The Epidemiology of Depression and Diabetes Distress in Type 2 Diabetes in Kuwait
Table 1
Distribution of explanatory variables stratified by PHQ-9 depression status and PAID score for diabetes distress in a nested sample ().
Explanatory variable
Total sample () Mean (SD)/proportion (%)
PHQ-9 case positive () Mean (SD)/proportion (%)
PHQ-9 case negative () Mean (SD)/proportion (%)
Mean difference or odds ratio [95% confidence interval] ( value)†
() Mean (SD)/proportion (%)
() Mean (SD)/proportion (%)
Mean difference or odds ratio [95% confidence interval] (value)†
PHQ-9 score (range 0-27)
7.0 (5.3)
13.7 (3.5)
4.2 (2.8)
9.53 [8.92, 10.13] (<0.001)
11.2 (5.3)
6.2 (4.9)
5.0 [3.72, 6.28] (<0.001)
Age (year)
55.3 (10.1)
54.5 (11.3)
55.6 (9.6)
-1.14 [-3.17, 0.88] (0.268)
53.3 (10.5)
55.7 (10.0)
-2.31 [-4.9, 0.28] (0.080)
Duration T2DM (year)
12.5 (8.2)
13.1 (8.1)
12.3 (8.3)
0.79 [-0.89, 2.47] (0.356)
12.8 (8.1)
12.5 (8.3)
0.30 [-1.85, 2.46] (0.784)
Sex
Male
241 (51.8)
54 (39.7)
187 (56.8)
1
24 (34.8)
217 (54.8)
1
Female
224 (48.2)
82 (60.3)
142 (43.2)
2.0 [1.3, 3.0] (0.001)
45 (65.2)
179 (45.2)
2.27 [1.33, 3.87] (0.003)
Nationality
Kuwaiti
341 (73.3)
93 (68.4)
248 (75.4)
1
60 (87.0)
281 (71.0)
2.7 [1.3, 5.68] (0.007)
Non-Kuwaiti
124 (26.7)
43 (31.6)
81 (24.6)
1.4 [0.91, 2.2] (0.122)
9 (13.0)
115 (29.0)
1
Marital status
Married
411 (91.1)
116 (87.2)
295 (92.8)
1
61 (89.7)
350 (91.4)
1
Separated/single
40 (8.9)
17 (12.8)
23 (7.2)
1.9 [0.97, 3.65] (0.062)
7 (10.3)
33 (8.6)
1.21 [0.51, 2.87] (0.654)
Employment status
Employed
208 (51.6)
61 (51.3)
147 (51.8)
1
25 (42.4)
183 (53.2)
1
Unemployed
195 (48.4)
58 (48.7)
137 (48.2)
1.02 [0.66, 1.57] (0.927)
34 (57.6)
161 (46.8)
1.5 [0.88, 2.70] (0.126)
Past history of depression
Yes
17 (3.7)
11 (8.1)
6 (1.8)
4.7 [1.71, 13.08] (0.003)
5 (7.2)
12 (3.0)
2.5 [0.85, 7.33] (0.095)
No
448 (96.3)
125 (91.9)
323 (98.2)
1
64 (92.8)
384 (97.0)
1
HbA1c (mmol/mol)
69.4 (20.5)
71.8 (20.1)
68.5 (20.6)
3.31 [-0.77, 7.40] (0.112)
74.9 (20.6)
68.5 (20.3)
6.39 [1.17, 11.61] (0.016)
BMI (kg/m2)
33.6 (6.8)
34.3 (6.6)
32.9 (7.0)
1.36 [0.01, 2.69] (0.047)
34.6 (5.7)
33.0 (7.0)
1.89 [0.17, 3.60] (0.031)
Serum triglycerides (mmol/L)
1.8 (1.0)
1.8 (1.0)
1.7 (1.1)
0.07 [-0.13, 0.27] (0.499)
1.9 (0.9)
1.7 (1.1)
0.11 [-0.15, 0.37] (0.402)
Serum total cholesterol (mmol/L)
4.6 (1.1)
4.7 (1.0)
4.6 (1.1)
0.14 [-0.77, 0.35] (0.208)
4.7 (0.9)
4.6 (1.1)
0.14 [-0.13, 0.41] (0.311)
Serum HDL (mmol/L)
1.1 (0.4)
1.2 (0.5)
1.1 (0.4)
0.06 [-0.23, 0.15] (0.149)
1.2 (0.5)
1.1 (0.4)
0.07 [-0.04, 0.17] (0.247)
Serum LDL (mmol/L)
2.7 (0.9)
2.7 (0.9)
2.7 (1.0)
0.01 [-0.18, 1.96] (0.955)
2.7 (0.8)
2.7 (1.0)
-0.02 [-0.26, 0.22] (0.874)
Blood pressure (mmHg)
Systolic
130 (17.7)
131.8 (18.9)
129.8 (17.1)
1.97 [-1.58, 5.53] (0.277)
135 (17.8)
129.6 (17.5)
5.49 [0.92, 10.05] (0.019)
Diastolic
