Diabetes mellitus and major depressive disorder: An overview of prevalence, complications, and treatment

Carney, Caroline P.

doi:10.1002/(sici)1520-6394(1998)7:4<149::aid-da2>3.0.co;2-5

Cited by 56 publications

(13 citation statements)

References 46 publications

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“…Particular emphasis has been placed on the association between depression and diabetes (27). Type 2 diabetes has been shown to be more common in elderly schizophrenic patients than in control subjects (28).…”

Section: Medication Use and Costs In Diabetesmentioning

confidence: 99%

Nationwide survey of comorbidity, use, and costs of all medications in Finnish diabetic individuals.

et al. 2000

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OBJECTIVE: To investigate comorbidity and overall use and costs of medication for all Finnish individuals with diabetes treated with drugs compared with sex- and age-matched control subjects. RESEARCH DESIGN AND METHODS: According to a cross-sectional population study using national registries, 116,224 individuals purchased antidiabetic medications in Finland in 1995. The same number of nondiabetic individuals matched for sex, age, and area of residence were chosen as control subjects. Age at onset of diabetes was used as a criterion for distinguishing between type 1 and type 2 diabetes. The criterion could be applied in 74% of cases. A total of 16,955 individuals were defined as having type 1 diabetes, and 68,517 were defined as having type 2 diabetes. Comorbidity was determined by linkage with a national register including all individuals entitled to special reimbursement for drug treatment for a range of chronic diseases. Data on use and costs of all medications prescribed were obtained from drug purchase records. RESULTS: Cardiovascular diseases and uremia were, as expected, the chronic diseases most closely associated with diabetes. Use of almost all kinds of medication was significantly greater in individuals with type 1 and type 2 diabetes than in control subjects. The greatest differences were observed in relation to cardiovascular drugs and antibiotics. Unexpectedly low use of antiasthmatics was observed in individuals with both types of diabetes, low use of neuroleptics was observed in type 1 diabetic individuals, and low use of hormone replacement therapy was observed in women with type 2 diabetes. Total costs of medications for individuals with diabetes were 3.5 times greater than those for nondiabetic control subjects. The higher costs were mostly attributable to insulin therapy for individuals with type 1 diabetes. The higher costs for individuals with type 2 diabetes were related to the cost of medications other than antidiabetic medication. The possible selection bias in omitting diabetic individuals treated with diet only and individuals in whom diabetes type could not be determined must be considered in interpreting the results. CONCLUSIONS: Greater use by and costs of medications for individuals with diabetes than for nondiabetic individuals is related not only to antidiabetic treatment but also to all other kinds of medications. Although drug treatment and the prevalence of several chronic conditions were overall greater in individuals with diabetes versus other individuals, some exceptions merit further study

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Section: Medication Use and Costs In Diabetesmentioning

confidence: 99%

Nationwide survey of comorbidity, use, and costs of all medications in Finnish diabetic individuals.

et al. 2000

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“…Other studies report that although medical conditions in general are a risk factor for affective disturbance, the contribution of diabetes may not add any additional risk above that found for chronic illness (11)(12)(13)(14)(15). This would suggest that factors involved in the general burden of illness contribute to the observed elevated prevalence of affective disturbance seen in patients with diabetes (16). In light of these inconsistent conclusions, the determination of whether depression and anxiety disorders are more common in patients with diabetes than in those without diabetes has yet to be reliably determined.…”

mentioning

confidence: 99%

A Descriptive and Comparative Study of the Prevalence of Depressive and Anxiety Disorders in Low-Income Adults With Type 2 Diabetes and Other Chronic Illnesses

et al. 2003

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OBJECTIVE—To determine whether type 2 diabetes contributes to the presence of depressive and anxiety disorder diagnoses in low-income adults with hypertension, asthma, and/or arthritis. RESEARCH DESIGN AND METHODS—Using a cross-sectional design, this study administered a structured diagnostic interview to low-income primary care patients diagnosed with type 2 diabetes, hypertension, arthritis, and asthma, as well as to those with no chronic illness (n = 326), to determine the 12-month prevalence of depressive and anxiety disorders. A logistic regression (LR) model was used to assess whether a diagnosis of depression and/or anxiety was associated with type 2 diabetes after adjusting for known risk factors. RESULTS—A high prevalence rate of depressive and/or anxiety disorders was found in the total sample (29%) and in all three illness groups: type 2 diabetes (36%), other chronic illnesses (24%), and no chronic illness (31%). Using LR, a main effect was detected for illness group when age and education were controlled (χ2 = 22.66, df 4, P = 0.000). Specifically, the odds of occurrence of a depressive and/or anxiety disorder in those with comorbid type 2 diabetes were twice that in the nondiabetic, chronically ill comparison group (odds ratio 2.26, 95% CI 1.28–4.01, P = 0.005). CONCLUSIONS—These results suggest a positive contribution of type 2 diabetes to increased rates of depressive and/or anxiety disorders in patients with hypertension, asthma, and/or arthritis and support prior research that type 2 diabetes may serve as an indicator of depression and anxiety in low-income adults treated in primary care clinics.

