Relationship between nutritional status, anxiety, and depression in hospitalized diabetic patients in Turkey

Abstract

Background Anxiety and depression often coexist in patients with chronic diseases. We evaluated the nutritional status of diabetic patients and its relationship with anxiety and depression. Methods Demographic, diabetic information (disease duration, treatment, hospitalization) information and anthropometric measurements (weight, height, waist, and hip circumference) were recorded. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression. 24-h food records were obtained to determine daily energy and nutrient intake. Results In this study of 222 patients, the rates of anxiety, depression and anxious depression were 23.8%, 21.6%, 12.2%, respectively. Those who skipped medication/insulin doses and did not exercise regularly had significantly higher anxiety and depression scores. Anxiety and depression scores were positively correlated with disease duration, waist circumference, waist/hip, and waist/height. Being married, engaging in regular exercise, and increased vitamin B6 consumption were inversely related to anxiety and depression. According to food records, patients with anxiety and depression have a higher proportion of energy from dietary carbohydrates. Anxiety and depression scores were negatively related to dietary energy, protein, fat, some vitamin (retinol, group B, C, and D), and mineral (K, Mg, P, Fe, Zn, Cu) intake. Conclusions Maintaining healthy body weight, compliance with medication/insulin treatment, and regular exercise may help in the prevention of anxiety and depression in hospitalized diabetic patients. Alternatively, anxiety and depression may adversely affect body weight, compliance with treatment, and engaging in regular exercise. Prospective studies are needed to determine the direction of causality.