Abstract
OBJECTIVES: The effect of depression or suicidal ideation on health-related quality of life (HRQoL) in diabetic individuals has not been thoroughly investigated. The purpose of this research was to investigate the influence of suicidal ideation and depression on HRQoL in diabetic patients. METHODS: This study is based on data from 5543 diabetic patients who participated in the US National Health and Nutrition Examination Survey (2005-2018). Diabetes was defined according to the criteria established by the American Diabetes Association and self-report questionnaires. Depression, including its severity, and suicidal ideation were evaluated using the Patient Health Questionnaire-9 (PHQ-9). HRQoL was assessed using the Centers for Disease Control and Prevention HRQoL-4 to evaluate physical health, mental health, days of activity limitation and general health status. Logistic and linear regression models were employed to examine the association of HRQoL of diabetic patients with depression and suicidal ideation. Sensitivity analysis determined the stability of the results. RESULTS: 661 reported depression and 265 reported suicidal ideation, with prevalence rates of 11.9% and 4.8%, respectively. After controlling for demographic factors, risk behaviors, and comorbidities, the PHQ-9 score, as well as depression and its severity, in addition to suicidal ideation, showed a strong association with decreased general health status, more physically and mentally unhealthy days, and activity limitation days for individuals suffering from diabetes (p < 0.05). CONCLUSIONS: In individuals with diabetes, a decrease in HRQoL is linked to suicidal ideation and depression. Healthcare providers are advised to incorporate concise depression screening evaluations, like the two-question PHQ, into their discussions with diabetic patients. If these screenings indicate elevated depression symptoms, it is advisable to recommend psychological referrals. However, since this study employs a cross-sectional design, it is unable to establish the causal relationships among these factors. Further prospective longitudinal studies are essential to address this limitation. CLINICAL TRIAL NUMBER: Not applicable.