other hand, a higher degree of QoL in all domains also predicted lower odds of depression.12”
From Study protocol on the efficacy of exergames-acceptance and commitment therapy program for the treatment of major depressive disorder: Comparison with acceptance and commitment therapy alone and treatment-as-usual in a multicentre randomised controlled trial (2024) · cites this paper as [12]
The Results section on stepwise multivariate regression reports lower odds of depression with higher physical-health and social-relationship quality of life. It says the other quality-of-life components did not significantly predict depression, so the claim overstates the finding by saying “all domains.” (LLM, conf=0.91)
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- Authors
- Woon, L. S.-C., Sidi, H. B., Ravindran, A., Gosse, P. J., Mainland, R. L., Kaunismaa, E. S., Hatta, N. H., Arnawati, P., Zulkifli, A. Y., Mustafa, N., & Leong Bin Abdullah, M. F. I.
- Affiliations
- University Kebangsaan Malaysia Medical Centre (MY)
- University of Toronto (CA)
- ORCID
- Venue
- BMC Psychiatry
- Published
- 2020-05-12
- Volume
- 20
- Issue
- 1
- Pages
- 227-227
- ISSN
- 1471-244X (ISSN-L)
- PMC
- PMC7218550
- OpenAlex
- W3026271884
- Cited by
- 63
- References
- 44
- Citations by year
- 2026: 5 · 2025: 14 · 2024: 12 · 2023: 9 · 2022: 11 · 2021: 11 · 2020: 1
- FWCI
- 6.03
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Psychiatry (publishedVersion, cc-by)
- Research Square (acceptedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- TSpace (University of Toronto) (submittedVersion, cc-by)
- Funders
- Universiti Kebangsaan Malaysia (GGPM2019-024)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- depression, anxiety, diabetes mellitus, comorbid depression, neuroticism, Big Five personality traits, quality of life, risk factors, prevalence of anxiety and depression, conscientiousness, age as protective factor, GAD-7, Beck Depression Inventory, WHOQOL-BREF, Big Five Inventory
- MeSH terms
- Aged, Anxiety, Anxiety Disorders, Cross-Sectional Studies, Depression, Diabetes Mellitus, Humans, Malaysia, Personality, Quality of Life
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