Female sex, young and old age, northern German residency, high HbA1c and insulin use predict depressed mood in 35,691 T2D patients
2015
Background and aims: A bidirectional relationship between type 2 diabetes
(T2D) and depressive symptoms has been reported. The primary
aim was to analyze predictors of depressed mood in T2D. Secondly, the
odds ratio of developing a clinically recognized depression in patients
with conspicuous screening result was evaluated.
Materials and methods: 35,691 T2D patients aged ≥18 years (median
[IQR]: 68.9 [59.2-76.5] years) from the German/Austrian multicenter
prospective diabetes follow-up registry (DPV) were analyzed. All patients
had completed the WHO-5 questionnaire, a reliable and validated
5-item screening tool for depression (score ≤7: likely depression). Logistic
regression modeling (SAS 9.4) was applied to study potential predictors
(e.g. demographics, regional aspect, diabetes therapy, glycemic
S414 Diabetologia (2015) 58 (Suppl 1):S1–S607
control) for depressed mood as well as the risk of developing clinically
recognized depression.
Results: Depressed mood was present in 11.2% (n=4,000) of patients
screened and thereby significantly more prevalent compared to the adult
German population (DEGS study: 8.1%, p<0.001). Patients with likely
depression had a later diabetes onset (60.5 [49.6-70.2] vs. 58.3 [49.1-
67.7] years, p<0.001) and were more often female (54.0 vs. 48.0%, p<
0.001) compared to patients with inconspicuous results. Duration of diabetes
did not differ significantly between groups (7.6 [2.4-12.9] vs. 7.0
[2.1-13.5] years, p=0.76). Young and very old age as well as female sex
were associated with depressed mood (table 1, model 1). Moreover, living
in northern federal states of Germany, poor glycemic control (HbA1c
≥58 mmol/mol) and insulin treatment were significantly related to depressed
mood in T2D (table 1). Overall, the odds of developing a clinical
diagnosis of depression was 1.95 (95%CI: 1.66-2.29) times higher in
patients scored ≤7 in the WHO-5 questionnaire.
Conclusion: Depressed mood is a frequent psychological comorbidity in
adult T2D patients. In clinical care, routinely screening for psychological
problems as recommended by guidelines is absolutely advisable, especially
in high-risk patients.
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