Psychological status of sudanese diabetic patients during armed conflict: a multi-city cross-sectional study

The armed conflict that erupted in Khartoum, Sudan, on 15 April 2023 rapidly expanded to multiple states, leading to widespread disruption of healthcare services and chronic disease management. Patients with diabetes mellitus are particularly vulnerable due to their need for continuous medication and care in fragile settings. A community-based, multi-source cross-sectional study was conducted among Sudanese adults with type 1 or type 2 diabetes from Khartoum and Gezira states during 2024. Psychological status was assessed using the Depression Anxiety Stress Scale-21 (DASS-21). Reporting followed STROBE guidelines. Associations between conflict-related variables and psychological outcomes were tested using chi-square and Fisher’s exact tests, with p < 0.05 considered significant. A total of 117 participants were included (response rate: 41.05%). Most participants were female (57.26%), aged > 50 years (66.67%), and displaced (87.18%). High levels of severe and extremely severe anxiety, depression, and stress symptoms were observed (36.75%, 28.21%, and 78.63%, respectively). Displacement was significantly associated with anxiety ( p = 0.04) and stress symptoms ( p = 0.012). These associations remained unadjusted and may be influenced by confounding factors. Sudanese patients with diabetes mellitus exposed to the ongoing armed conflict experienced substantial psychological distress, with high levels of depression, anxiety, and stress symptoms reported. Displacement was significantly associated with increased anxiety and stress symptoms.