Association of Depressive Symptoms With Impaired Glucose Regulation, Screen-Detected, and Previously Known Type 2 Diabetes

Mäntyselkä, Pekka; Korniloff, Katariina; Saaristo, Timo; Koponen, Hannu; Eriksson, Johan G.; Puolijoki, Hannu; Timonen, Markku; Sundvall, Jouko; Kautiainen, Hannu; Vanhala, Mauno

doi:10.2337/dc10-1044

Cited by 38 publications

(42 citation statements)

References 24 publications

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“…Since Nouwen et al's meta-analysis, two further studies have reported the prevalence of depressive symptoms in undiagnosed diabetes. In a study from Finland, a higher prevalence of depressive symptoms was found in previously diagnosed diabetes but not in undiagnosed diabetes or in those with impaired glucose regulation in comparison to people with normal glucose metabolism (Mäntyselkä et al, 2011). In contrast, undiagnosed diabetes and impaired glucose tolerance was associated with a modestly increased higher prevalence of depressive symptoms in a large population-based study of more than 23,000 people in southern India (Poongothai et al, 2010).…”

Section: Prevalence Of Depression In Undiagnosed Diabetesmentioning

confidence: 92%

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

Lloyd¹,

Roy²,

Nouwen³

et al. 2012

Journal of Affective Disorders

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This paper reviews the most up-to-date epidemiological evidence of the relationship between depression and diabetes, and considers the risk factors for the development of depression and the consequences of depression in diabetes with an emphasis on international and cross-cultural data. The difficulties that researchers face when epidemiological studies require assessment of psychological phenomena, such as depression, across different cultural settings are explored. Methods:Relevant papers were sought on the epidemiology of diabetes and depression in people with diabetes by undertaking a literature search of electronic databases including MEDLINE, Psych-INFO, CINAHL and EMBASE. These papers were assessed by the authors and a narrative review of the relevant literature was composed.Results: Systematic reviews of the prevalence of depression in people with diabetes have focused on studies conducted in English speaking countries and emerging data suggest that there may be international variations in prevalence and also in how symptoms of depression are reported. There appears to be a bi-directional relationship between depression and diabetes, with one influencing the other; however, research in this area is further complicated by the fact that potential risk factors for depression in people with diabetes often interact with each other and with other factors. Further research is needed to elucidate the causal mechanisms underlying these associations. Limitations:Data from non-English speaking countries remain scarce and so it is difficult to come to any firm conclusions as to the international variation in prevalence rates of comorbid diabetes and depression in these countries until further research has been conducted. Conclusion:It is important to take a culture-centered approach to our understanding of mental health and illness and has outlined some of the key issues related to the development of culturally sensitive depression screening tools. In order to come to any firm conclusions about the international variation in prevalence of co-morbid diabetes and depression, issues of culture and diversity must be taken into account prior to conducting international epidemiological studies.

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Section: Prevalence Of Depression In Undiagnosed Diabetesmentioning

confidence: 92%

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

Lloyd¹,

Roy²,

Nouwen³

et al. 2012

Journal of Affective Disorders

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“…That is, is receiving a diagnosis of diabetes and the accompanying clinical recommendations to substantially change lifestyle (i.e., diet, exercise, alcohol use), rather than the state of chronic hyperglycemia, the “depressogenic” element in this comorbidity. A recent meta-analysis found that the prevalence of elevated depressive symptoms among persons with undiagnosed diabetes or prediabetes is lower than the prevalence among those with diagnosed diabetes (Nouwen et al, 2011), although the majority of these studies did not account for key confounders (e.g., race/ethnicity, health behaviors, comorbidity), which previous reports have demonstrated can substantially influence this association (Mäntyselkä et al, 2011). This limitation is important because recent evidence from epidemiologic studies has indicated that in the context of high levels of stress, engaging in poor health behaviors (i.e., alcohol use, smoking, poor diet) is associated with lower risk of depression for some groups (Jackson, Rafferty, & Knight, 2010; Mezuk et al, 2010), suggesting that efforts to modify health behaviors in stressful, socially disadvantaged contexts without feasible alternative coping behaviors may have the perverse consequence of increasing risk of depression.…”

mentioning

confidence: 99%

Is ignorance bliss? Depression, antidepressants, and the diagnosis of prediabetes and type 2 diabetes.

