Relationship between statin use and depression among diabetic patients in Seremban: a cross-sectional study

INTRODUCTION: Statins are one of the most commonly used drugs in primary care. Both hyperlipidaemia and diabetes have independently shown statistically significant association with depression. Conversely, patients with depression have also been shown to have increased comorbidity with and poorer control of both diabetes and hyperlipidaemia.

MATERIALS AND METHODS: A retrospective cross-sectional study was conducted for about 7 months (from 23 January 2024 to 9 August 2024) among adult Type 2 diabetic patients in the non-communicable disease section of Seremban Health Clinic to determine the association between statin use and depression. The data was collected via interviewerguided questionnaire that consisted of 5 sections: Section A (Participant Information), Section B (Depression, Anxiety and Stress Scale 21 [DASS-21]), Section C (Beliefs about Medicines Questionnaire [BMQ]), Section D (Malaysia Medication Adherence Assessment Tool [MyMAAT]) and Section E (Patient Health Questionnaire-9 [PHQ-9]). Consecutive patients that met inclusion and exclusion criteria who consent to be involved in the study were sampled. Although the ideal sample size that was required is 242, only 82 participants were enrolled in this study. These participants were also part of the Seremban Diabetes cohort study.

RESULTS: Since only 82 participants consented to be part of this study, the response rate was 33.9%. About 25% of patients had depression. As the statin dosage intensity increased, the prevalence of depression also increased but this was not statistically significant. Based on Pearson's chi square test, only stress (p<0.001), anxiety (p=0.002), beliefs about medicines (p=0.010) and marital status (p=0.039) had a statistically significant association with depression. Upon adjusted logistic regression of the 4 factors (marital status, stress, anxiety and belief about medicines), only stress (OR 14.000, 95% CI 2.682 - 73.076, p=0.002) was statistically significant.

CONCLUSION: The association between depression and statin use among patients with Type 2 diabetes mellitus is not statistically significant. Further studies are needed to confirm the cause of depression in this group of patients.