The burden of common mental disorders and their association with diabetes in rural Bangladesh: findings from a population-based cross-sectional study

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Background: Type 2 diabetes mellitus (T2DM) and common mental disorders (CMDs), including depression and anxiety, are significant public health challenges, particularly in low- and middle-income countries (LMICs). However, evidence on the distribution and associations between T2DM and CMDs in rural LMIC populations remains limited. We aimed to examine this relationship in a sample of adults from rural Bangladesh. Methods: In this cross-sectional study, we analysed baseline data from a cluster-randomised controlled trial conducted in rural Faridpur, Bangladesh in 2021. A total of 1392 randomly sampled adults aged ≥30 years participated in the original trial. Here, we identified T2DM through fasting glucose levels and post-glucose load results, or self-reported healthcare diagnosis. We assessed depression and anxiety using the Bangla versions of the Patient Health Questionnaire and Generalized Anxiety Disorder 7 scales. Among others, we also collected data on sociodemographic factors. We assessed the prevalence of different CMDs and T2DM, and estimated the association between the two through multivariate logistic regression adjusted for sociodemographic variables. Results: We found a prevalence of 6.0% for depression, 4.0% for anxiety, and 2.2% for the comorbid depression and anxiety. Compared to those without T2DM, participants with T2DM had higher odds of having depression (adjusted odds ratio (aOR) = 1.93; 95% confidence interval (CI) = 1.37-2.73) and comorbid depression and anxiety (aOR = 1.99; 95% CI = 1.13-3.50). No significant association was found between T2DM and anxiety (aOR = 1.38; 95%CI = 0.87-2.19). Age, marital status, and employment also influenced CMD risk. Conclusions: There is a significant association between T2DM, depression, and comorbid depression and anxiety in rural Bangladesh, with gender potentially playing a modifying role. Integrated, gender-sensitive care models addressing both mental health and diabetes are essential in rural healthcare settings.

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