Prevalence and associated factors of depression and anxiety in Saudi adults with type 1 diabetes: a cross-sectional study

Background Psychological distress is common in individuals with type 1 diabetes mellitus (T1DM) and can impair adherence to self-care and glycemic control. Limited studies in the Middle East, particularly post-COVID, have comprehensively examined the prevalence and associated factors of depression and anxiety in this population. Materials and methods We conducted a cross-sectional study of 122 Saudi adults with T1DM. Depression and anxiety were assessed using the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder scale (GAD-7). Diabetes self-care activities were evaluated using the Summary of Diabetes Self-Care Activities (SDSCA). Descriptive statistics, chi-square tests, t-tests, ANOVA, Pearson/Spearman correlations, and logistic/linear regression models were applied to examine associations. Results The mean PHQ-9 and GAD-7 scores were 5.8 ± 4.5 and 5.1 ± 4.9, respectively. Overall, 54.9% of participants had depression (37.7% mild, 11.5% moderate, 4.9% moderately severe, 0.8% severe), and 45.1% had anxiety (27.9% mild, 10.7% moderate, 6.6% severe). Females reported significantly higher scores than males for both depression (p = 0.030) and anxiety (p = 0.002). Logistic regression identified high-density lipoprotein (HDL) as an independent predictor of depression (OR 6.60, 95% CI 1.81-24.02, p = 0.004), while female gender (OR 0.36 for males, p = 0.018) and lower self-care adherence (OR 0.63, p = 0.025) independently predicted anxiety. Self-care adherence was inversely correlated with PHQ-9 (r=-0.180, p = 0.047) and GAD-7 scores (r=-0.207, p = 0.022). Conclusion Depression and anxiety were highly prevalent among Saudi adults with T1DM, with female gender, lipid profile, and poor self-care adherence emerging as significant associated factors. Therefore, we recommend integrating systematic mental health screening into diabetes clinic protocols. Collaborative care models that are tailored to the patient involving mental health professionals may enhance outcomes by addressing both medical and psychological needs, particularly in the post-COVID era where psychosocial stressors remain heightened.