Evaluation of depressive symptoms and their association with diabetes self-care among patients with Type 2 Diabetes Mellitus in Jouf Region, Saudi Arabia

Type 2 Diabetes Mellitus (T2DM) is a global health problem. Cognitive and emotional aspects, such as depressive symptoms, influence patients' ability to engage in self-care and maintain optimal diabetes management. To determine the frequency of depressive symptoms and their association with diabetes self-care, as well as related demographic and clinical characteristics, among patients with T2DM in the Jouf region. A hospital-based cross-sectional study was conducted among patients attending diabetes clinics at regional health centers in Jouf, Saudi Arabia. Participants completed validated Arabic versions of the 9-item Patient Health Questionnaire (PHQ-9) to measure depressive symptoms and the 16-item Diabetes Self-Management Questionnaire (DSMQ) to assess self-care behaviors. Demographic, clinical, and metabolic data (BMI, HbA1c, lipid profile) were extracted. Analyses included descriptive statistics, Spearman correlations, chi-square tests, and logistic regression using SPSS v25. The final sample included 283 patients (mean age 56 ± 11 years; 61.5 % female). Clinically significant depressive symptoms (PHQ-9 ≥ 10) were reported in 39.9 % of participants. DSMQ self-care classification showed 0.7 % with poor, 67.5 % with moderate, and 31.8 % with good self-care. Depression scores were inversely correlated with DSMQ scores ( r = −0.469, p < 0.001). Multivariate regression identified family history of diabetes (OR = 6.24; p < 0.001), lower DSMQ scores (OR = 0.52; p < 0.001), and combination therapy with OHAs plus insulin (OR = 0.39; p = 0.007) as significant predictors of depressive symptoms. Elevated triglycerides were marginally associated ( p = 0.051). Depressive symptoms are common among patients with T2DM and strongly associated with poorer diabetes self-care. Screening, education programs, and integrated care models that combine metabolic and psychological interventions are essential to improve outcomes.