Proportion of Depression in Diabetes Patients: A Cross-Sectional Study Using HAM-D Scale

Proportion of Depression in Diabetes Patients: A Cross-Sectional Study Using HAM-D Scale | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Proportion of Depression in Diabetes Patients: A Cross-Sectional Study Using HAM-D Scale Dr Muhammad Unais, Dr Muskan Malviya This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6435575/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Depression is a common but often underrecognized comorbidity in individuals with diabetes mellitus. Identifying its prevalence can help in early intervention and better management. Objective To estimate the proportion of depression in patients with diabetes mellitus using the Hamilton Depression Rating Scale (HAM-D) and to evaluate associations with gender, age, diabetes duration, and comorbid conditions. Methods This descriptive cross-sectional study was conducted among 89 diabetic patients attending outpatient services at a tertiary care hospital. Data was collected via structured interviews using the HAM-D questionnaire. A HAM-D score ≥ 8 was considered indicative of depression. Data analysis was conducted using descriptive statistics and subgroup analysis based on gender, age groups, and other variables. Results Among 89 patients, 26 (29.2%) were found to have depression. The prevalence was higher in females (36.8%) compared to males (23.5%). Depression was more frequent in older age groups, particularly among patients aged 60–74 years. [Pie chart and bar graphs to be inserted.] Conclusion A significant proportion of diabetic patients exhibit depressive symptoms, particularly older individuals and females. Routine screening using tools like HAM-D can aid in early identification and intervention. Endocrinology & Metabolism Depression Diabetes Mellitus HAM-D Gender Differences Age Factors Comorbidities Figures Figure 1 Figure 2 Introduction Diabetes mellitus is one of the most prevalent chronic diseases worldwide, affecting an estimated 537 million adults globally. It is associated with a host of complications that not only impact physical health but also contribute to psychological stress. Depression is one such comorbidity that frequently coexists with diabetes. This association may arise due to the chronic nature of diabetes, complex treatment regimens, fear of complications, or financial and social burdens. Patients with both conditions are at risk of poor glycemic control, lower treatment adherence, and worsened quality of life. Despite this known association, depression remains underdiagnosed and undertreated among diabetic individuals, particularly in developing countries like India. There is a growing need to identify and quantify this burden in local populations to initiate early psychological interventions. This study utilizes the Hamilton Depression Rating Scale (HAM-D), a widely accepted clinical tool for assessing depressive symptoms, to explore the prevalence and associated demographic patterns of depression among diabetic patients attending a tertiary hospital. Methodology Study Design : This was a descriptive cross-sectional study designed to assess the proportion of depression among patients with diabetes mellitus. Study Site and Duration : The study was conducted at the Outpatient Department of Rajarajeswari Medical College and Hospital, Bangalore. Data collection took place over a defined period following approval from the Institutional Ethics Committee. Sample Size : A total of 89 patients diagnosed with diabetes mellitus were enrolled based on convenience sampling. The required sample size was calculated using the formula for prevalence studies: n = Z^2. P(1-P)/d^2. Assuming a prevalence (P) of 30% based on prior literature, a confidence level of 95% (Z = 1.96), and a margin of error of 10%, the minimum sample size was estimated to be 81. We included 89 participants, fulfilling the sample size requirement.” Inclusion Criteria : Adults (aged >18 years) diagnosed with diabetes mellitus Attending the outpatient clinic during the study period Provided informed consent Exclusion Criteria : Children less than 18 years of age Pregnant woman Individuals with previously diagnosed psychiatric conditions Patients unwilling to participate Data Collection Procedure : Each participant was interviewed using a structured questionnaire which included demographic data, clinical history including duration of diabetes, comorbid conditions, and the HAM-D scale. The HAM-D is a clinician-administered depression assessment scale with multiple items measuring various symptoms of depression. A total score of ≥ 8 was used as a cutoff to identify the presence of depression. Statistical Analysis : Data were entered into Microsoft Excel and analyzed using descriptive statistics. Frequencies and percentages were used to represent categorical variables. Subgroup analysis was performed to assess the association of depression with gender, age groups, duration