Prevalence of depression, anxiety, and stress among internally displaced diabetic patients: Cross-sectional study, Kassala State, Sudan

The recent ongoing Sudanese Armed Forces Conflict since 2023(SAFC2023) has led to substantial displacement of citizens. Displacement often causes psychological disorders of depression, anxiety, and stress (DAS). The DAS disorders could worsen the control of chronic diseases. Diabetes is one of the diseases that DAS could critically influence. Awareness about the prevalence of DAS among internally displaced diabetic patients (IDDPs) is crucial for mitigating the worsening of diabetes control. This study aimed to assess the prevalence of DAS among IDDPs during the SAFC2023. A total of 141 DDPs were included in this cross-sectional study conducted from July to August 2024 in eastern Sudan (Kassala State). An adapted and modified structured DAS questionnaire, comprising 21 questions (ADASQ-21), was used for data collection, with dichotomous open closed answers (Yes or No). The findings revealed a mean age of 48.5±17.3 years, with males accounting for 53.2%. University (36.1%) and secondary (35.5%) education levels are the most dominant. Most participants (49.6%) had a middle-income. However, the overall prevalence of DAS was 40.9% (depression 36.1%, anxiety 35.0%, and stress 51.6%). Remarkably, the prevalence rate is strikingly high compared to global reports (22.1%) in similar contexts. Moreover, the DAS severity grouping revealed a mild/moderate threshold to be most for depression (66.0%), and Stress (60.3%). In comparison, anxiety emerged with severe levels in 44.0% of patients. Nevertheless, the Chi-square test (χ2) revealed a statistically insignificant association and no differences in DAS prevalence between socio-demographic groups. However, the gender factor showed statistically significant differences with anxiety and depression (t-test, p=0.010 and p=0.023, at α=0.05, respectively). These findings among IDDPs highlighted the need for targeted psychological rehabilitation interventions, strengthening community support links, and encouraging policies to support displaced diabetic patients. Furthermore, the finding is scientific evidence for integrating psychological clinics into healthcare settings for better diabetes control among IDDPs.