Study on psychiatric morbidities in patients with newly (recently) detected type 2 diabetes mellitus

Aims and objectives: Psychiatric co-morbidity in patients with diabetes mellitus (DM) is associated with higher level of functional impairment and poor self-care. This study was carried out with the aim to find out existing psychiatric morbidity in newly detected diabetic patients who were not yet started on anti-diabetic medication so that proper evaluation of mental health and comprehensive management of both the conditions can be planned. Methodology: Hundred newly detected and diagnosed type 2 DM patients attending endocrinology and psychiatry outpatient departments of Sir Sunder Lal Hospital, Institute of Medical Sciences, Banaras Hindu University, Varanasi were screened and selected for the study. Psychiatric evaluation was done on the basis of structured proforma containing socio-demographic details, physical and mental status examination, and relevant investigations pertaining to diagnosis of DM. Psychiatric diagnosis was made on the basis of the text revision of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) criteria. Relevant rating scales (Hamilton Anxiety Rating Scale for anxiety disorder, Hamilton Depression Rating Scale for depression, Yale-Brown Obsessive Compulsive Scale [Y-BOCS] for obsessive compulsive disorder, and Brief Psychiatric Rating Scale [BPRS] for psychosis) were used for assessing severity of the conditions. Result: Majority of the patients were males (65%). Psychiatric morbidity was detected in 34% of patients – most common was major depressive disorder (21%) followed by anxiety disorder (eight per cent), dysthymic disorder (four per cent), and substance abuse (one per cent). In major depressive disorder group, moderate (ten per cent) to severe (four per cent) level of depression was detected and in anxiety disorder group, five per cent patients had moderate level of anxiety. Conclusion: Evaluation of psychiatric status at the very beginning when DM is detected ; may help in proper management of both the conditions resulting in better outcome, self-care, and maintenance therapy in follow-up.