03227nas a2200361   4500000000100000008004100001653001000042653002800052653001500080653001500095653003000110653001100140653001100151653001800162653000900180653001600189653002600205653001000231653002000241653003100261653003000292100001400322700001300336700001600349700001900365700001200384245013000396856007800526300001300604490000700617520222700624022001402851       2015                            d10aAdult10aCross-Sectional Studies10aDemography10aDepression10aDiabetes Mellitus, Type 210aFemale10aHumans10aLinear Models10aMale10aMiddle Aged10aMultivariate Analysis10aNepal10aQuality of Life10aSurveys and Questionnaires10aWorld Health Organization1 aMishra SR1 aSharma A1 aBhandari PM1 aBhochhibhoya S1 aThapa K00aDepression and Health-Related Quality of Life among Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study in Nepal.  uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4658137/pdf/pone.0141385.pdf  ae01413850 v103 a<p><strong>BACKGROUND: </strong>Diabetes is accompanied by a marked reduction in patient's quality of life (QOL) and leads to higher disability-adjusted life years than most diseases. Depression further deteriorates QOL and is associated with poor treatment outcomes and lowered glycemic control in diabetes. We analysed the QOL and depression among the people living with diabetes in Nepal.</p>

<p><strong>METHODS: </strong>We conducted a cross-sectional survey among a random sample of 157 diabetic patients visiting diabetes clinic at a major teaching hospital in Kathmandu, Nepal. We administered the Nepali version of WHO-BREF for face to face interviews to obtain data on QOL scores. The Nepali version of Patient Health Questionnaire-9was also used to record responses on depression items.</p>

<p><strong>RESULTS: </strong>More than half of the respondents (54.1%) experienced depression with mean PHQ-9 score of 6.15 ± 5.01 on a scale of 0-27. On a scale of 0 to 100, highest QOL mean score was reported in social relationship domain (57.32 ± 11.83), followed by environment domain (54.71 ± 7.74), psychological health (53.25 ± 10.32) and physical health (50.74 ± 11.83). After adjusting for other covariates, urban residence decreased the physical health score by 4.74 (β = -4.74, 95% CI: -8.664,-0.821), social relationship domain score by 3.420 (β = -3.420, 95% CI: -6.433,-0.406) and the overall QOL by 2.773 (β = -2.773, 95% CI: -5.295,-0.252). Having diagnosed with diabetes since more than 10 years increased physical health by 5.184 score points (β = 5.184; 95% CI: 0.753, 9.615).Similarly, having severe depression decreased social relation domain score by 6.053 (β = -6.053, 95% CI:-11.169,-.936).</p>

<p><strong>CONCLUSION: </strong>Having urban residence significantly decreased the physical health and social relation domain scores as well as the overall QOL scores. Similarly, having diagnosed since more than 10 years increased physical health domain score. Severe depression decreased social relationship domain score. Since depression affects QOL, we suggest early diagnosis and prompt treatment of depression in T2DM people as part of their routine primary care in Nepal.</p>
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