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

Anxiety and depression often coexist in patients with chronic diseases. We evaluated the nutritional status of diabetic patients and its relationship to anxiety and depression.

Demographic, clinical information (disease duration, treatment, hospitalization), 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.Twenty-four hour food diaries were obtained to determine daily energy and nutrient intake.

Among the 222 patients in this study, rates of anxiety, depression, and anxious depression were 23.8%, 21.6%, and 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 ratio, and waist/height ratio. Being married, engaging in regular exercise, and increased vitamin B6 were inversely related to anxiety and depression. According to food records, patients with anxiety and depression consumed a higher proportion of energy from dietary carbohydrates. Anxiety and depression scores were negatively related to dietary energy, protein, fat, vitamins (retinol, group B, C, and D), and mineral (K, Mg, P, Fe, Zn, Cu) intake.

Maintaining healthy body weight, complying with medication/insulin treatment, and engaging in regular exercise may help in the prevention of anxiety and depression in hospitalized diabetic patients in Turkey. Alternatively, anxiety and depression may adversely affect body weight, compliance with treatment, and regular exercise. Prospective studies are needed to determine the direction of causation.