Abstract
BackgroundPrevious studies assessing the relationship between depression and diabetes mellitus did not consider the severity of depression. In the present study we assessed the risk of developing type 2 diabetes mellitus (T2DM) among people with various severity of depression.MethodsThis prospective longitudinal cohort study included 9,936 individuals residing in Stockholm County, Sweden who responded to the baseline questionnaire in 1998–2000. The participants were followed from 1 year after the baseline up to 2015 for the occurrence of T2DM, using the National Patient Register, Swedish Prescribed Drug Registers, and Cause of Death Register. Depression and anxious distress were assessed using psychiatric rating scales and defined according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).ResultsDepression was associated with a statistically significant increased risk of T2DM after adjusting for potential confounders (OR 1.48, CI 1.10, 1.99). The strongest association was observed for severe depression (OR 1.72, CI 1.15, 2.59). Further, those with depression, regardless of severity, and with concurrent moderate/severe anxious distress had an increased risk of T2DM (OR 1.73, CI 1.13, 2.63) compared to those with neither depression nor anxious distress.ConclusionsThe study adds evidence that depression is associated with a higher risk for developing T2DM, and the association is stronger among people with severe depression.
Highlights
Previous studies assessing the relationship between depression and diabetes mellitus did not consider the severity of depression
Depression was in the crude model associated with future risk of type 2 diabetes mellitus (T2DM) and after adjustment for potential confounders, the association was statistically significant (1.48, confidence intervals (CI) 1.10, 1.99) (Table 2, model 3)
Participants who had severe depression had a higher risk for T2DM (1.72, CI 1.15, 2.59) after adjustment for potential confounders (Table 2, model 3)
Summary
Previous studies assessing the relationship between depression and diabetes mellitus did not consider the severity of depression. In the present study we assessed the risk of developing type 2 diabetes mellitus (T2DM) among people with various severity of depression. Additional to several well known risk factors for developing T2DM, such as obesity, physical inactivity, sedentary lifestyle, and high fat intake, it has been suggested that depression plays a role for an increased risk of T2DM [4, 5]. This has previously been shown in meta-analyses [5,6,7,8]. It has been known that depression with anxious symptoms is associated with poorer health outcomes [15].In this population-based cohort study, we aimed to assess the association between depression and anxious distress and the risk of T2DM and to assess the association of severity of depression and concomitant symptoms of anxious distress
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