of diabetes, and other comorbid conditions. Visual aids like pie charts and bar graphs were generated to better illustrate findings. Results Overall Prevalence : 29.2% (26/89) patients had depression (HAM-D ≥ 8). By Gender : Gender Not Depressed Depressed Total Female 24 14 38 Male 39 12 51 🟠 Depression Rate in Females : 36.8% 🔵 Depression Rate in Males : 23.5% Females: 36.8% depressed (14/38) Males: 23.5% depressed (12/51) Bye Age Group : Age Group Not Depressed Depressed <30 3 0 30–44 16 2 45–59 23 10 60–74 20 13 75+ 1 1 Highest prevalence: 60–74 years (13/33) Discussion The findings of our study indicate that nearly one-third (29.2%) of diabetic patients experienced symptoms of depression as measured by the HAM-D scale. This is consistent with international studies that report comorbidity rates ranging from 20–30% among diabetic populations. The observed higher prevalence in females (36.8%) compared to males (23.5%) aligns with existing literature that highlights gender as a key determinant in depression, potentially due to hormonal fluctuations, psychosocial stressors, and societal roles. Age was another significant factor. The age group 60–74 years showed the highest prevalence, possibly reflecting cumulative health burdens, social isolation, or financial dependency in older adults. Such findings underscore the need for targeted mental health screening among elderly diabetic patients. Moreover, the lack of routine mental health evaluations in primary care and diabetic clinics is a critical gap. This study reinforces the utility of simple tools like the HAM-D in clinical settings. Early detection of depressive symptoms can help initiate timely psychiatric referral, lifestyle counseling, or pharmacological interventions, thereby improving both mental well-being and diabetes management outcomes. While the cross-sectional design limits causality, the results still provide valuable insights for clinicians and health policy makers. Future longitudinal studies with larger sample sizes and multi-center participation are recommended. Conclusion Nearly one-third of diabetic patients in this sample were found to be suffering from depression. Gender and age were significant factors. Addressing depression in diabetes care is crucial for holistic treatment. Declarations Ethical Clearance Approved by the Institutional Ethics Committee (RRMCH-IEC/226/2022). Conflict of Interest None declared. References American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Publishing Anderson RJ, Freedland KE, Clouse RE, Lustman PJ (2001) Prevalence of depression in adults with diabetes: A meta-analysis. Diabetes Care 24(6):1069–1078. https://doi.org/10.2337/diacare.24.6.1069 Ali S, Stone MA, Peters JL, Davies MJ, Khunti K (2006) The prevalence of co-morbid depression in adults with Type 2 diabetes: A systematic review and meta-analysis. Diabet Med 23(11):1165–1173. https://doi.org/10.1111/j.1464-5491.2006.01943.x Eren I, Erdi A, Sahin M (2008) The effect of blood glucose regulation on depression and anxiety in type 2 diabetic patients. Pakistan J Med Sci 24(3):345–350 Hamilton M (1960) A rating scale for depression. J Neurol Neurosurg Psychiatry 23(1):56–62 Kumar P, Verma M (2019) Prevalence of depression and its association with glycemic control in type 2 diabetes patients in India. J Family Med Prim Care 8(3):857–861. https://doi.org/10.4103/jfmpc.jfmpc_44_19 Pouwer F, Kupper N, Adriaanse MC (2010) Does emotional stress cause type 2 diabetes mellitus? A review from the European Depression in Diabetes (EDID) Research Consortium. Diabetologia 53(1):1–9. https://doi.org/10.1007/s00125-009-1586-2 Raval A, Dhanaraj E, Bhansali A, Grover S, Tiwari P (2010) Prevalence and determinants of depression in type 2 diabetes patients in a tertiary care center of western India. Indian J Psychiatry 52(1):47–52. https://doi.org/10.4103/0019-5545.58891 Siddiqui MA, Khan MF, Carole P, Khuwaja AK (2014) Prevalence of depression among patients with type 2 diabetes attending a rural health center in India. Int J Health Sci Res 4(6):110–117 Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6435575","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":442115512,"identity":"0152f71c-bc71-4f02-a58b-366d57cdae69","order_by":0,"name":"Dr Muhammad Unais","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABEklEQVRIiWNgGAWjYFACHjDJ2AAkDjAY/JfjB3ETCojWUsFsLAliJRgQqYWB4Qxz4oYDIAYeLbozcg9+upljJ7vhdvPDgz/b2BI3n1+d+OGBAYM8v9gBrFrMbuQlS+duSzbecOeYwWHeNh7jbTfebpYAOsxw5uwEHFpyDIBagO65kWBwmLFNQnbbjbMbQFoSDG7j1GL8O3dbPVBL+gegwwwYN884u/kHAS1mQFsOA7XkGBzgOZOguIG/dxt+W868MbPO3XbceOaNnILDPBUHjCVu8G6zSDCQwO2X4znGt3O3Vcv23Ujf/PGHwQE5/v6zm2/+qLCR55fGrgULkACrlCBWOQjwHyBF9SgYBaNgFIwAAACPQG369oucRQAAAABJRU5ErkJggg==","orcid":"https://orcid.org/0009-0006-0267-0026","institution":"Rajarajeswari Medical College and Hospital","correspondingAuthor":true,"prefix":"Dr","firstName":"Muhammad","middleName":"","lastName":"Unais","suffix":""},{"id":442115513,"identity":"8a507585-c6c2-4a24-b8e1-bb217130a806","order_by":1,"name":"Dr Muskan Malviya","email":"","orcid":"","institution":"Rajarajeswari medical college and Hospital","correspondingAuthor":false,"prefix":"Dr","firstName":"Muskan","middleName":"","lastName":"Malviya","suffix":""}],"badges":[],"createdAt":"2025-04-12 16:07:34","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-6435575/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6435575/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":80779892,"identity":"eb643cf0-9e4c-4d8d-8c03-95c0d33dea8e","added_by":"auto","created_at":"2025-04-17 04:24:19","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":39501,"visible":true,"origin":"","legend":"\u003cp\u003eUnnumbered image in the Results section.