51
|
Esterson YB, Carey M, Boucai L, Goyal A, Raghavan P, Zhang K, Mehta D, Feng D, Wu L, Kehlenbrink S, Koppaka S, Kishore P, Hawkins M. Central Regulation of Glucose Production May Be Impaired in Type 2 Diabetes. Diabetes 2016; 65:2569-79. [PMID: 27207526 PMCID: PMC5001178 DOI: 10.2337/db15-1465] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 04/19/2016] [Indexed: 12/21/2022]
Abstract
The challenges of achieving optimal glycemic control in type 2 diabetes highlight the need for new therapies. Inappropriately elevated endogenous glucose production (EGP) is the main source of hyperglycemia in type 2 diabetes. Because activation of central ATP-sensitive potassium (KATP) channels suppresses EGP in nondiabetic rodents and humans, this study examined whether type 2 diabetic humans and rodents retain central regulation of EGP. The KATP channel activator diazoxide was administered in a randomized, placebo-controlled crossover design to eight type 2 diabetic subjects and seven age- and BMI-matched healthy control subjects. Comprehensive measures of glucose turnover and insulin sensitivity were performed during euglycemic pancreatic clamp studies following diazoxide and placebo administration. Complementary rodent clamp studies were performed in Zucker Diabetic Fatty rats. In type 2 diabetic subjects, extrapancreatic KATP channel activation with diazoxide under fixed hormonal conditions failed to suppress EGP, whereas matched control subjects demonstrated a 27% reduction in EGP (P = 0.002) with diazoxide. Diazoxide also failed to suppress EGP in diabetic rats. These results suggest that suppression of EGP by central KATP channel activation may be lost in type 2 diabetes. Restoration of central regulation of glucose metabolism could be a promising therapeutic target to reduce hyperglycemia in type 2 diabetes.
Collapse
Affiliation(s)
- Yonah B Esterson
- Diabetes Research and Training Center and Division of Endocrinology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
| | - Michelle Carey
- Diabetes Research and Training Center and Division of Endocrinology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
| | - Laura Boucai
- Diabetes Research and Training Center and Division of Endocrinology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
| | - Akankasha Goyal
- Diabetes Research and Training Center and Division of Endocrinology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
| | - Pooja Raghavan
- Diabetes Research and Training Center and Division of Endocrinology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
| | - Kehao Zhang
- Diabetes Research and Training Center and Division of Endocrinology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
| | - Deeksha Mehta
- Diabetes Research and Training Center and Division of Endocrinology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
| | - Daorong Feng
- Diabetes Research and Training Center and Division of Endocrinology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
| | - Licheng Wu
- Diabetes Research and Training Center and Division of Endocrinology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
| | - Sylvia Kehlenbrink
- Diabetes Research and Training Center and Division of Endocrinology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
| | - Sudha Koppaka
- Diabetes Research and Training Center and Division of Endocrinology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
| | - Preeti Kishore
- Diabetes Research and Training Center and Division of Endocrinology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
| | - Meredith Hawkins
- Diabetes Research and Training Center and Division of Endocrinology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
| |
Collapse
|
52
|
Abstract
Major depressive disorder (MDD: unipolar depression) is widely distributed in the USA and world-wide populations and it is one of the leading causes of disability in both adolescents and adults. Traditional diagnostic approaches for MDD are based on patient interviews, which provide a subjective assessment of clinical symptoms which are frequently shared with other maladies. Reliance upon clinical assessments and patient interviews for diagnosing MDD is frequently associated with misdiagnosis and suboptimal treatment outcomes. As such, there is increasing interest in the identification of objective methods for the diagnosis of depression. Newer technologies from genomics, transcriptomics, proteomics, metabolomics and imaging are technically sophisticated and objective but their application to diagnostic tests in psychiatry is still emerging. This brief overview evaluates the technical basis for these technologies and discusses how the extension of their clinical performance can lead to an objective diagnosis of MDD.
