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

Lind, Torbjörn; Waernbaum, Ingeborg; Berhan, Yonas; Dahlquist, Gisela

doi:10.1007/s00125-011-2405-0

Cited by 6 publications

(6 citation statements)

References 34 publications

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“…Our study highlights that associations vary by time from diabetes diagnosis, with double the rates of depression within 5 years of diagnosis, but less marked associations subsequently. Our findings support a recent register‐based Swedish study that found young adults with diabetes had a higher risk of being prescribed antidepressants (odds ratio 1.44, 95% CI 1.32–1.58) , although this study predominantly included prevalent cases with average diabetes duration of 18 years, which makes direct comparisons difficult. Subjects with diabetes had elevated depression rates even in the first 5 years after diagnosis (hazard ratio 2.14, 95% CI 1.51–3.03, P < 0.001).…”

Section: Discussionsupporting

confidence: 86%

“…We were, however, unable to adjust for potential confounders such as socio‐economic factors, which in a previous study confounded the association between Type 1 diabetes and depression . However, there is only weak evidence that social class is associated with Type 1 diabetes and, as we matched on practice, our comparisons will to some extent be adjusted for social class.…”

Section: Discussionmentioning

confidence: 95%

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General practice‐recorded depression and antidepressant use in young people with newly diagnosed Type 1 diabetes: a cohort study using the Clinical Practice Research Datalink

2013

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Aims To investigate whether young people with Type 1 diabetes have an increased rate of depression and antidepressant use and whether their risk varies by age group, time from diabetes diagnosis, calendar period of diagnosis or complications status.Methods A cohort of incident cases of patients with Type 1 diabetes diagnosed before 35 years of age (n = 5548) was identified within the Clinical Practice Research Datalink and individually age and sex matched with up to two control subjects without diabetes (n = 10 657). Patients with depression were identified through general practice-recorded depression codes and antidepressant prescriptions. Cox regression models gave hazard ratios for depression in people with Type 1 diabetes compared with control subjects.Results People with Type 1 diabetes were twice as likely to have a record of antidepressant use and general practice-diagnosed depression as their matched control subjects (hazard ratio 2.08, 95% CI 1.73-2.50, P < 0.001). These associations varied by time from diagnosis, with marked increases observed within the first 5 years of diagnosis (hazard ratio 2.14, 95% CI 1.51-3.03, P < 0.001), and by age at diabetes diagnosis, with excesses noted even in the 10-to 19-year age group (hazard ratio 1.45, 95% CI 1.06-1.98, P = 0.02). ConclusionsThis population-based study shows that people with Type 1 diabetes have higher rates of general practice-recorded depression and antidepressant use. The excess is present within 5 years of diabetes diagnosis, suggesting psychological input for patients is warranted in the early years of their condition.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 95%

General practice‐recorded depression and antidepressant use in young people with newly diagnosed Type 1 diabetes: a cohort study using the Clinical Practice Research Datalink

2013

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“…The average effect of T1DM in the study population is estimated to 0.01 (1% increased risk of antidepressant medication usage) with a 95% confidence interval of (−0.002, 0.023). This stands in contrast to earlier findings that have found an increased risk of depression among diabetic adults [46] but supports previous findings from the SCDR [37] where no effect was found when controlling for socioeconomic risk factors. If we ignore the sampling design and apply an equivalent unweighted matching estimator (omitting w i in (13)), the resulting estimate is 0.008 with a 95% confidence interval of (−0.002, 0.019).…”

Section: Estimating the Effect Of Type 1 Diabetes Mellitus On Antidepsupporting

confidence: 79%

“…Several studies have shown an increased risk of depression among individuals with diabetes [34][35][36]. However, in a recently published paper, we found that socioeconomic risk factors, for example, receiving economical or other support or disability pension, explained the differences in antidepressant use between T1DM individuals and controls [37]. Here, we aim to investigate the average causal effect of T1DM on antidepressant medication usage.…”

Section: Estimating the Effect Of Type 1 Diabetes Mellitus On Antidepmentioning

confidence: 93%

Estimating marginal causal effects in a secondary analysis of case-control data

2017

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When an initial case-control study is performed, data can be used in a secondary analysis to evaluate the effect of the case-defining event on later outcomes. In this paper, we study the example in which the role of the event is changed from a response variable to a treatment of interest. If the aim is to estimate marginal effects, such as average effects in the population, the sampling scheme needs to be adjusted for. We study estimators of the average effect of the treatment in a secondary analysis of matched and unmatched case-control data where the probability of being a case is known. For a general class of estimators, we show the components of the bias resulting from ignoring the sampling scheme and demonstrate a design-weighted matching estimator of the average causal effect. In simulations, the finite sample properties of the design-weighted matching estimator are studied. Using a Swedish diabetes incidence register with a matched case-control design, we study the effect of childhood onset diabetes on the use of antidepressant medication as an adult. Copyright © 2017 John Wiley & Sons, Ltd.

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“…We were unable to investigate the effects of socioeconomic factors. In general, low socioeconomic position is associated with increased mental health problems, and has previously been associated with higher depression rates among young patients with IDDM, and low health‐related QOL in young women with pregnancy‐related DVT . Thus, further research exploring socioeconomic factors would be relevant.…”

Section: Study Strengths and Limitationsmentioning

confidence: 99%

Long‐term mental wellbeing of adolescents and young adults diagnosed with venous thromboembolism: results from a multistage mixed methods study

Højen

Sørensen

Dreyer

et al. 2017

Journal of Thrombosis and Haemostasis

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Background Critical and chronic illness in youth can lead to impaired mental wellbeing. Venous thromboembolism (VTE) is a potentially traumatic and life-threatening condition. Nonetheless, the long-term mental wellbeing of adolescents and young adults (AYAS) with VTE is unclear. Objectives To investigate the long-term mental wellbeing of AYAS (aged 13-33 years) diagnosed with VTE. Methods We performed a multistage mixed method study based on data from the Danish nationwide health registries, and semistructured interviews with 12 AYAS diagnosed with VTE. An integrated mixed methods interpretation of the findings was conducted through narrative weaving and joint displays. Results The integrated mixed methods interpretation showed that the mental wellbeing of AYAS with VTE had a chronic perspective, with a persistently higher risk of psychotropic drug purchase among AYAS with a first-time diagnosis of VTE than among sex-matched and age-matched population controls and AYAS with a first-time diagnosis of insulin-dependent diabetes mellitus. Impaired mental wellbeing was largely connected to a fear of recurrence and concomitant uncertainty. Therefore, it was important for the long-term mental wellbeing to navigate uncertainty. The perceived health threat played a more profound role in long-term mental wellbeing than disease severity, as the potential life threat was the pivot which pointed back to the initial VTE and forward to the perception of future health threat and the potential risk of dying of a recurrent event. Conclusion Our findings show that the long-term mental wellbeing of AYAS diagnosed with VTE is negatively affected, and highlights these patients' need for adequate support.

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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

Cited by 6 publications

References 34 publications

General practice‐recorded depression and antidepressant use in young people with newly diagnosed Type 1 diabetes: a cohort study using the Clinical Practice Research Datalink

General practice‐recorded depression and antidepressant use in young people with newly diagnosed Type 1 diabetes: a cohort study using the Clinical Practice Research Datalink

Estimating marginal causal effects in a secondary analysis of case-control data

Long‐term mental wellbeing of adolescents and young adults diagnosed with venous thromboembolism: results from a multistage mixed methods study

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