Diabetes and depression? Secular trends in the use of antidepressants among persons with diabetes in Finland in 1997–2007

Abstract

The association between diabetes and depression is well demonstrated. Less is known about the trends in use of antidepressants in the rapidly growing population of diabetics. We examined trends in antidepressant medication use during 1997-2007 in Finland among persons with or without diabetes using register-based data on both diabetes and antidepressant use. The diabetes population was obtained from the FinDM II database including 50,027 persons with insulin treated (ITDM) and 346,290 persons with non-insulin treated diabetes (NITDM) identified from several administrative registers. Data on persons without diabetes were obtained from the yearly population statistics and their antidepressant use from the register for refunded prescription medicine costs covering all medicine purchases of non-institutionalised residents. Differences in trends and prevalence were examined using the binomial regression model. Antidepressant use was more common among persons with diabetes in all age groups and each study year among both genders (prevalence ratios (RR) 1.4-2.2 for women and 1.7-2.2 for men). Prevalence was both higher (RR 2.0-2.2 women, 1.9-2.2 men), and increased more rapidly among younger persons with NITDM. The use of register data linked using unique personal identifiers allowed us to identify a total cohort of persons with diabetes, to separate between ITDM and NITDM patients and to examine patterns of antidepressant use in populations with and without diabetes during an 11 year study period. Our results suggest that more attention should be focused on psychological well-being in those with diabetes and especially young people in risk of type 2 diabetes.