(18-05-13) The association between diabetes and an episode of depressive symptoms in the 2002 World Health Survey

The association between diabetes and an episode of depressive symptoms in the 2002 World Health Survey: an analysis of 231 797 individuals from 47 countries.

Mommersteeg PM, Herr R, Pouwer F, Holt RI, Loerbroks A.
Source
CoRPS, Center of Research on Psychology in Somatic diseases, Tilburg
University, Tilburg, the Netherlands.
Abstract
AIMS:
Depression is common in people with diabetes and increases the risk of poor
health outcomes, including premature mortality. We explored the association
between diabetes and an episode of depressive symptoms in a cross-sectional
multinational study, which included a large number of low- and middle-income
non-Western countries.
METHODS:
Data from 47 countries of the 2002 World Health Organization World Health
Survey were used, including 231 797 adults (mean age 41 years, 53% female).
Diabetes was assessed by self-report of diagnosis or treatment. The presence of
an episode of depressive symptoms was assessed by self-report using an
algorithm based on DSM-IV criteria. Odds ratios and 95% confidence intervals
were calculated to quantify associations between diabetes and episodes of
depressive symptoms in the entire sample and for countries aggregated into four
continents: Africa, South America, Asia and Europe. Odds ratios were adjusted
for age, sex, education, BMI, smoking and physical activity level.
RESULTS:
The prevalence of diabetes (mean 3.6%, range 0.2-13%) and episodes of
depressive symptoms (mean 7.9%, range 0.4-38%) differed widely across
countries. Globally, individuals with diabetes had increased odds of an episode
of depressive symptoms compared with those without diabetes (adjusted odds
ratio 2.36, 95% confidence interval 1.91-2.92). Similar associations were found
in South America, Asia and Europe (odds ratio > 1.97), but not in Africa (odds
ratio 0.86, 95% confidence interval 0.54-1.37).
CONCLUSIONS:
Globally, diabetes is associated with a twofold increased prevalence of an
episode of depressive symptoms, except in Africa. Given the worldwide rise in
diabetes in the coming decades, and the increased risk of poor diabetes
outcomes associated with co-morbid depression, studies examining mechanisms and
interventions are necessary

Source: Diabet Med. 2013 Mar 21. doi: 10.1111/dme.12193. [Epub ahead of print]

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