Depression and All-Cause and Coronary Heart Disease Mortality Among Adults With and Without Diabetes

Abstract

OBJECTIVE -The aim of this study was to evaluate the effect of depression on all-cause and coronary heart disease (CHD) mortality among adults with and without diabetes.RESEARCH DESIGN AND METHODS -We studied 10,025 participants in the population-based National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study who were alive and interviewed in 1982 and had complete data for the Center for Epidemiologic Studies Depression Scale. Four groups were created based on diabetes and depression status in 1982: 1) no diabetes, no depression (reference group); 2) no diabetes, depression present; 3) diabetes present, no depression; and i4) diabetes present, depression present. Cox proportional hazards regression models were used to calculate multivariate-adjusted hazard ratios (HRs) of death for each group compared with the reference group.RESULTS -Over 8 years (83,624 person-years of follow-up), 1,925 deaths were documented, including 522 deaths from CHD. Mortality rate per 1,000 person-years of follow-up was highest in the group with both diabetes and depression. Compared with the reference group, HRs for all-cause mortality were no diabetes, depression present, 1.20 (95% CI 1.03-1.40); diabetes present, no depression 1.88 (1.55-2.27); and diabetes present, depression present, 2.50 (2.04 -3.08). HRs for CHD mortality were no diabetes, depression present, 1.29 (0.96 -1.74); diabetes present, no depression 2.26 (1.60 -3.21); and diabetes present, depression present, 2.43 (1.66 -3.56).CONCLUSIONS -The coexistence of diabetes and depression is associated with a significantly increased risk of death from all causes, beyond that due to having either diabetes or depression alone.

Relationship of depression screening in cardiometabolic disease with vascular events and mortality: findings from a large primary care cohort with 4 years follow-up

“…In our study, patients with positive depression screening were more likely to have adverse outcomes, this is consistent with previous evidence which shows increased risk of mortality and cardiovascular related outcomes in patients with depression co-morbid with CHD (31), diabetes (32) and history of previous stroke (33). The potential influence of antidepressant prescribing on the findings of our study remains unclear.…”

Epidemiology of depression in diabetes: International and cross-cultural issues

“…Depression has been proposed to exert an additive effect in those with diabetes (Egede et al, 2005). A large scale study separated 10,025 participants into four groups according to whether they had depression or diabetes or not.…”

Primary Care Physician Perceptions on Caring for Complex Patients with Medical and Mental Illness

“…2 Mental illness significantly affects outcomes in patients with other chronic medical illnesses. [3][4][5][6][7][8][9][10] The concept of patient complexity, which encompasses the influences of multiple chronic diseases, demographic factors, and psychosocial issues on disease outcomes, 11,12 could prove helpful in understanding the interplay between co-occurring mental and medical illness. Although researchers have studied the deleterious effect of mental illness on medical illnesses, the experiences of providers and the clinical context in which they work to care for complex patients need further elucidation.…”