Psychological Comorbidities Among Patients With Type 2 Diabetes Mellitus (T2DM) in Anakaputhur, Chennai: A Cross-Sectional Study

Background Psychological comorbidities such as depression, anxiety, and stress may occur in patients with type 2 diabetes mellitus (T2DM), potentially influencing clinical outcomes. Data from semi-urban areas of India remain limited, and differences in healthcare availability and social factors may influence these outcomes. This study aims to assess the prevalence and socio-demographic determinants of depression, anxiety, and stress in individuals with T2DM and to explore the interrelationships among these comorbidities. Methodology An analytical cross-sectional study was conducted over three months in the community, served by the Urban Health Training Centre (UHTC) of Sree Balaji Medical College and Hospital in Anakaputhur, Chennai, India. The study population included adults (≥18 years) diagnosed with T2DM and receiving treatment for at least six months. Individuals with pre-existing psychiatric disorders or advanced diabetic complications were excluded. A multistage sampling strategy was applied: in the first stage, eligible patients were identified from outpatient medical records at the UHTC; in the second stage, a simple random sampling method was used to select 412 participants from this list. Data were collected through household visits, where trained investigators administered a structured questionnaire to obtain socio-demographic information, clinical history, and psychological distress levels using the Depression Anxiety Stress Scale-21 (DASS-21). Data were entered in Microsoft Excel (Microsoft Corp., Redmond, WA, USA) and analyzed using IBM SPSS Statistics for Windows, V. 25.0 (IBM Corp., Armonk, NY, USA). Descriptive statistics were used to determine prevalence rates, while the chi-squared test assessed associations between psychological comorbidities and socio-demographic variables. Multivariate logistic regression was performed to identify independent predictors, with results expressed as odds ratios (OR) and 95% confidence intervals (CI). Results Psychological comorbidities were prevalent among participants: 44.7% (n=184) experienced stress, 51.5% (n=212) had anxiety, and 48.8% (n=201) suffered from depression. A significant overlap existed among these conditions, with 74.1% of those with stress also experiencing anxiety and 82.1% of depressed individuals reporting anxiety (p<0.001). Significant socio-demographic predictors included older age (51-60 years), which was associated with higher odds of stress (OR=3.68; p=0.004), anxiety (OR=3.54; p=0.007), and depression (OR=3.92; p=0.004). Female participants had a higher likelihood of experiencing stress (adjusted OR=1.36; 95% CI: 0.76-2.43; p=0.3) and were independently more likely to have anxiety (OR=2.85; p<0.001). Additionally, student status emerged as a strong predictor of depression (OR=8.19; p<0.001). Conclusion Psychological comorbidities were common among individuals with T2DM in this peri-urban Indian setting. Higher prevalence was observed in older adults, women, and those identified as students. Considerable overlap existed between depression, anxiety, and stress. These findings underscore the importance of incorporating routine mental health screening into diabetes care and implementing targeted interventions for vulnerable groups to improve their overall psychological well-being.