Mezuk¹,

Johnson-Lawrence²,

Lee³

et al. 2013

Health Psychology

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Objective To examine the association between clinically identified and undiagnosed prediabetes and Type 2 diabetes with depression and antidepressant medication use. Methods Data come from the National Health and Nutrition Examination Study (2005 and 2007), a population-based cross-sectional survey. Analysis is limited to adults aged 30 and older (n = 3,183, Mean age = 52.1 year). Depression syndrome was measured by the Patient Health Questionnaire-9. Participants were categorized using fasting glucose levels as normoglycemic (glucose <100 mg/dL), undiagnosed prediabetes (glucose 100–125.9), clinically identified prediabetes (glucose 100–125.9 plus clinician diagnosis), undiagnosed Type 2 diabetes (glucose >126), and clinically identified Type 2 diabetes (glucose >126 plus clinician diagnosis or use of antidiabetic medications). Health behaviors included smoking, poor diet, excessive alcohol use, and obesity. Health promotion behaviors included efforts to change diet, lose weight, and increase physical activity. Results Clinically identified diabetes was associated with 4.3-fold greater odds of depression, but undiagnosed diabetes was not significantly associated with depression. This relationship was more pronounced for prediabetes. Clinically identified diabetes was associated with 1.8-fold greater odds of antidepressant use, but undiagnosed diabetes was not significantly associated with antidepressant use. Health behaviors were not consistently related to depression syndrome. Conclusion The relationship between diabetes status and depression and antidepressant use depends on whether the diabetes has been clinically identified. Findings are consistent with the hypothesis that the relationship between diabetes and depression may be attributable to factors related to disease management. Previous reports linking antidepressants and diabetes may be attributable to clinical ascertainment bias.

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“…The cut-off point for DS was 10, which has been reported to be a feasible instrument for depression screening [26]. It has also been shown to be a useful tool for detecting depressive symptoms in various adult populations [27-32]. Out of the whole study population, 429 (15%) subjects with a BDI score ≥10 were identified.…”

Section: Methodsmentioning

confidence: 99%

“…A chronic diseases sum index was based on the question “Have you had any of the following diseases that have been diagnosed or treated by a doctor in the last 12 months?” The diseases included elevated blood pressure, heart failure, angina pectoris/other cardiovascular event, diabetes, cancer, bronchial asthma/emphysema and rheumatoid arthritis/other arthropathy/spinal diseases. The chronic diseases sum index ranged from 0 to 7 [32]. The use of antidepressive medications was also recorded.…”

Section: Methodsmentioning

confidence: 99%

Association between vitamin b12 levels and melancholic depressive symptoms: a Finnish population-based study

et al. 2013

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BackgroundAn association between vitamin B12 levels and depressive symptoms (DS) has been reported in several epidemiological studies. The purpose of this study was to evaluate vitamin B12 levels in population-based samples with melancholic or non-melancholic DS as the relationship between vitamin B12 levels and different subtypes of DS has not been evaluated in previous studies.MethodsSubjects without previously known type 2 diabetes, aged 45–74 years were randomly selected from the National Population Register as a part of the Finnish diabetes prevention programme (FIN-D2D). The study population (N = 2806, participation rate 62%) consisted of 1328 men and 1478 women. The health examinations were carried out between October and December 2007 according to the WHO MONICA protocol. The assessment of DS was based on the Beck Depression Inventory (BDI, cut-off ≥10 points). A DSM-IV- criteria based summary score of melancholic items in the BDI was used in dividing the participants with DS (N = 429) into melancholic (N = 138) and non-melancholic DS (N = 291) subgroups. In the statistical analysis we used chi-squared test, t-test, permutation test, analysis of covariance, multivariate logistic regression analysis and multinomial regression model.ResultsThe mean vitamin B12 level was 331±176 pmol/L in those without DS while the subjects with non-melancholic DS had a mean vitamin B12 level of 324 ± 135 pmol/L, and those with melancholic DS had the lowest mean vitamin B12 level of 292±112 pmol/L (p < 0.001 after adjusted for age, sex, use of antidepressive medication and chronic diseases sum index). The adjusted difference of vitamin B12 levels between the non-melancholic and the melancholic group was 33 pmol/L (95%CI 8 to 57, p = 0.008). Melancholic DS and vitamin B12 levels showed an independent linearly inverse association. The relative risk ratio (RRR) for melancholic DS was 2.75 (95%CI 1.66 to 4.56) in the lowest vitamin B12 level tertile versus the highest (p for linearity <0.001) when those without DS formed the reference group. The RRR in the non-melancholic subgroup was nonsignificant.ConclusionsThe vitamin B12 level was associated with melancholic DS but not with non-melancholic DS.

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Association of Depressive Symptoms With Impaired Glucose Regulation, Screen-Detected, and Previously Known Type 2 Diabetes

Cited by 38 publications

References 24 publications

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

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

Is ignorance bliss? Depression, antidepressants, and the diagnosis of prediabetes and type 2 diabetes.

Association between vitamin b12 levels and melancholic depressive symptoms: a Finnish population-based study

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