74 (10.9)
74.7 (9.9)
73.8 (11.3)
0.85 [-1.34, 3.04] (0.446)
75.1 (11.2)
73.9 (10.8)
1.22 [-1.60, 4.04] (0.396)
Diagnosis of dyslipidaemia
Diagnosis
339 (72.9)
99 (72.8)
240 (72.9)
1.0 [0.63, 1.56] (0.973)
52 (75.4)
287 (72.5)
1.2 [0.64, 2.10] (0.619)
None
126 (27.1)
37 (27.2)
89 (27.1)
1
17 (24.6)
109 (27.5)
1
Retinopathy
Diagnosis
132 (28.4)
42 (30.9)
90 (27.4)
1.8 [0.76, 1.84] (0.443)
17 (24.6)
115 (29.0)
0.8 [0.44, 1.44] (0.455)
None
333 (71.6)
94 (69.1)
239 (72.6)
1
52 (75.4)
281 (71.0)
1
Nephropathy
Diagnosis
93 (20.0)
28 (20.6)
65 (19.8)
1.05 [0.64, 1.73] (0.838)
14 (20.3)
79 (19.9)
1.0 [0.54, 1.93] (0.948)
None
372 (80.0)
108 (79.4)
264 (80.2)
1
55 (79.7)
317 (80.1)
1
Neuropathy
Diagnosis
199 (43.3)
66 (48.9)
133 (40.9)
1.38 [0.92, 2.06] (0.117)
34 (49.3)
165 (42.2)
1.33 [0.80, 2.22] (0.275)
None
261 (56.7)
69 (51.1)
192 (59.1)
1
35 (50.7)
226 (57.8)
1
Stroke
Yes
9 (1.9)
3 (2.2)
6 (1.8)
1.21 [0.29, 4.92] (0.786)
1 (1.4)
8 (2.0)
0.7 [0.09, 5.79] (0.752)
No
456 (98.1)
133 (97.8)
323 (98.2)
1
68 (98.6)
388 (98.0)
1
Hypertension
Yes
314 (67.5)
101 (74.3)
213 (64.7)
1.57 [1.0, 2.45] (0.047)
49 (71.0)
265 (66.9)
1.2 [0.69, 2.12] (0.503)
No
151 (32.5)
35 (25.7)
116 (35.3)
1
20 (29.0)
131 (33.1)
1
CVD
Yes
49 (10.5)
17 (12.5)
32 (9.7)
1.32 [0.70, 2.47] (0.377)
5 (7.2)
44 (11.1)
0.6 [0.24, 1.63] (0.339)
No
416 (89.5)
119 (87.5)
297 (90.3)
1
64 (92.8)
352 (88.9)
1
Diet treated alone
Yes
37 (8.0)
12 (8.8)
25 (7.6)
1.17 [0.57, 2.41] (0.657)
6 (8.7)
31 (7.8)
1.10 [0.45, 2.80] (0.806)
No
428 (92.0)
124 (91.2)
304 (92.4)
1
63 (91.3)
365 (92.2)
1
Oral agents alone
Yes
399 (86.2)
114 (83.8)
285 (87.2)
0.76 [0.43, 1.33] (0.345)
57 (83.8)
342 (86.6)
0.8 [0.40, 1.63] (0.543)
No
64 (13.8)
22 (16.2)
42 (12.8)
1
11 (16.2)
53 (13.4)
1
Insulin
Yes
252 (54.4)
91 (66.9)
161 (49.2)
2.08 [1.37, 3.16] (0.001)
41 (60.3)
211 (53.4)
1.3 [0.78, 2.24] (0.294)
No
211 (45.6)
45 (33.1)
166 (50.8)
1
27 (39.7)
184 (46.6)
1
Smoking
Smoker
98 (21.7)
25 (18.7)
73 (23.0)
1.3 [0.80, 2.16] (0.312)
12 (18.2)
86 (22.3)
0.8 [0.40, 1.51] (0.456)
Ex/nonsmoker
354 (78.3)
109 (81.3)
245 (77.0)
1
54 (81.8)
300 (77.7)
1
Exercise
Plan
135 (29.0)
30 (22.1)
105 (31.9)
1
19 (27.5)
116 (29.3)
1
None
330 (71.0)
106 (77.9)
224 (68.1)
1.65 [1.03, 2.64] (0.034)
50 (72.5)
280 (70.7)
1.09 [0.61, 1.92] (0.767)
PAID (range 0-92.5)
17.9 (20.1)
28.6 (25.7)
13.4 (15.2)
15.21 [11.42, 18.99] (<0.001)
56.8 (11.1)
11.1 (11.4)
45.66 [42.63, 48.69] (<0.001)
PHQ-9: Patients Health Questionnaire Nine; PAID: Problem Area in Diabetes; HDL: high-density lipoprotein; LDL: low-density lipoprotein; CVD: cardiovascular disease; BMI: body mass index. was used to define PHQ-9 positive; was used to define PHQ-9 negative; is considered clinically significant psychological distress. †Test statistic represents -tests or regression analysis for odd ratio.