Prevalence of mental disorders and related functioning and treatment engagement among people with diabetes

To examine prevalence, functioning and treatment associated with all DSM-5 12-month mood, anxiety, eating and substance use disorders among people with diabetes in data obtained from the National Epidemiologic Survey on Alcohol and Related Conditions-III.

Through multistage stratified randomized sampling a sample representative of the United States civilian population was obtained. Prevalence of diabetes (Type 1 and 2), DSM-5 disorders, physical and mental functioning, and treatment utilization were assessed via telephone interview. Analyses of weighted data (N=36,138) included calculation of descriptive statistics, and chi-square, logistic and linear regression analyses.

Participants with (vs. without) diabetes (9.3% of weighted sample) had a significantly: (a) higher prevalence of any anxiety disorder and posttraumatic stress disorder (with and without adjustment for sociodemographic characteristics), and any mood disorder, major depressive disorder and specific phobia (with adjustment), (b) lower prevalence of any substance use disorder and alcohol and tobacco use disorders (with and without adjustment), and cannabis use disorder (without adjustment). Among participants with diabetes, mental disorder prevalence was consistently associated with sex and age, and to a lesser frequency, race/ethnicity. Lower levels of physical and mental functioning were found among participants with diabetes and a comorbid mental disorder. A minority of participants with diabetes and a comorbid mental disorder received treatment for mood and anxiety disorders, and few received treatment for eating and substance use disorders.

Multiple types of mood, anxiety, eating and substance use disorders are prevalent, problematic, and often untreated among people with diabetes.