Objective: This cross-sectional study aimed to explore the multifaceted interplay of screening tools for the mental health of patients with type 1 (T1D) and type 2 (T2D) diabetes in Kerala, India, with a focus on depression and anxiety. Materials and methods: Data were collected from 384 patients with diabetes in Kerala, between August and October 2023. The Krejcie and Morgan Method was employed for sample selection, ensuring a confidence level of 99.0% and a margin error of 3.5%. Participants, aged 35 years and above, with T1D or T2D and proficiency in Malayalam, were included. Demographic and clinical factors, World Health Organization 5 Well-Being (WHO-5), and Problem Areas in Diabetes 5 (PAID-5) data were gathered through structured interviews. Statistical analyses included mean, 95% confidence interval, independent sample test, chi-square test, and receiver operating characteristic (ROC) curve analysis. Results: The study revealed a high prevalence of depression (74%) and anxiety (82%) among patients with diabetes in Kerala. T2D participants exhibited significantly higher rates of depression and anxiety. Poor glycemic control, longer disease duration, lower socioeconomic status, comorbid conditions, and a lack of strong social support were identified as significant predictors of psychological distress. ROC analysis demonstrated the predictive capacity of the WHO-5 [area under the curve (AUC) 0.745 and PAID-5 index (AUC 0.822) for depression and anxiety, respectively]. Conclusions: Tailored interventions addressing glycemic control, disease management, and psychosocial support are crucial for reducing the burden of depression and anxiety. Health education programs targeting vulnerable subgroups and routine screening for mental health issues in diabetes care are recommended to improve patient outcomes in Kerala.
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George et al. (2024) studied this question.
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