The Prevalence and Specificity of Depression Diagnosis in a Clinic-Based Population of Adults With Type 2 Diabetes Mellitus

Abstract

Objective To estimate the crude prevalence of minor depressive disorder (MinD) in a clinic-based population of adults with type 2 diabetes. Methods We screened a clinical sample of 702 adults with type 2 diabetes for depressive symptoms using the Patient Health Questionnaire-2 and performed a structured diagnostic psychiatric interview on 52 screen-positive and a convenience sample of 51 screen-negative individuals. Depressive disorder diagnoses were made using Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) Text Revised criteria and categorized as MinD, major depressive disorder (MDD), or no depressive disorder. We estimated prevalence of MinD and MDD and derived 95% CIs. Results The crude prevalence of current, past, and current or past MinD was 4.3% (95% CI: 0.9–9.2%), 9.6% (95% CI: 3.9–15.9%), and 13.9% (95% CI: 7.7–21.2%), respectively. The crude prevalence of current, past, and current or past MDD was slightly higher—5.0% (95% CI: 1.9–9.4%), 12.0% (95% CI: 6.1–19.5%), and 17.0% (95% CI: 10.1–24.8%), respectively. There was a high prevalence of coexisting anxiety disorders in individuals with MinD (42.2%) and MDD (8.1%). Hemoglobin A1c levels were not significantly different in individuals with MinD or MDD compared to those without a depressive disorder. Conclusions MinD is comparably prevalent to MDD in patients with type 2 diabetes; both disorders are associated with concomitant anxiety disorders. MinD is not included in the DSM-5; however, our data support continuing to examine patients with chronic medical conditions for MinD.

Anxiety and depression in patients with moderate‐to‐severe psoriasis and comparison of change from baseline after treatment with guselkumab vs. adalimumab: results from the Phase 3 VOYAGE 2 study

“…Limitations of this study include the limitations of the instrument to measure anxiety or depression. While the HADS has been used to assess the prevalence of anxiety and depression in clinical trials of many diseases, including moderate‐to‐severe plaque psoriasis, some studies have proposed that HADS is best suited for screening rather than assessment of severity of anxiety and depression over time . In addition, the optimal HADS score cut‐off to define clinically important improvement in symptoms of anxiety or depression remains undertermined.…”

“…While the HADS has been used to assess the prevalence of anxiety and depression in clinical trials of many diseases, [34][35][36][37] including moderate-to-severe plaque psoriasis, 29,[38][39][40][41] some studies have proposed that HADS is best suited for screening rather than assessment of severity of anxiety and depression over time. [42][43][44] In addition, the optimal HADS score cut-off to define clinically important improvement in symptoms of anxiety or depression remains undertermined. Finally, the active comparator-controlled period in VOYAGE 2 extended only through week 24 for HADS evaluation, which may be a relatively short period of time to assess HADS.…”

Depression and diabetes distress in adults with type 2 diabetes: results from the Australian National Diabetes Audit (ANDA) 2016

“…Like many other chronic conditions, T2DM is associated with depression. Depression has been reported to affect up to 40% of patients with diabetes 4 – 6 . Indeed, individuals with diabetes have a 2–4 fold greater risk of depression when compared to individuals without diabetes 7 .…”

Association of dietary acid load and plant-based diet index with sleep, stress, anxiety and depression in diabetic women

“…Moreover, anxiety and depression are more prevalent in diabetic patients than individuals with normal glucose tolerance (4) . Approximately one-third of type 2 diabetic patients have sub-threshold depression (5) and over 40 % present with minor or major depression with anxiety disorders (6) .…”