Key Points
Question
To what extent are established cardiovascular risk factors associated with risk of venous thromboembolism (VTE)?
Findings
In this analysis of individual participant data from the Emerging Risk Factors Collaboration and the UK Biobank including 1.1 million participants, among a panel of several established cardiovascular risk factors, older age, smoking, and greater adiposity were consistently associated with higher VTE risk.
Meaning
There is overlap in at least some of the major population determinants of important venous and arterial thrombotic diseases.
Aims
To determine (1) the prevalence of SubD states among adults with diabetes, and (2) whether evidence exists of an independent association between diabetes status and SubD, controlling for selected confounders.
Methods
Data from the 2007–2012 National Health and Nutrition Examination Surveys were combined to estimates of depressive states by diabetes status among the noninstitutionalized U.S. adult population, and to assess the association of diabetes status and depressive states using a polytomous logistic regression model.
Results
An estimated 17%, or 3.7 million, of U.S. adults with diabetes (diagnosed and undiagnosed) met criteria for either mD or ssD. The majority of SubD cases with diabetes were found to be ssD (10.1%) compared with mD (6.9%). After controlling for the effects of age, sex, race and ethnicity, education, body mass index, and poverty as covariates, an independent association persists between diagnosed diabetes and each SubD grouping (ssD: OR = 1.82, CIs 1.33, 2.47; mD: OR = 1.95, CIs 1.39, 2.74) compared with respondents having no diabetes. No association was found between depression and undiagnosed diabetes or prediabetes compared with those having no diabetes.
Conclusion
Milder forms of depression such as ssD and mD are more extant than major depressive episodes among adults with diabetes. The odds that an adult with diagnosed diabetes meets the criteria for ssD or mD are higher by 80% and 95%, respectively, after controlling for age, sex, race and ethnicity, education, body mass index, and poverty factors when compared against adults with no diabetes.
A529ants (from 1 in Turkey to 30 in Switzerland), costs spent for mental health (% from healthcare) also differ significantly from 2 % (Bulgaria) to almost 14 % (UK). Average European costs for pharmacotherapy (ATC groups N3-N7) is 25 Euro/capita (2013 data); from 6 € in Russia to 57 € in Switzerland. Since 2009 the penetration of atypical antipsychotics steadily increases across Europe from 48 % among all antipsychotics (2009) to 56 % (2013). We however found differences in individual countries (46 % penetration in Slovenia; 69 % penetration in Hungary). The average annual European consumption of antidepressants is 18 units per capita (2 units in Russia; 42 units in the UK). SSRIs represent approximately 50 % of all antidepressants in the majority of countries. Penetration of pharmacotherapy for dementia (ATC group N7D1) is poor across Europe except Finland and Greece. In almost all countries it is below 50 % if a hypothetical common prevalence of 1.17 % is assumed. ConClusions: Our findings indicate unequal access, treatment penetration and allocation of financial resources across 29 evaluated European countries.
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