Prevalence of Major Depression, Simple Phobia, and Other Psychiatric Disorders in Patients With Long-standing Type I Diabetes Mellitus

Popkin, Michael K.; Callies, Allan L.; Lentz, Richard D.; Colón, Eduardo A.; Sutherland, David E.R.

doi:10.1001/archpsyc.1988.01800250078010

Cited by 213 publications

(123 citation statements)

References 26 publications

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“…In a systematic review of studies (26) that have specifically addressed depression in adults with T1D published through 2004 (14 studies, mostly small Ns), the reported prevalence of depression ranged from 10.7 (27) to 43.3% (28). In this study, 4.6 (algorithm method) to 10.3% (cutoff of 10) of adult participants with T1D could be classified as probable major depression.…”

Section: Discussionmentioning

confidence: 99%

“…Our finding is low compared with earlier T1D studies; however, significant differences exist. The other studies assessed small homogenous samples (N = 75, 60, and 487), young or old populations, and each used different depression measures (27)(28)(29). Our sample was large and heterogeneous and used a measure of depression with reported sensitivity and specificity of 88% (19).…”

Section: Discussionmentioning

confidence: 99%

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Depression in Adults in the T1D Exchange Clinic Registry

et al. 2014

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OBJECTIVELittle is known about the frequency of depression in adults with type 1 diabetes (T1D) or its relationship to diabetes outcomes. The T1D Exchange clinic registry allowed us to explore depression in a large, heterogeneous sample. RESEARCH DESIGN AND METHODSParticipants ‡18 years old (N = 6,172; median age 34 years; median diabetes duration 16 years; 55% female; and 89% non-Hispanic white) completed the eight-item Patient Health Questionnaire (PHQ-8), a validated, reliable measure of current depression. Probable major depression was defined in four ways: PHQ-8 ‡10, PHQ-8 ‡12, per diagnostic algorithm, and as a continuous variable. Characteristics and clinical outcomes of those with and without depression were compared using logistic and linear regression models. RESULTSA total of 4.6-10.3% of participants were classified as probable major depression depending on how defined. Participants classified as depressed were more likely female, nonwhite race/ethnicity, to have a lower household income and lower education level, to exercise less often, to miss insulin doses, and to have one or more complications (neuropathy, nephropathy, treatment for retinopathy, or cardiovascular/cerebrovascular disease) (all P < 0.01). HbA 1c was higher in the depressed versus not depressed groups (8.4 6 1.7% [68 6 8.6 mmol/mol] vs. 7.8 6 1.4% [62 6 15.3 mmol/mol]; P < 0.001). Occurrence of one or more diabetic ketoacidosis events (11 vs. 4%; P < 0.001) and one or more severe hypoglycemic events (18 vs. 9%; P < 0.001) in the past 3 months was higher among depressed participants. CONCLUSIONSIn the T1D Exchange clinic registry, adults with probable major depression have worse clinical outcomes than those not depressed. Whether identification and treatment of depression improves diabetes outcomes requires study. Depression is common in T1D, and better identification and treatment of this comorbid condition is needed.The prevalence of depression is almost two times higher in persons with diabetes than it is in the general population (1-3). Not only do persons with diabetes have an increased risk of developing depression (4), but persons with depression have an increased risk of developing diabetes (5), which may relate to their use of antidepressants (6) or other biological or psychosocial factors associated with diabetes. Depression in diabetes is a particular concern because it is associated with poorer glycemic control (7) and regimen adherence (8), greater morbidity and mortality

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Depression in Adults in the T1D Exchange Clinic Registry

et al. 2014

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“…Few studies have related the prevalence of depression in type 1 diabetes to that in controls. Popkin et al [7] found that the prevalence of depression among individuals with longstanding type 1 diabetes awaiting pancreas transplantation was 10.7% compared with 2.9% in their firstdegree relatives (and potential donors) [7]. Furthermore, in adults with new onset type 1 diabetes, the prevalence of depression was twice that of controls [8].…”

Section: Introductionmentioning

confidence: 99%

Socioeconomic factors, rather than diabetes mellitus per se, contribute to an excessive use of antidepressants among young adults with childhood onset type 1 diabetes mellitus: a register-based study

et al. 2011

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“…Clinical and subclinical expressions of depression are present in Ͼ25% of patients with type 1 or type 2 diabetes (6)(7)(8)(9)(10)(11)(12)(13)(14) and have adverse effects on functioning and quality of life (15,16). The existing literature is not consistent and clear with regard to the association between depression and poor glycemic control.…”

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confidence: 99%

Depression and poor glycemic control: a meta-analytic review of the literature.

et al. 2000

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Hyperglycemia has been linked to the development of diabetic complications (1). Treatments that lower blood glucose levels reduce the risks of retinopathy, neuropathy, and nephropathy in patients with type 1 (2,3) or type 2 (4,5) diabetes. Accordingly, maintenance of good glycemic control is the focus of diabetes therapy, and the importance of other clinical factors is judged largely in relation to their effects on this parameter.Clinical and subclinical expressions of depression are present in Ͼ25% of patients with type 1 or type 2 diabetes (6-14) and have adverse effects on functioning and quality of life (15,16). The existing literature is not consistent and clear with regard to the association between depression and poor glycemic control. Such an association would suggest the possibility that depression treatment might have favorable effects on diabetic outcomes. We surveyed the scientific literature, identified studies that measured the association of depression (either by symptoms or the diagnosis) with glycemic control, and performed a metaanalysis to assess the reliability and strength of any association. RESEARCH DESIGN ANDMETHODS -Medline and PsycINFO were used to locate studies published in the last 25 years that reported the association of depression with glycemic control in adult diabetic subjects. The reference lists of these articles were examined to identify additional studies, and this led to the consideration of several unpublished papers and manuscripts. Inclusion and exclusion criteriaStudies were limited to adult participants (Ն18 years of age), to those that assessed glycemic control using a measure of glycohemoglobin (denoted as GHb within this article) (17,18), and to those that measured depression and GHb coincident to the study evaluation. Studies with Ͻ25 patients, those neither published nor available in English, and those that ascertained only a history of depression were excluded. Subjects in the included studies were patients diagnosed with type 1 or type 2 diabetes; studies of subjects with impaired glucose tolerance, borderline diabetes, or gestational diabetes were not considered. Studies were included without regard to the way the depression-glycemic control association was tested. In some studies, depression was the independent variable and glycemic control the dependent variable. Other studies used the reverse approach, and some reported only the correlation between the 2 variables.Study procedures and statistical analysis Study characteristics were recorded, and the studies were categorized by methodology. Type of diabetes and method of depression assessment were recorded, and effect sizes (ESs) were examined in relation to these factors. The diagnosis of depression (major depressive disorder) was established by using structured or semistructured clinical interviews and the diagnostic criteria in use at the time of the study (e.g., American Psychiatric Association' s Diagnostic and Statistical Manual of Mental Disorders [19,20] Depression and Poor Glycemic ControlA meta-an...

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Prevalence of Major Depression, Simple Phobia, and Other Psychiatric Disorders in Patients With Long-standing Type I Diabetes Mellitus

Cited by 213 publications

References 26 publications

Depression in Adults in the T1D Exchange Clinic Registry

Depression in Adults in the T1D Exchange Clinic Registry

Socioeconomic factors, rather than diabetes mellitus per se, contribute to an excessive use of antidepressants among young adults with childhood onset type 1 diabetes mellitus: a register-based study

Depression and poor glycemic control: a meta-analytic review of the literature.

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