Depression, anxiety and cognitive function in patients with type 2 diabetes: an 8-year prospective observational study

Trento, Marina; Charrier, Lorena; Salassa, Martina; Merlo, Stefano; Passera, P; Cavallo, Franco; Porta, Massimo

doi:10.1007/s00592-015-0806-0

Cited by 35 publications

(26 citation statements)

References 29 publications

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“…There was a high risk of GAD among patients with a long duration (4 9 years) of T2DM, which is consistent with reports that a long duration of DM is associated with a high risk of AD and with worsening anxiety symptoms. 27,28 Of the T2DM patients in this study, those with the highest GAD risk had comorbid depressive disorder, which is consistent with the literature. 28 Another study reported that MDD patients and GAD patients often exhibit symptoms of both disorders simultaneously.…”

Section: Discussionsupporting

confidence: 91%

“…Most studies of T2DM patients have focused on the prevalence of anxiety symptoms or AD, rather than on GAD. 11,[17][18][19][20][21][27][28][29][30][31][32] Another unique feature of this study is that it analyzed a specific Asian population (i.e., ethnic Han Chinese). Table 1 shows that, compared to GAD patients in the GP, T2DM GAD patients were more likely to have high CCI scores, be older, female, and have multiple comorbidities.…”

Section: Discussionmentioning

confidence: 99%

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Generalized anxiety disorder in type 2 diabetes mellitus: prevalence and clinical characteristics

Huang

Hsieh

et al. 2020

Braz. J. Psychiatry

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Objective: This study investigated the prevalence of generalized anxiety disorder (GAD) in Taiwanese patients with type 2 diabetes mellitus (T2DM). Methods: This retrospective observational study was conducted with a random sample of patients from the entire population of National Health Insurance enrollees during 2000-2010 and used ICD-9-CM diagnostic codes to identify T2DM patients and GAD. The prevalence of GAD was compared between T2DM patients and the general population. Results: Between 2000 and 2010, the prevalence of GAD was significantly greater in the T2DM patients than the general population, while the increase of GAD was higher in the general population (from 0.25 to 0.63%) than among T2DM patients (from 0.81 to 1.03%). In T2DM patients, GAD was associated with female gender, a Charlson Comorbidity Index X 1, diabetes mellitus duration 4 9 years, and the following comorbidities: congestive heart failure, peripheral vascular disease, and depressive disorder. The prevalence of GAD among T2DM patients was negatively associated with rapid-acting insulin injection therapy and with the use of metformin and sulfonylureas. Conclusion: Since the prevalence of GAD was greater among T2DM patients than the general population, public health initiatives are needed to prevent and treat GAD in T2DM patients, specifically those with the above mentioned risk factors.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Generalized anxiety disorder in type 2 diabetes mellitus: prevalence and clinical characteristics

Huang

Hsieh

et al. 2020

Braz. J. Psychiatry

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“…This is consistent with the recent prospective observational study demonstrating that a lower education level at baseline was associated with significantly higher depression scores among individuals with diabetes [32]. Thus, combining all of our earlier results, we recommend that subjects newly diagnosed with diabetes should be screened for depression and that specific interventions for depression should be provided, especially for those with less education.…”

Section: Discussionsupporting

confidence: 91%

Diagnosed but Not Undiagnosed Diabetes Is Associated with Depression in Rural Areas

Zhao

Guo

Jiang

et al. 2016

IJERPH

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Abstract:Background: There is a lack of study on the relation between undiagnosed diabetes and depression in the general population. Methods: A total of 11,531 adults were examined using a multistage cluster sampling method to select a representative sample of individuals who were at least 35 years old. Subjects were classified into three groups: no diabetes (ND), diagnosed diabetes (DD), and undiagnosed diabetes (UD). The participants were surveyed with the Patient Health Questionnaire-9 (PHQ-9). Results: Of all the 11,531 participants, the prevalence of depression was higher in the DD group than in the other two groups. Multi variable logistic regression analyses show that the DD group had significantly higher odds for depression compared with the ND group (p < 0.01), while the UD group showed no significant differences compared to the ND group. Subgroup analyses show that diagnosed diabetes in subjects with a lower educational level, compared with subjects with an educational level of high school or above, had higher odds for a PHQ-9 score ≥5 (p < 0.01). Conclusion: In this general population, diagnosed but not undiagnosed diabetes was significantly associated with depression. Much higher odds for depression were found among diagnosed diabetic individuals with a lower level of education.

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“…These data indicate that screening for and management of anxiety symptoms in diabetes, particularly in those with suboptimal diabetes management, chronic complications and depression, may be beneficial. Current recommendations are to screen and consider therapies for anxiety at key points in the course of type 2 diabetes, including diagnosis, onset of complications and commencement of insulin [11,26]. The most important finding in this study is that, for a group of individuals with long duration disease and chronic complications (median diabetes duration of 8.9 years in group 2), less severe anxiety symptoms were more prevalent and persistent than previously recorded and displayed a lifetime course.…”

Section: Discussionmentioning

confidence: 50%

“…By assessing anxiety symptoms over 4 years, we found that a substantially larger proportion (12.6%) continued to experience subthreshold anxiety symptoms that waned but remained higher than those with low-no anxiety. One explanation for this finding is that GAD presents as residual anxiety symptoms that recur over time, displaying the pattern of relapse and remission observed in the general population [12,26]. Thus, a single assessment and relying on DSM-IV GAD criteria may underestimate the impact of psychological issues in people with diabetes.…”

Section: Discussionmentioning

confidence: 99%

Risk factors and outcomes of anxiety symptom trajectories in type 2 diabetes: the Fremantle Diabetes Study Phase II

et al. 2020

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Aim To identify determinants and outcomes of 4‐year trajectories of anxiety symptoms in a community‐based cohort with type 2 diabetes. Methods Some 1091 participants in the Fremantle Diabetes Study‐Phase II with type 2 diabetes completed the Generalized Anxiety Disorder Scale at baseline and biennially for 4 years, in addition to psychological, biomedical and self‐management measures. Latent growth mixture modelling identified trajectories of anxiety symptom severity, and regression models determined predictors of trajectory membership and associated outcomes. Results Two distinct groups of participants were identified: those with continuously low–no anxiety symptoms (87%) and those with improving but consistently high anxiety symptoms (elevated anxiety; 13%). Higher HbA1c and BMI, macrovascular complications and a history of generalized anxiety and/or major depressive disorder increased the risk of elevated anxiety. Elevated anxiety did not predict change in health‐related outcomes over time. Elevated anxiety and depression symptoms were highly comorbid and those with both displayed the most persistent anxiety symptoms. Conclusions A subgroup of individuals with type 2 diabetes are at risk of persistently elevated anxiety symptoms. Routine monitoring of the severity of psychological symptoms over time in this population should facilitate earlier and more intensive mood management.

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Depression, anxiety and cognitive function in patients with type 2 diabetes: an 8-year prospective observational study

Abstract: word count: 200

Cited by 35 publications

References 29 publications

Generalized anxiety disorder in type 2 diabetes mellitus: prevalence and clinical characteristics

Generalized anxiety disorder in type 2 diabetes mellitus: prevalence and clinical characteristics

Diagnosed but Not Undiagnosed Diabetes Is Associated with Depression in Rural Areas

Risk factors and outcomes of anxiety symptom trajectories in type 2 diabetes: the Fremantle Diabetes Study Phase II

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