Abstract
BACKGROUND : Diabetes Mellitus (DM) and depression share a bidirectional association- both influencing each other in multiple ways with depression increasing the risk of incidence of diabetes and diabetes increasing the risk of subsequent depression. Both diabetes and depression are associated with increased risk of cognitive decline. Less attention has been given to the effect of diabetes on cognitive function which is not a well-recognized complication of diabetes. AIMS: 1.To assess the cognitive function in persons with Type 2 Diabetes Mellitus with depressive disorder and without Depressive Disorder. 2.To assess the cognitive performance in a healthy control group and compare with the subjects with Type 2 Diabetes Mellitus with depressive disorder and without Depressive Disorder. METHODS: The present study is a cross-sectional observational study ,consisted of 3 study groups,patients with diabetes mellitus and depression (n = 35),only diabetes mellitus (n = 35) and healthy controls(n=35).Participants were assessed clinically and cognitively using the Mini International Neuropsychiatric Interview (6.0), Hamilton Depression Rating Scale(HAM-D) ,Global Assessment of Functioning Scale (GAF), Hindi Mental Status Examination (HMSE) , NIMHANS Neuropsychology Battery- 2004 and a questionnaire about sociodemographic data and were analysed across cognitive domains of attention, speed, executive functioning, comprehension, visuospatial orientation, learning and memory. RESULTS : The study participants were of age between 18 to 60 years comprising of both male and female. The study showed that patients with both DM and depression had more cognitive dysfunction compared with the group who only had DM. The study also showed significant difference in the cognitive domains when compared between the control group and the DM with depression group. Also significant difference was found when compared between the control group and the DM only group. CONCLUSION : Multipronged interaction between depression and diabetes makes the management of these more challenging. Despite the close relationship between DM,depression and their synergistic effect on cognitive decline, the awareness amongst the medical professionals as well as the public seems to be minimal. Alleviating depressive symptoms in these patients has a positive impact on improving their cognitive, mental as well as physical functioning. Increased awareness about this and timely psychiatrist consultation would help in better care in these group of patients.