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-6435575/v1/828e9cd75ecad8370544777c.png"},{"id":80780763,"identity":"b7c045e5-d160-47e2-aa29-b13794922008","added_by":"auto","created_at":"2025-04-17 04:32:17","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":35574,"visible":true,"origin":"","legend":"\u003cp\u003eUnnumbered image in the Results section.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-6435575/v1/7a3173e6dcdd47e82bc6cdfb.png"},{"id":80781341,"identity":"381135fc-33da-4fb0-954b-6315e59007c6","added_by":"auto","created_at":"2025-04-17 04:40:17","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":495638,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6435575/v1/21189cb8-8576-4574-ba6f-83d1b0b526e4.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eProportion of Depression in Diabetes Patients: A Cross-Sectional Study Using HAM-D Scale\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eDiabetes mellitus is one of the most prevalent chronic diseases worldwide, affecting an estimated 537\u0026nbsp;million adults globally. It is associated with a host of complications that not only impact physical health but also contribute to psychological stress. Depression is one such comorbidity that frequently coexists with diabetes. This association may arise due to the chronic nature of diabetes, complex treatment regimens, fear of complications, or financial and social burdens. Patients with both conditions are at risk of poor glycemic control, lower treatment adherence, and worsened quality of life.\u003c/p\u003e \u003cp\u003eDespite this known association, depression remains underdiagnosed and undertreated among diabetic individuals, particularly in developing countries like India. There is a growing need to identify and quantify this burden in local populations to initiate early psychological interventions. This study utilizes the Hamilton Depression Rating Scale (HAM-D), a widely accepted clinical tool for assessing depressive symptoms, to explore the prevalence and associated demographic patterns of depression among diabetic patients attending a tertiary hospital.\u003c/p\u003e"},{"header":"Methodology","content":"\u003cp\u003e\u003cstrong\u003eStudy Design\u003c/strong\u003e: This was a descriptive cross-sectional study designed to assess the proportion of depression among patients with diabetes mellitus.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy Site and Duration\u003c/strong\u003e: The study was conducted at the Outpatient Department of Rajarajeswari Medical College and Hospital, Bangalore. Data collection took place over a defined period following approval from the Institutional Ethics Committee.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSample Size\u003c/strong\u003e: A total of 89 patients diagnosed with diabetes mellitus were enrolled based on convenience sampling.\u003c/p\u003e\n\u003cp\u003eThe required sample size was calculated using the formula for prevalence studies:\u003c/p\u003e\n\u003cp\u003en = Z^2. P(1-P)/d^2.\u003c/p\u003e\n\u003cp\u003eAssuming a prevalence (P) of 30% based on prior literature, a confidence level of 95% (Z = 1.96), and a margin of error of 10%, the minimum sample size was estimated to be 81.\u003c/p\u003e\n\u003cp\u003eWe included 89 participants, fulfilling the sample size requirement.”\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInclusion Criteria\u003c/strong\u003e:\u003c/p\u003e\n\u003cul type=\"disc\"\u003e\n \u003cli\u003eAdults (aged \u0026gt;18 years) diagnosed with diabetes mellitus\u003c/li\u003e\n \u003cli\u003eAttending the outpatient clinic during the study period\u003c/li\u003e\n \u003cli\u003eProvided informed consent\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eExclusion Criteria\u003c/strong\u003e:\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eChildren less than 18 years of age\u003c/li\u003e\n \u003cli\u003ePregnant woman\u003c/li\u003e\n\u003c/ul\u003e\n\u003cul type=\"disc\"\u003e\n \u003cli\u003eIndividuals with previously diagnosed psychiatric conditions\u003c/li\u003e\n \u003cli\u003ePatients unwilling to participate\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eData Collection Procedure\u003c/strong\u003e: Each participant was interviewed using a structured questionnaire which included demographic data, clinical history including duration of diabetes, comorbid conditions, and the HAM-D scale. The HAM-D is a clinician-administered depression assessment scale with multiple items measuring various symptoms of depression. A total score of ≥ 8 was used as a cutoff to identify the presence of depression.