Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Diabetes. Jun 15, 2012; 3(6): 123-129
Published online Jun 15, 2012. doi: 10.4239/wjd.v3.i6.123
Association between psychological distress and gastrointestinal symptoms in diabetes mellitus
Abdulbari Bener, Suhaila Ghuloum, Abdulla OAA Al-Hamaq, Elnour E Dafeeah
Abdulbari Bener, Department of Medical Statistics and Epidemiology, Hamad Medical Corporation, Doha, PO Box 3050, Qatar
Abdulbari Bener, Department of Public Health, Weill Cornell Medical College, Doha, PO Box 3050, Qatar
Abdulbari Bener, Department of Evidence for Population Health Unit, School of Epidemiology and Health Sciences, University of Manchester, Manchester, M13 9PL, United Kingdom
Suhaila Ghuloum, Abdulla OAA Al-Hamaq, Department of Psychiatry, Psychology Unit, Rumailah Hospital, Hamad Medical Corporation, Doha, PO Box 3050, Qatar
Elnour E Dafeeah, Qatar Diabetic Associations and Qatar Foundation, Doha, PO Box 5825, Qatar
Author contributions: Bener A contributed to the research idea, design of this study, collection and analysis of the data and preparation of the manuscript; Ghuloum S, Al-Hamaq AOAA and Dafeeah EE contributed to the data collection, design and preparation of the manuscript; all authors have read and approved the final version of the manuscript.
Supported by The Qatar Diabetic Association and Qatar National Research Fund- QNRF NPRP 30-6-7-38
Correspondence to: Abdulbari Bener, Professor, Consultant and Head, Advisor to WHO, Department of Medical Statistics and Epidemiology, Hamad Medical Corporation, Doha, PO Box 3050, Qatar. abener@hmc.org.qa
Telephone: +974-439-3765 Fax: +974-439-3769
Received: April 8, 2012
Revised: May 27, 2012
Accepted: June 10, 2012
Published online: June 15, 2012
Abstract

AIM: To examine the possible association between gastrointestinal symptoms and anxiety and depression in type 2 diabetes mellitus (T2DM).

METHODS: The study was a matched case-control study based on a face to face interview with designed diagnostic screening questionnaires for gastrointestinal (GI) symptoms and T2DM, Patient Health Questionnaire (PHQ-9) for depression and General Anxiety Disorders (GAD-7) for anxiety. The questionnaire consisted of questions about symptoms and signs of anxiety and depression disorders. Also, socio-demographic characteristics, life style habits and the family history of patients were collected. It was carried out from June 2010 to May 2011 among Qatari and other Arab nationals over 20 years of age at Primary Health Care Centers of the Supreme Council of Health, Qatar, including patients with diabetes mellitus and healthy subjects over 20 years of age.

RESULTS: In the studied sample, most of the studied T2DM patients with GI symptoms (39.3%) and healthy subjects (33.3%) were in the age group 45-54 years (P < 0.001). The prevalence of severe depression (9.5% vs 4.4%, P < 0.001) and anxiety (26.3% vs 13.7%, P < 0.001) was significantly higher in T2DM patients with GI symptoms than in general population. Obesity (35.7% vs 31.2%) and being overweight (47.9% vs 42.8%) were significantly higher in T2DM patients with GI symptoms than in healthy subjects (P = 0.001). Mental health severity score was higher in T2DM patients with GI symptoms than in healthy subjects; depression (8.2 ± 3.7 vs 6.0 ± 3.6) and anxiety (7.6 ± 3.3 vs 6.0 ± 3.7). The most significant GI symptom which was considerably different from controls was early satiety [odds ratio (OR) = 10.8, P = 0.009] in depressed T2DM patients and loose/watery stools (OR = 2.79, P = 0.029) for severe anxiety. Anxiety was observed more than depression in T2DM patients with GI symptoms.

CONCLUSION: Gastrointestinal symptoms were significantly associated with depression and anxiety in T2DM patients, especially anxiety disorders.

Keywords: Gastrointestinal; Type 2 diabetes mellitus; Distress; Depression; Anxiety; Qatar