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“…Ainda podem causar aumento do peso e do desejo por ingesta de carboidratos e, no início do tratamento, há descrição de causarem hipoglicemia 21 . Por todas essas evidências, essa classe de antidepressivos não deve ser considerada como primeira escolha.…”

Section: Antidepressivosunclassified

“…Os tratamentos disponíveis para depressão melhoram os sintomas depressivos, mas a terapia cognitivo-comportamental e as abordagens de intervenção integrada não têm sido associadas à redução dos níveis glicêmicos. Os ISRS são boas opções para o tratamento da depressão em pacientes diabéticos por apresentarem poucos efeitos anticolinérgicos, cardiovasculares e de hipotensão postural, não aumentarem o peso e tenderem a reduzir os níveis glicêmicos, embora não haja estudos que comprovem isso com significância estatística 21 . Por outro lado, os antidepressivos tricíclicos, embora eficazes em tratar a depressão, foram associados a aumento da glicemia.…”

Section: Antidepressivosunclassified

Depressão e diabetes mellitus

Fráguas

Soares

Bronstein³

2009

Rev. psiquiatr. clín.

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ResumoO diabetes mellitus possui elevada prevalência, acometendo cerca de 7% da população brasileira. Em torno de 20% a 30% dos pacientes com diabetes apresentam depressão. A depressão pode atuar como um fator de risco para o desenvolvimento do diabetes, piorar seus sintomas e interferir com o autocuidado dos pacientes. Quando não tratada adequadamente, a depressão nesses pacientes tende a evoluir com elevada taxa de recorrência. Entre os tratamentos disponíveis, encontramos na literatura um benefício da psicoterapia, cognitiva ou cognitivo-comportamental, para melhora dos sintomas depressivos, mas sem evidência de um benefício no controle glicêmico. Os antidepressivos tricíclicos, em especial os com maior ação noradrenérgica, e os inibidores da monoaminoxidase (IMAOs) tendem a aumentar os níveis glicêmicos. A bupropiona não interfere na glicemia e há evidências de que os inibidores seletivos de recaptura de serotonina (ISRS) melhoram os níveis glicêmicos e podem reduzir a taxa de recaídas, mostrando-se boas opções de tratamento farmacológico. A eletroconvulsoterapia também é uma estratégia interessante para esses pacientes, recomendando-se, no entanto, monitorização da glicemia. Não foram encontrados estudos significativos sobre os demais antidepressivos disponíveis para comercialização. Fráguas R, et al. / Rev Psiq Clín. 2009;36(3):93-9Palavras-chave: Diabetes mellitus, depressão, tratamento, antidepressivo, prevalência, prognóstico. AbstractDiabetes mellitus has an estimated prevalence of 7% among Brazilian population. Around 20% to 30% of these patients have a depressive disorder. Depression can work as risk factor to the development of diabetes, can worse its symptoms and interfere with self-care. When not adequately treated, depressive disorder in these patients tends to have high rates of recurrence. Among the available treatments literature shows a benefit of psychotherapy, mainly cognitive or cognitive-behavioral, in ameliorating depressive symptoms, but without impact on glycaemic control. Tryciclic antidepressants, especially those with more noradrenergic profile, and monoamino oxidase inhibitors are associated with worsening of glycaemic control. Bupropion shows no action on glucose blood levels and there are evidences that serotonin selective reuptake inhibitors may improve the glycaemic levels and reduce the recurrence, being good choices to treat these patients. Electroconvulsive therapy is an interesting treatment to these patients, but monitoring of blood glucose is recommended. We did not find data about other antidepressants. R, et al. / Rev Psiq Clín. 2009;36(3):93-9 Fráguas

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Diabetes mellitus and major depressive disorder: An overview of prevalence, complications, and treatment

Cited by 56 publications

References 46 publications

Nationwide survey of comorbidity, use, and costs of all medications in Finnish diabetic individuals.

Nationwide survey of comorbidity, use, and costs of all medications in Finnish diabetic individuals.

A Descriptive and Comparative Study of the Prevalence of Depressive and Anxiety Disorders in Low-Income Adults With Type 2 Diabetes and Other Chronic Illnesses

Depressão e diabetes mellitus

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