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical Analysis\u003c/strong\u003e: Data were entered into Microsoft Excel and analyzed using descriptive statistics. Frequencies and percentages were used to represent categorical variables. Subgroup analysis was performed to assess the association of depression with gender, age groups, duration of diabetes, and other comorbid conditions. Visual aids like pie charts and bar graphs were generated to better illustrate findings.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eOverall Prevalence\u003c/strong\u003e: 29.2% (26/89) patients had depression (HAM-D \u0026ge; 8).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eBy Gender\u003c/strong\u003e:\u003c/p\u003e\n\u003ctable border=\"0\" cellpadding=\"0\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eNot Depressed\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eDepressed\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e🟠\u0026nbsp;\u003cstrong\u003eDepression Rate in Females\u003c/strong\u003e: 36.8%\u003cbr\u003e 🔵 \u003cstrong\u003eDepression Rate in Males\u003c/strong\u003e: 23.5%\u003c/p\u003e\n\u003cul type=\"disc\"\u003e\n \u003cli\u003eFemales: 36.8% depressed (14/38)\u003c/li\u003e\n \u003cli\u003eMales: 23.5% depressed (12/51)\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eBye Age Group\u003c/strong\u003e:\u003c/p\u003e\n\u003ctable border=\"0\" cellpadding=\"0\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eAge Group\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eNot Depressed\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eDepressed\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026lt;30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e30\u0026ndash;44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e45\u0026ndash;59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e60\u0026ndash;74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e75+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cul type=\"disc\"\u003e\n \u003cli\u003eHighest prevalence: 60\u0026ndash;74 years (13/33)\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe findings of our study indicate that nearly one-third (29.2%) of diabetic patients experienced symptoms of depression as measured by the HAM-D scale. This is consistent with international studies that report comorbidity rates ranging from 20\u0026ndash;30% among diabetic populations. The observed higher prevalence in females (36.8%) compared to males (23.5%) aligns with existing literature that highlights gender as a key determinant in depression, potentially due to hormonal fluctuations, psychosocial stressors, and societal roles.\u003c/p\u003e \u003cp\u003eAge was another significant factor. The age group 60\u0026ndash;74 years showed the highest prevalence, possibly reflecting cumulative health burdens, social isolation, or financial dependency in older adults. Such findings underscore the need for targeted mental health screening among elderly diabetic patients.\u003c/p\u003e \u003cp\u003eMoreover, the lack of routine mental health evaluations in primary care and diabetic clinics is a critical gap. This study reinforces the utility of simple tools like the HAM-D in clinical settings. Early detection of depressive symptoms can help initiate timely psychiatric referral, lifestyle counseling, or pharmacological interventions, thereby improving both mental well-being and diabetes management outcomes.\u003c/p\u003e \u003cp\u003eWhile the cross-sectional design limits causality, the results still provide valuable insights for clinicians and health policy makers. Future longitudinal studies with larger sample sizes and multi-center participation are recommended.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eNearly one-third of diabetic patients in this sample were found to be suffering from depression. Gender and age were significant factors. Addressing depression in diabetes care is crucial for holistic treatment.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eEthical Clearance\u003c/h2\u003e \u003cp\u003eApproved by the Institutional Ethics Committee (RRMCH-IEC/226/2022).\u003c/p\u003e\u003ch2\u003eConflict of Interest\u003c/h2\u003e \u003cp\u003eNone declared.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAmerican Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Publishing\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAnderson RJ, Freedland KE, Clouse RE, Lustman PJ (2001) Prevalence of depression in adults with diabetes: A meta-analysis. Diabetes Care 24(6):1069\u0026ndash;1078. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.2337/diacare.24.6.1069\u003c/span\u003e\u003cspan address=\"10.2337/diacare.24.6.1069\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAli S, Stone MA, Peters JL, Davies MJ, Khunti K (2006) The prevalence of co-morbid depression in adults with Type 2 diabetes: A systematic review and meta-analysis. Diabet Med 23(11):1165\u0026ndash;1173. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1111/j.1464-5491.2006.01943.x\u003c/span\u003e\u003cspan address=\"10.1111/j.1464-5491.2006.01943.x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEren I, Erdi A, Sahin M (2008) The effect of blood glucose regulation on depression and anxiety in type 2 diabetic patients. Pakistan J Med Sci 24(3):345\u0026ndash;350\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHamilton M (1960) A rating scale for depression. J Neurol Neurosurg Psychiatry 23(1):56\u0026ndash;62\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKumar P, Verma M (2019) Prevalence of depression and its association with glycemic control in type 2 diabetes patients in India. J Family Med Prim Care 8(3):857\u0026ndash;861. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.4103/jfmpc.jfmpc_44_19\u003c/span\u003e\u003cspan address=\"10.4103/jfmpc.jfmpc_44_19\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePouwer F, Kupper N, Adriaanse MC (2010) Does emotional stress cause type 2 diabetes mellitus? A review from the European Depression in Diabetes (EDID) Research Consortium. Diabetologia 53(1):1\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s00125-009-1586-2\u003c/span\u003e\u003cspan address=\"10.1007/s00125-009-1586-2\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRaval A, Dhanaraj E, Bhansali A, Grover S, Tiwari P (2010) Prevalence and determinants of depression in type 2 diabetes patients in a tertiary care center of western India. Indian J Psychiatry 52(1):47\u0026ndash;52. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.4103/0019-5545.58891\u003c/span\u003e\u003cspan address=\"10.4103/0019-5545.58891\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSiddiqui MA, Khan MF, Carole P, Khuwaja AK (2014) Prevalence of depression among patients with type 2 diabetes attending a rural health center in India. Int J Health Sci Res 4(6):110\u0026ndash;117\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Rajarajeswari Medical College and Hospital","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Depression, Diabetes Mellitus, HAM-D, Gender Differences, Age Factors, Comorbidities","lastPublishedDoi":"10.21203/rs.3.rs-6435575/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6435575/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eDepression is a common but often underrecognized comorbidity in individuals with diabetes mellitus. Identifying its prevalence can help in early intervention and better management.\u003c/p\u003e\u003ch2\u003eObjective\u003c/h2\u003e \u003cp\u003eTo estimate the proportion of depression in patients with diabetes mellitus using the Hamilton Depression Rating Scale (HAM-D) and to evaluate associations with gender, age, diabetes duration, and comorbid conditions.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis descriptive cross-sectional study was conducted among 89 diabetic patients attending outpatient services at a tertiary care hospital. Data was collected via structured interviews using the HAM-D questionnaire. A HAM-D score\u0026thinsp;\u0026ge;\u0026thinsp;8 was considered indicative of depression. Data analysis was conducted using descriptive statistics and subgroup analysis based on gender, age groups, and other variables.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eAmong 89 patients, 26 (29.2%) were found to have depression. The prevalence was higher in females (36.8%) compared to males (23.5%). Depression was more frequent in older age groups, particularly among patients aged 60\u0026ndash;74 years. [Pie chart and bar graphs to be inserted.]\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eA significant proportion of diabetic patients exhibit depressive symptoms, particularly older individuals and females. Routine screening using tools like HAM-D can aid in early identification and intervention.\u003c/p\u003e","manuscriptTitle":"Proportion of Depression in Diabetes Patients: A Cross-Sectional Study Using HAM-D Scale","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-04-17 04:24:11","doi":"10.21203/rs.3.rs-6435575/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"fdb1c24f-608f-44bd-8bd0-a87baaafb6a8","owner":[],"postedDate":"April 17th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":47073878,"name":"Endocrinology \u0026 Metabolism"}],"tags":[],"updatedAt":"2025-05-26T08:08:44+00:00","versionOfRecord":[],"versionCreatedAt":"2025-04-17 04:24:11","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6435575","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6435575","identity":"rs-6435575","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}