Collapse
Affiliation(s)
- John A Bilello
- Ridge Diagnostics Laboratories, Research & Development, Research Triangle Park, NC, USA
| |
Collapse
|
53
|
Husk K, Blockley K, Lovell R, Bethel A, Bloomfield D, Warber S, Pearson M, Lang I, Byng R, Garside R. What approaches to social prescribing work, for whom, and in what circumstances? A protocol for a realist review. Syst Rev 2016; 5:93. [PMID: 27255362 PMCID: PMC4891904 DOI: 10.1186/s13643-016-0269-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 05/24/2016] [Indexed: 03/20/2023] Open
Abstract
BACKGROUND The use of non-drug, non-health-service interventions has been proposed as a cost-effective alternative to help those with long-term conditions manage their illness and improve their health and well-being. Interventions typically involve accessing activities run by the third sector or community agencies and may also be described as non-medical referral, community referral or social prescribing. To be effective, patients need to be "transferred" from the primary care setting into the community and to maintain their participation in activities. However, it is not currently known how and why these approaches enable which people under what circumstances to reach community services that may benefit their health and well-being. METHODS Database searches and extensive searching of grey sources will be carried out in an attempt to find evidence associated with referral and retention in social prescribing. After initial scoping searches, two main phases of searching will be conducted: (a) will focus on the identification of programme theories to illustrate how approaches to social prescribing work for different people and in different contexts and (b) will consist of targeted searches to locate evidence to refine these candidate theories into configurations of the contexts in which populations and the main mechanisms outcomes are achieved. Inclusion criteria will initially be broad in order to develop a clear picture of the ways in which social prescriptions might operate but may iteratively become more focused in response to initially identified evidence, for example, in terms of the population group. An expert advisory group consisting of professionals working in a range of organisations involved in social prescribing will be convened to check the approaches in the review and provide real-life experience of social prescribing. Findings from the review will be disseminated to commissioners, published in a peer-reviewed journal and used to help refine an intervention model for an outdoor nature-based group intervention. DISCUSSION This realist review will explore why mechanisms of social prescribing work, for what groups of people and their impact on enrolment, attendance and adherence to programmes. The use of realist approaches to detail the social prescribing process is novel and will offer insights into effective transfer of patients. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016039491.
Collapse
Affiliation(s)
- Kerryn Husk
- NIHR CLAHRC South West Peninsula (PenCLAHRC), Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth University, Plymouth, England.
| | - Kelly Blockley
- NIHR CLAHRC South West Peninsula (PenCLAHRC), Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth University, Plymouth, England
| | - Rebecca Lovell
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Exeter, England
| | - Alison Bethel
- NIHR CLAHRC South West Peninsula (PenCLAHRC), University of Exeter Medical School, University of Exeter, Exeter, England
| | - Dan Bloomfield
- College of Life and Environmental Sciences, University of Exeter, Exeter, England
| | - Sara Warber
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Exeter, England
- University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Mark Pearson
- NIHR CLAHRC South West Peninsula (PenCLAHRC), University of Exeter Medical School, University of Exeter, Exeter, England
| | - Iain Lang
- NIHR CLAHRC South West Peninsula (PenCLAHRC), University of Exeter Medical School, University of Exeter, Exeter, England
| | - Richard Byng
- NIHR CLAHRC South West Peninsula (PenCLAHRC), Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth University, Plymouth, England
| | - Ruth Garside
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Exeter, England
| |
Collapse
|
54
|
Meier SM, Mattheisen M, Mors O, Schendel DE, Mortensen PB, Plessen KJ. Mortality Among Persons With Obsessive-Compulsive Disorder in Denmark. JAMA Psychiatry 2016; 73:268-274. [PMID: 26818216 PMCID: PMC5082974 DOI: 10.1001/jamapsychiatry.2015.3105] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
IMPORTANCE Several mental disorders have consistently been found to be associated with decreased life expectancy, but little is known about whether this is also the case for obsessive-compulsive disorder (OCD). OBJECTIVE To determine whether persons who receive a diagnosis of OCD are at increased risk of death. DESIGN, SETTING, AND PARTICIPANTS Using data from Danish registers, we conducted a nationwide prospective cohort study with 30 million person-years of follow-up. The data were collected from Danish longitudinal registers. A total of 3 million people born between 1955 and 2006 were followed up from January 1, 2002, through December 31, 2011. During this period, 27,236 people died. The data were analyzed primarily in June 2015. MAIN OUTCOMES AND MEASURES We estimated mortality rate ratios (MRRs), adjusted for calendar year, age, sex, maternal and paternal age, place of residence at birth, and somatic comorbidities, to compare persons with OCT with persons without OCD. RESULTS Of 10,155 persons with OCD (5935 women and 4220 men with a mean [SD] age of 29.1 [11.3] years who contributed a total of 54,937 person-years of observation), 110 (1.1%) died during the average follow-up of 9.7 years. The risk of death by natural or unnatural causes was significantly higher among persons with OCD (MRR, 1.68 [95% CI, 1.31-2.12] for natural causes; MRR, 2.61 [95% CI, 1.91-3.47] for unnatural causes) than among the general population. After the exclusion of persons with comorbid anxiety disorders, depression, or substance use disorders, OCD was still associated with increased mortality risk (MRR, 1.88 [95% CI, 1.27-2.67]). CONCLUSIONS AND RELEVANCE The presence of OCD was associated with a significantly increased mortality risk. Comorbid anxiety disorders, depression, or substance use disorders further increased the risk. However, after adjusting for these and somatic comorbidities, we found that the mortality risk remained significantly increased among persons with OCD.
