The association between self-care activities and depression in adult patients with type 2 diabetes in Taif City: a crosssectional study

Background: Depression is a common comorbidity in individuals with type 2 diabetes and can significantly affect self-care behaviors, leading to poor health outcomes. Objectives: To examine the association between depression and diabetes self-care activities among adults with type 2 diabetes in Taif City, Saudi Arabia. Methods: A cross-sectional study was conducted at a specialized diabetes center in Taif on 354 adults with type 2 diabetes. Depression severity was assessed using the Patient Health Questionnaire (PHQ-9), while selfcare behaviors were evaluated using the Summary of Diabetes Self-Care Activities (SDSCAs). Results: Depression was identified in 21.2% of participants, with a mean PHQ-9 score of 6.62 ± 5.44. While 90.7% demonstrated adequate self-care practices, depression was significantly associated with lower adherence to physical activity recommendations. Patients with higher depression scores engaged in fewer self-care behaviors overall, though the strongest negative correlation was observed between depression and physical activity levels (r = -0.32, p < 0.001). Non-smoking was the only independent predictor of better self-care, highlighting the role of lifestyle factors in diabetes management. Unemployment, lower education, and diabetes complications were associated with poorer self-care adherence. Conclusion: Depression significantly affects self-care behaviors, particularly physical activity, among adults with type 2 diabetes. Integrating mental health support into routine diabetes care, alongside lifestyle interventions such as physical activity promotion and smoking cessation, may improve self-care outcomes. Future research should focus on longitudinal and intervention studies to develop culturally tailored care models.