Article

The Association of Comorbid Depression With Mortality in Patients With Type 2 Diabetes

Department of Psychiatry and Behavioral Sciences, University of Washington Seattle, Seattle, Washington, United States
Diabetes Care (Impact Factor: 8.42). 12/2005; 28(11):2668-72. DOI: 10.2337/diacare.28.11.2668
Source: PubMed

ABSTRACT

We assessed whether patients with comorbid minor and major depression and type 2 diabetes had a higher mortality rate over a 3-year period compared with patients with diabetes alone.
In a large health maintenance organization (HMO), 4,154 patients with type 2 diabetes were surveyed and followed for up to 3 years. Patients initially filled out a written questionnaire, and HMO-automated diagnostic, laboratory, and pharmacy data and Washington State mortality data were collected to assess diabetes complications and deaths. Cox proportional hazards regression models were used to calculate adjusted hazard ratios of death for each group compared with the reference group.
There were 275 (8.3%) deaths in 3,303 patients without depression compared with 48 (13.6%) deaths in 354 patients with minor depression and 59 (11.9%) deaths among 497 patients with major depression. A proportional hazards model with adjustment for age, sex, race/ethnicity, and educational attainment found that compared with the nondepressed group, minor depression was associated with a 1.67-fold increase in mortality (P = 0.003), and major depression was associated with a 2.30-fold increase (P < 0.0001). In a second model that controlled for multiple potential mediators, both minor and major depression remained significant predictors of mortality.
Among patients with diabetes, both minor and major depression are strongly associated with increased mortality. Further research will be necessary to disentangle causal relationships among depression, behavioral risk factors (adherence to medical regimens), diabetes complications, and mortality.

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    • "According to two meta-analyses (Knol et al. 2006; Nouwen et al. 2010) diabetic subjects have 24 % increased risk of developing depression and depressed adults have 37 % higher risk of developing diabetes, which is even higher with the long term use of antidepressants (Khoza et al. 2012). In diabetes, depression can exacerbate outcomes as depressed diabetics have poor self-management , rarely adhere to prescribed medications, miss preventive measurements, avoid therapy appointments and skip regular exercise (Lin et al. 2004; Ludman et al. 2004; Katon et al. 2005). Moreover, in diabetes, depression is found to be a significant risk factor for cardiovascular disorders, contributing in every step in the continuum from diabetes to heart diseases (Singh et al. 2015) and predicts higher mortality (van Dooren et al. 2013). "

    Full-text · Dataset · Jan 2016
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    • "According to two meta-analyses (Knol et al. 2006; Nouwen et al. 2010) diabetic subjects have 24 % increased risk of developing depression and depressed adults have 37 % higher risk of developing diabetes, which is even higher with the long term use of antidepressants (Khoza et al. 2012). In diabetes, depression can exacerbate outcomes as depressed diabetics have poor self-management , rarely adhere to prescribed medications, miss preventive measurements, avoid therapy appointments and skip regular exercise (Lin et al. 2004; Ludman et al. 2004; Katon et al. 2005). Moreover, in diabetes, depression is found to be a significant risk factor for cardiovascular disorders, contributing in every step in the continuum from diabetes to heart diseases (Singh et al. 2015) and predicts higher mortality (van Dooren et al. 2013). "

    Full-text · Dataset · Jan 2016
    • "Over 80% of patients seen by a family doctor experience emotional and social difficulties, in addition to physical health ailments (Bikson, McGuire, Blue-Howells, &amp; Seldin-Sommer, 2009). Mental health comorbidities such as depression and anxiety along with chronic medical conditions such as hypertension, cardiac disease or diabetes (Ai, Rollman, &amp; Berger, 2010;Culpepper, 2002) contribute to significantly more patient somatic complaints and impairment compared to chronic conditions without comorbid mental health symptoms (Katon et al., 2005;Parker, Wilson, Vandenberg, DeJoy, &amp; Orpinas, 2009). Further, anxiety and depression increase awareness of physical symptoms (Waghorn, 2009). "
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