TYPE 2 DIABETES MELLITUS, EXACERBATION OF PERSONALITY CHANGES CHARACTERISTICS

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TYPE 2 DIABETES MELLITUS, EXACERBATION OF PERSONALITY

CHANGES CHARACTERISTICS

Mardiev Otabek Asriddinovich

Assistant of the Department of Psychiatry, Medical Psychology and Narcology

Samarkand State Medical University, Samarkand, Uzbekistan

Abstract.

This article describes a high level of polymorphism of mental

disorders in patients who are resorting to preventive institutions in the div.

According to the WHO, more than half of patients with moderate to severe somatic

diseases have some kind of mental illness. High prevalence of somatic and mental

disorders, chronic course, polyethiology, polymorphism make diabetes the most

appropriate model for the study and systematization of mental disorders in somatic

patients.

Key words

: diabetes, personality change, polymorphism, quality of life,

metabolic, neuroticism.

Diabetes is a heterogeneous disease that can lead to severe diseases that have

a significant emotional impact. The International Diabetes Federation (IDF)

estimates that in 2017, about 425 million adults between the ages of 2 and 79 had

diabetes, and that number is estimated to increase to 629 million by 2045 [1].

Although diabetes is an international health crisis, its prevalence is growing faster

in low-and middle-income countries [2].

In recent decades, research has focused on mental disorders associated with

diabetes. People with diabetes may have twice the incidence of anxiety and

depressive disorders. These mood disorders are associated with Suboptimal diabetic

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self-care, unhealthy behavior, high hba1c, and other Suboptimal metabolic rates

[4,5,6].

Evidence suggests a double link between diabetes, anxiety, and depressive

disorders. Patients with anxiety symptoms may have an increased risk of developing

Type 2 diabetes and vice versa [7]. The development of anxiety disorders in patients

with diabetes can be facilitated by various factors, including personal and family

history, stressful life events, drug use, and somatic diseases [7]. Diabetes and

depression can be similar or stem from General etiology, or having one condition

can increase the prevalence of another [8]. Risk factors that can contribute to the

development of depression in patients with diabetes are personal and family history,

stressful life events, domestic violence, physical illnesses, and clinical factors

[8,9,10,11]. Personality traits and quality of life (CF) may affect the development

and severity of mental illness in diabetic patients, but this has not been extensively

studied.

The purpose of the study.

To study the features of the comorbid course of

anxiety, depressive disorders and personality pathology in people with Type 2

diabetes.

Research materials and methods.

The study used cross-sectional design.

Sample size was calculated based on previous estimates of depression prevalence

and overall anxiety disorder in patients with diabetes [13, 14]. The required sample

size was 92 people. The average age of the participants was 52 ± 3.4 years all

participants who were diagnosed with depression and anxiety disorders were sent to

the dispensary Department of the Samarkand Regional Psychiatric Hospital for

further examination.

Clinical variables include disease history, diabetes history (onset, type, and

application of insulin therapy), div mass index (BMI), and self-assessment in

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diabetes management (assessed using a five-point Likert scale). The data from the

survey was supplemented with a review of the medical records of patients, if

necessary. In addition, participants were assigned a seven-part general anxiety

disorder scale (GAD-7) to assess anxiety prevalence, A Beck-II depression survey

(BDI-II), a big five survey (BFI) to assess depression prevalence. To assess personal

qualities and the quality of life of the World Health Organization-BREF

(WHOQOL-BREF) to measure the quality of life (QOL).

Research results.

Most of the participants were diagnosed with Type 2

diabetes (n = 69; 75%) and gestational diabetes (n = 23; 25%). The average duration

of diabetes was 14 years, with an average hba1c measurement of 7.6%. Almost half

of the participants received insulin therapy (n = 44; 47.8%).

