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Vladut Ioana Corina , MA

Evaluating depression in type 2 diabetes co-morbidities in Romanian patients - implications for hypertensive patients. Vladut Ioana Corina , MA Center for Health Policy and Public Health, Babes -Bolyai University Cluj-Napoca, Romania.

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Vladut Ioana Corina , MA

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  1. Evaluating depression in type 2 diabetes co-morbidities in Romanian patients -implications for hypertensive patients VladutIoanaCorina, MA Center for Health Policy and Public Health, Babes-Bolyai University Cluj-Napoca, Romania

  2. Public Health and Social Services: Education and Practice conference Tbilisi, Georgia, June 27th, 2012 Presentation overview 1. Background (issue/problem) 2.Description of the problem 3.Results (effects/changes) 4.Lessons 5.Acknowlegements 6. Selected references

  3. Public Health and Social Services: Education and Practice conference Tbilisi, Georgia, June 27th, 2012 Background • Depression is one of the leading contributing factors to the burden of disease worldwide (1) • Patients with chronic diseases have been found to have two-to threefold higher rates of major depression compared with age- and gender-matched primary care patients • High prevalence of depression in diabetes patients with co-morbid medical diseases compared with patients with type 2 diabetes only or no chronic disease at all (2)

  4. Public Health and Social Services: Education and Practice conference Tbilisi, Georgia, June 27th, 2012 Background • 75% diabetes patients have associated conditions • Special attention to depression in hypertension and diabetes • Raised blood pressure is more common in people with type 2 diabetes than in the general population(3) • Risk of hypertension increases with repeated experience of depressive episodes over time(4)

  5. Public Health and Social Services: Education and Practice conference Tbilisi, Georgia, June 27th, 2012 Description of the problem • Setting: Nutrition and Diabetes Center in Cluj-Napoca, Romania • Participants: 1171 patients with type 2 diabetes • Objectives: • Explore the prevalence of co-morbidities in diabetes and the level of depression in the first five diabetes comorbidities. • Examine the relationship between high blood pressure and depression, as high blood pressure is a debated risk factor for type two diabetes.

  6. Public Health and Social Services: Education and Practice conference Tbilisi, Georgia, June 27th, 2012 Description of the problem • Questionnaires: Diabetes Cost Questionnaire (DCQ) and Patient Health Questionnaire (PHQ9) • Data analysis • descriptive statistics and Chi-Square tests -> the prevalence of co-morbidities, and the difference in the depression level in the associated diabetes conditions • regression -> examine the probability of having major and mild depression in patients with high blood pressure

  7. Public Health and Social Services: Education and Practice conference Tbilisi, Georgia, June 27th, 2012 Results (effects/changes)

  8. Public Health and Social Services: Education and Practice conference Tbilisi, Georgia, June 27th, 2012 The probability of having major depression for patients with high blood pressure is dependent on (p<0.01): • low educational level • female gender • not having a caregiver

  9. Public Health and Social Services: Education and Practice conference Tbilisi, Georgia, June 27th, 2012 Lessons • The results of the study confirm previous findings that indicate a higher prevalence of depression in diabetes patients with associated medical conditions. • Integrated approachof diabetes management and comorbidities specific guides • Raise awareness on depression in patients with high blood pressure and diabetes, especially in women, people without caregivers and with low educational status. • More research is demanded in order to elucidate the bi-directional relationships between depression, diverse chronic diseases and the associated risk factors. c

  10. Public Health and Social Services: Education and Practice conference Tbilisi, Georgia, June 27th, 2012 Acknowledgements This work was financed directly by grant number 5 D43 TW005810-07, “Finance and Mental Health Services Training in Czech Republic/Central Europe,” sponsored by the U.S. National Institutes of Health “John E. Fogarty International Center”. c

  11. Public Health and Social Services: Education and Practice conference Tbilisi, Georgia, June 27th, 2012 Selectes References 1.Michaud CM, Murray CJ, Bloom BR (2001) Burden of disease- implications for future research. JAMA 285:535–539 2. PouwerF, Beekman AT, Nijpels G et al (2003) Rates and risks for co-morbid depression in patients with type 2 diabetes mellitus: results from a community-based study. Diabetologia46:892–898 3.Kannel W, McGee D. Diabetes and cardiovascular disease. The Framing­ham study. JAMA 1979;241:2035­8 4.Nabi H., et al., Trajectories of Depressive Episodes and Hypertension Over 24 Years,Hypertension. 2011;57:710-716

  12. Public Health and Social Services: Education and Practice conference Tbilisi, Georgia, June 27th, 2012 Thank you for your attention !

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