Psychological distress and mental disorders among Spanish diabetic adults: a case-control study

To compare the prevalence of psychological distress and mental disorders between diabetes and non-diabetes sufferers and to identify associated factors.

Case-control study based on data from the 2006 to 2007 Spanish National Health Survey. We identified 2193 type 2 diabetic adults. Non-diabetic controls were 1:1 matched by age-and-sex. The presence of a mental disorder was considered if subjects answered yes to the questions: "Have you suffered depression and/or anxiety over the previous 12 months?" AND "Has your medical doctor confirmed the diagnosis?". The 12-item General Health Questionnaire was used to measure psychological distress. Independent covariables included socio-demographics and heath related variables.

Prevalence of mental disorders was 18.6% among diabetics and 16.4% among controls (adjusted OR 1.17 CI 95% 1.01-1.38). 26% of diabetics and 18.9% of the non-diabetic suffered psychological distress (adjusted OR 1.51 CI 95% 1.25-1.83). Among diabetics variables associated with suffering a mental disorder and psychological distress were: female sex, younger age, worse self rated health, comorbidity, GP visit in the last 4 weeks and ER attendance in last year.

Diabetic adults have significantly higher prevalence of diagnosed mental disorders and psychological distress than non-diabetic subjects. Programs targeted at preventing, monitoring and controlling these mental health problems at primary care should be implemented.