Prevalence and predictors of generalised anxiety disorder symptoms among adult patients with type 2 diabetes mellitus at Mulago National Referral Hospital

Abstract

Background; Diabetes mellitus (DM) is associated with several physical and psychological conditions including Generalised Anxiety Disorder (GAD). Patients with comorbid DM and GAD do not properly adhere to DM self-care management practices, which worsens their glycemic control, making them prone to diabetic complications hence increasing their morbidity and mortality. In Uganda, the link between DM and GAD has not been investigated. Thus, this study aimed to establish the prevalence and predictors of GAD symptoms among adult patients with Type 2 DM (T2DM) attending the diabetes clinic at Mulago National Referral Hospital(MNRH). Objectives; To determine the prevalence and predictors of GAD symptoms among adult patients with T2DM attending the diabetes clinic at MNRH. Methods; Three hundred thirty-six (336) patients were conveniently sampled and assessed using a semi-structured interviewer-administered questionnaire to capture socio-demographic characteristics, biological and psychological predictors of GAD symptoms while a 7-item GAD tool was used to assess GAD symptoms. Simple frequency was used to determine proportions, logistic regression using bivariate and multivariate analysis was done to determine the predictors of GAD symptoms. Results; Out of 336 patients sampled, 50 (14.9%) had significant symptoms of GAD. More than half 216 (64.3%) of whom were females and 238 (70.8%) were middle-aged adults (36-64 years). The majority 201 (59.8%) of these had been living with diabetes for less than 10 years and more than half 204 (60.7%) were married. There was a statistically significant association between proximity to the hospital (PR 0.55, 95% CI 0.23-1.0, P-value 0.119), marital status (PR 1.43, 95% CI 0.85-2.38, P-value 0.172), chronic diabetic complications (PR 0.40, 95% CI 0.24-0.67, P-value <0.001), family history of mental illness (PR 3.02, 95% CI 1.78-4.91, P-value <0.001) and alcohol use (PR 1.89, 95% CI 0.93-3.35, P-value 0.048) with GAD symptoms. Not married marital status, absence of chronic diabetic complications and family history of mental illness independently predicted significant GAD symptoms among participants. Conclusion; Findings from this study reflect a low prevalence of significant GAD symptoms among adult patients with T2DM. Single adult patients with T2DM recently diagnosed, without chronic diabetic complications as well as those with a family history of mental illness are likely to have symptoms of GAD. Therefore, they should be routinely screened for anxiety and be provided with integrated mental health support services.