Notre étude avait pour objectifs d’estimer la prévalence des symptômes dépressifs chez les sujets âgés diabétiques et d’étudier leurs stratégies de coping.

Il s’agissait d’une étude transversale, descriptive et analytique, réalisée auprès de 50 sujets âgés suivis pour diabète de type 2. Nous avons utilisé l’échelle « Activity of Daily Living » pour évaluer le degré de dépendance, la « Geriatric Depression Scale » pour le dépistage des symptômes dépressifs et le « Brief Coping with Problems Experienced » pour l’évaluation des stratégies de coping.

Le score « Activity of Daily Living » moyen était de 4,9. Les patients étaient autonomes dans 28 %, et dépendants dans 4 % des cas. Le score « Geriatric Depression Scale » moyen était de 9,7. Parmi nos patients, 34 % avaient des symptômes dépressifs. Une corrélation significative était mise en évidence entre la présence de symptômes dépressifs et le tabagisme (p=0,04), l’absence d’activité de loisir (p=0,035), les antécédents personnels psychiatriques (p=0,031), le score ADL (p=0,028), l’ancienneté du diabète (p=0,04) et la présence d’idée suicidaire (p=0,013). La stratégie de coping la plus mise en place était celle centrée sur le problème (44 %). Les sujets présentant des symptômes dépressifs étaient significativement plus susceptibles d’adopter des stratégies de coping centrées sur l’émotion (p=0,01).

Notre étude confirme la prévalence élevée de symptômes dépressifs chez les sujets âgés diabétiques. Ainsi, un dépistage régulier d’une éventuelle dépression ainsi qu’un accompagnement psychologique sont fortement recommandés, afin d’assurer un meilleur équilibre du diabète et d’améliorer la qualité de vie.

Elderly patients with diabetes have been shown to have more diabetes-related complications, and they are more likely to develop somatic and psychiatric comorbidities including cognitive dysfunction and depression. Several studies have shown a close association between diabetes and depression. This comorbidity may lead to functional disability and quality of life deterioration. Thus, the elderly will face various constraints through the coping strategies. In this context, we conducted our study to assess the prevalence of depressive symptoms in elderly patients with diabetes as well as its associated factors, and to investigate their coping strategies.

We conducted a cross-sectional, descriptive and analytic study among 50 elderly patients (age≥65 years) being followed for type 2 diabetes at the outpatient department for chronic diseases of the Regional Hospital of Aguereb, Sfax, Tunisia. We used the “Activity of Daily Living” to assess the dependence level, the “Geriatric Depression Scale” to screen for depressive symptoms, and the “Brief Coping with Problems Experienced” to investigate the coping strategies.

The mean age of patients was 73.3 years, with a sex-ratio (M/F) of 0.62. Smoking and alcohol consumption were reported respectively in 20% and 4% of participants. The mean duration of diabetes was 7.7 years. Diabetes complications were noted in 70% of participants. Somatic comorbidities were noted in 94% of cases (hypertension 84%; dyslipidemia 34%). Psychiatric histories were reported in 18% of patients who suffered from anxio-depressive symptoms. No patient among those with mental disorder histories benefited from any psychiatric management prior to the study. Three patients (6%) had previously presented suicidal ideations but none of them had attempted suicide. The mean “Activity of Daily Living” score was 4.9 points. Patients were autonomous in 28%, and dependent in 4% of cases. The mean “Geriatric Depression Scale” score was 9.8 points. According to this scale, the prevalence of depressive symptoms was 34%. They were correlated with: smoking (P=0.04), psychiatric histories (P=0.031), absence of leisure activity (P=0.035), “Activity of Daily Living” score (P=0.028), long duration of diabetes (P=0.04) and the presence of suicidal ideation (P=0.013). According to the « Brief Coping with Problems Experienced », the problem-focused coping strategies were the most frequently used (44%), followed by emotion-focused (38%) and passive strategies (18%). Participants with depressive symptoms are significantly more likely to adopt emotion-focused coping strategies (P=0.01).

Our study highlighted a high prevalence of depressive symptoms among elderly patients with diabetes. This relationship seems to be bi-directional and may increase somatic complications and alter the quality of life, and then darken the prognosis. Thus, besides pharmacological treatment, regular depression screening and psychological support are essential to ensure a better control of diabetes and to improve well-being.