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Does diabetes double the risk of depression?
Patrick J O'Connor1, A Lauren Crain, William A Rush
1HealthPartners Research Foundation, Minneapolis, Minnesota, USA. Patrick.J.OConnor@healthpartners.com
Annals of Family Medicine
|July 15, 2009
Summary
Diabetes patients do not have an increased risk of depression when controlling for primary care visits. Previous studies may have overlooked this crucial factor, leading to inaccurate associations.
Area of Science:
- Medical research
- Clinical epidemiology
Background:
- Diabetes mellitus is a prevalent chronic condition.
- The association between diabetes and depression is complex and debated.
- Previous studies suggest a link, but may not adequately control for healthcare utilization.
Purpose of the Study:
- To compare depression diagnosis rates in adults with and without diabetes mellitus.
- To specifically control for the number of primary care visits in the analysis.
Main Methods:
- Matched cohort study design.
- Inclusion of incident and prevalent diabetes cases (n=17,076).
- Matching with non-diabetic controls based on age, sex, and outpatient visit frequency.
- Logistic regression analysis to assess depression risk.
Main Results:
- When controlling for age and sex only, prevalent diabetes patients with few visits showed higher depression diagnosis rates (OR=1.46).
- This association diminished with more primary care visits.
- After additional matching for visit frequency, the association between prevalent diabetes and depression was weaker and reversed with more visits (OR=0.99).
- Similar trends were observed for incident diabetes.
Conclusions:
- Diabetes patients show little to no increased risk of new depression diagnoses when primary care visits are carefully controlled.
- Inadequate adjustment for healthcare exposure may explain previously reported associations between diabetes and depression.
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