T1DM is defined as a chronic disease characterized by hyperglycemia as a result of inadequate production of insulin by the pancreas. This occurs due to autoimmune destruction of the β cells in the islets of Langerhans (10) which is triggered in genetically susceptible individuals by environmental factors.(11)
Maintaining an appropriate glycemic control is important to prevent long term complications of …show more content…
(145,146) Depressed mood occurs in some psychiatric syndromes such as major depressive disorder,(146) but it may also be a normal reaction, if not persist for a long duration, to some life events such as bereavement, a side effect of some drugs and medical treatments or it may occur as a symptom of some diseases.
Depression screening tools include (e.g., Beck Depression Inventory [BDI],(172) The Center for Epidemiologic Studies Depression Scale (CES-D) (173), and The Hospital Anxiety And Depression Scale (HADS).(174)
The Hospital Anxiety and Depression Scale (HADS) was developed by Zigmond and Snaith. It consists of 14 items of which 7 to assess anxiety and 7 to assess depression. Responses are rated on a four-point Likert scale score (0 -3), where the lowest level of anxiety and depression is represented by 0 and 3 represents the highest level.
Scores for each subscale (anxiety and depression) range from 0 to 21 and
Scores for the entire scale ,which are used to measure emotional distress, range from 0 to 42, with higher scores indicating more