Hindawi Publishing Corporation Depression Research and Treatment Volume 2013, Article ID 341782, 6 pages http://dx.doi.org/10.1155/2013/341782 Clinical Study Prevalence and Impact of Anxiety and Depression on Type 2 Diabetes in Tunisian Patients over Sixty Years Old Jawaher Masmoudi, 1 Rahma Damak, 1 Hela Zouari, 2 Uta Ouali, 1 Anouar Mechri, 3 Nouri Zouari, 2 and Abdelaziz Jaoua 1 1 Department of Psychiatry A, University Medical Center H´ edi Chaker, 3000 Sfax, Tunisia 2 Department of Functional Exploration and Metabolic Diseases, University Medical Center Habib Bourguiba, 3000 Sfax, Tunisia 3 Department of Psychiatry, University Medical Center Fattouma Bourguiba, 5000 Monastir, Tunisia Correspondence should be addressed to Rahma Damak; d rahma@live.com Received 14 February 2013; Revised 27 May 2013; Accepted 30 May 2013 Academic Editor: H. Grunze Copyright © 2013 Jawaher Masmoudi et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objectives. To estimate the prevalence of anxiety and depression using the Hospital Anxiety and Depression Scale (HADS) in a population aged over sixty years with type 2 diabetes and to study the impact of anxiety and depression on glycemic balance and disease outcome. Results. Te prevalence of anxiety and depression in the 62 subjects included in the study was, respectively, 40.3% and 22.6%. We found a relationship between these disorders and complicated diabetes. Te subjects having an imperfectly balanced diabetes had a higher average anxiety score than those having a good glycemic control (9.1 ± 4.2 versus 6.5 ± 3.1;  = 0.017). No relationship was found between diabetes balance and depression. Conclusion. Association between anxiety and depressive disorders and diabetes is frequent and worsens patients’ outcome, in terms of diabetes imbalance as well as in terms of diabetic complications. Our study shows that there is need for physicians to detect, confrm, and treat anxiety and depressive disorders in elderly diabetic patients. 1. Introduction In Tunisia, the proportion of individuals over 60 years is increasing, and it reached 9% in 2004 [1]. Diabetes is a major public health problem in Tunisia. Its prevalence has increased steadily and is currently about 9.9% [2]. Prevalence increases with age (11.9% for 60 years or older) [3, 4]. In addition, depression and anxiety, at the top of mental disorders list, mainly remain undiagnosed [5, 6], in particular in the elderly [7, 8] and consequently untreated [9]. Studying the link between diabetes and depressive as well as anxiety disorders in elderly subjects is useful for several reasons. First, diabetes as well as depression constitutes a major source of functional incapacity, and thus of loss of autonomy, in the elderly population [10]. Second, the association of these two pathologies in the same person worsens total health outcome [11] and quality of life [6, 12]. Finally, this association increases health care expenditures [11] and mortality [13]. Te aim of this study is to estimate the prevalence of anxiety and depression in a population of elderly subjects aged over sixty sufering from type 2 diabetes and to study the impact of anxiety and depression on glycemic control and the evolution of the disease. 2. Methods We undertook a descriptive and analytical cross-sectional study on 62 patients who have consulted during September and October 2010 at the Department of Functional Explo- rations and Metabolic Diseases of Habib Bourguba University Hospital, Sfax, Tunisia. Recruitment was carried out on an ad hoc basis. Te patients included were those who had agreed to take part in the investigation and who were 60 years old or over. We used this age limit because under Tunisian law, 60 is the retirement age. Exclusion criteria were the incapacity to answer the questions because of cognitive deterioration and refusal to take part in the study.