The Prevalence and Determinants of Anxiety and Depressive Symptoms in Patients with Type II Diabetes Mellitus in Mogadishu, Somalia: A Cross-Sectional Study

Abstract

Purpose: This study aims to determine the prevalence of depression, anxiety, and stress among TIIDM patients in Mogadishu, Somalia, and identify predicting factors, as there is limited research on these disorders in Somalia.
Methods: A hospital-based cross-sectional study was conducted on adult patients with TIIDM from November 2023 to January 2024 at Erdogan Hospital, in the capital city of Somalia. A total of 360 participants were recruited using the systematic sampling technique. Data was collected using questionnaires on sociodemographic, clinical and behavioral characteristics. The depression, anxiety, and stress scale (DASS-21) questionnaire was used to assess symptoms of depression, anxiety, and stress. Bivariate and multivariate logistic regression analyses were performed to identify variables predicted by the outcome variables.
Results: Out of the 360 participants included in this study, 44.7%, 55.0%, and 30.3% had depression, anxiety, and stress symptoms, respectively. A lack of regular exercise (AOR = 1.79; 95% CI: 1.14– 2.79) and an illness duration of 4– 7 years (AOR = 1.94; 95% CI: 1.16– 3.23) were statistically associated with depression. Being female (AOR = 2.07; 95% CI: 1.31– 3.28), having ≥ 9 children (AOR = 1.94; 95% CI: 1.07– 3.53), and a lack of regular exercise (AOR = 1.57; 95% CI: 1.01– 2.45) were statistically associated with anxiety. A lack of regular exercise (AOR = 2.07; 95% CI: 1.31– 3.28), having DM complications (AOR = 2.14; 95% CI: 1.01– 4.54), an illness duration of 4– 7 years (AOR = 2.22; 95% CI: 1.25– 3.94), and DM management non-compliance (AOR = 2.74; 95% CI: 1.20– 6.26) were statistically associated with stress.
Conclusions: This study found that TIIDM patients had moderately high rates of depression, anxiety, and stress symptoms, with a lack of physical activity associated with increased odds of depression, anxiety, and stress symptoms. Healthcare workers should screen for psychological symptoms, provide interventions, monitor sedentary patients, and encourage adherence to treatment and physical exercise to reduce mental health burden.

Keywords: type II diabetes mellitus, depression, anxiety, stress, Mogadishu, Somalia