A study with GAD-7 found that only a small percentage of participants

experienced anxiety (9%, n = 8), while BDI-II screening showed that a relatively

large proportion of participants suffered from depression (84.7%; n = 78). In the BFI

assessment, the median of extraversion was 3.38, compliance was 3.78,

conscientiousness was 3.67, neuroticism was 2.50, and openness was 3.30. The

Whoqol - BREF study found that the average assessment for physical health was

14.29, psychological assessment was 15.33, social relationship assessment was

16.00, and environmental assessment was 15.00.

There are four demographics associated with depression (p <0.25). for

example, age, work status, family income, and regular religious practice. There was

no meaningful correlation between social traits and depression among participants.

Some clinical features, personality traits, and life quality components are associated

with depression. Variables associated with depression include self-assessment in

diabetes management, anxiety, overall perception of quality of life, overall health

perception, physical quality of life, psychological quality of life, social quality of

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Life, Environmental Quality, extraversion, politeness, conscientiousness, and

neuroticism, as well as the interaction between perceived social support and

neuroticism.

Depressed participants with high levels of neuroticism were more likely to

have anxiety. Conversely, low likelihood of anxiety was associated with high

psychological scores and high conscientiousness rates in the quality of life survey.

Other demographic characteristics, personality traits, and components of quality of

life were not important predictors of anxiety among participants. The logistic

regression model reported that Cox and Snell's R2 was 0.29 (p <0.001), Hosmer-

Lemeshow's compromise criteria were not significant (p = 0.843), and the area under

the Roc curve (AUC) was 0.949 (95%). CI = 0.912-0.986, p <0.001), which indicates

an acceptable model fit to differentiate participants from the presence and absence

of anxiety.

The only clinical factor associated with high capacity. depression was anxiety,

which increased the frequency of depression by almost 20 times. Conversely, older,

higher quality of life in terms of physical health, and higher social quality of life

were associated with a lower likelihood of developing depression. The approximate

management of diabetes, other demographic characteristics, personal characteristics

and components of quality of life did not reliably predict depression among

participants. The logistic regression model Cox and Snell's R2s showed acceptable

model consistency to differentiate participants from the presence and absence of

depression.

The ADAPT-DM study aims to identify the prevalence and associated factors

of depression and anxiety in patients with diabetes mellitus. Our results show that

neuroticism and depression increase the likelihood of developing anxiety by almost

12 and 10 times, respectively. The good psychological quality of life and high

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consciousness protected it from anxiety, which reduced it by half (0.47 and 0.45

times, respectively). In our study, the occurrence of depression significantly

increased the likelihood of anxiety. The positive relationship between depression

and anxiety is well documented in chronic diseases, and the occurrence of depression

can increase the risk of anxiety symptoms in patients with chronic diseases [8,9].

This correlation is expected because some theories suggest that anxiety and

depression have the same neurobiological mechanism, in which they represent

different phenotypic manifestations that occur in constancy. The high quality of life

associated with physical health and the high quality of life associated with social

relationships reduced the occurrence of depression by 0.69 and 0.84 times,

respectively. First, this study was carried out in one specialized medical center.

Therefore, it is impossible to convey the results to all diabetic residents of the

country. Second, the cross-design of the study fails to determine the causal

relationship between related factors, depression, and anxiety. Thirdly, symptoms of

depression and anxiety were measured by self-assessment tools rather than

diagnostic interviews, which could affect the reliability of classifying participants

into depressive and anxious groups. Fourth, chronic pain is a common symptom in

patients with diabetes mellitus, and it often coexists and interacts with anxiety and

depression in these people.

Conclusions.

Comorbid depression and high neuroticism increased the

likelihood of developing anxiety. The high psychological quality of life and high

conscientiousness prevented the appearance of anxiety. Shared anxiety has increased

the likelihood of developing depression, older age, higher quality of life associated

with physical health, and higher quality of life associated with social relationships

have protected against depression.

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Our findings suggest that personality traits and quality of life screening are

necessary to manage anxiety and depression for a holistic approach to treating

diabetes.

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