Collapse
Affiliation(s)
- Sandra M. Meier
- National Centre for Register-Based Research, Aarhus University, Aarhus V, Denmark2Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark3Child and Adolescent Mental Health Centre–Mental Health Services Capital Region, Copenhagen, Denmark
| | - Manuel Mattheisen
- Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark4Department of Biomedicine, Aarhus University, Aarhus C, Denmark
| | - Ole Mors
- Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark5Research Department P, Aarhus University Hospital, Risskov, Aarhus, Denmark
| | - Diana E. Schendel
- National Centre for Register-Based Research, Aarhus University, Aarhus V, Denmark2Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark6Department of Public Health, Section of Epidemiology, Aarhus University, Aarhus C, Denmark
| | - Preben B. Mortensen
- National Centre for Register-Based Research, Aarhus University, Aarhus V, Denmark2Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark7Centre for Integrated Register-Based Research, Aarhus University, Aarhus C, Denmark
| | - Kerstin J. Plessen
- Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark3Child and Adolescent Mental Health Centre–Mental Health Services Capital Region, Copenhagen, Denmark
| |
Collapse
|
55
|
Semenkovich K, Brown ME, Svrakic DM, Lustman PJ. Depression in type 2 diabetes mellitus: prevalence, impact, and treatment. Drugs 2016; 75:577-87. [PMID: 25851098 DOI: 10.1007/s40265-015-0347-4] [Citation(s) in RCA: 234] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Clinically significant depression is present in one of every four people with type 2 diabetes mellitus (T2DM). Depression increases the risk of the development of T2DM and the subsequent risks of hyperglycemia, insulin resistance, and micro- and macrovascular complications. Conversely, a diagnosis of T2DM increases the risk of incident depression and can contribute to a more severe course of depression. This linkage reflects a shared etiology consisting of complex bidirectional interactions among multiple variables, a process that may include autonomic and neurohormonal dysregulation, weight gain, inflammation, and hippocampal structural alterations. Two recent meta-analyses of randomized controlled depression treatment trials in patients with T2DM concluded that psychotherapy and antidepressant medication (ADM) were each moderately effective for depression and that cognitive behavior therapy (CBT) had beneficial effects on glycemic control. However, the number of studies (and patients exposed to randomized treatment) included in these analyses is extremely small and limits the certainty of conclusions that can be drawn from the data. Ultimately, there is no escaping the paucity of the evidence base and the need for additional controlled trials that specifically address depression management in T2DM. Future trials should determine both the effects of treatment and the change in depression during treatment on measures of mood, glycemic control, and medical outcome.
Collapse
Affiliation(s)
- Katherine Semenkovich
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | | | | | | |
Collapse
|
56
|
Psychosocial Predictors of Weight Loss among American Indian and Alaska Native Participants in a Diabetes Prevention Translational Project. J Diabetes Res 2015; 2016:1546939. [PMID: 26649314 PMCID: PMC4662977 DOI: 10.1155/2016/1546939] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 04/13/2015] [Indexed: 12/04/2022] Open
Abstract
The association of psychosocial factors (psychological distress, coping skills, family support, trauma exposure, and spirituality) with initial weight and weight loss among American Indians and Alaska Natives (AI/ANs) in a diabetes prevention translational project was investigated. Participants (n = 3,135) were confirmed as prediabetic and subsequently enrolled in the Special Diabetes Program for Indians Diabetes Prevention (SDPI-DP) demonstration project implemented at 36 Indian health care programs. Measures were obtained at baseline and after completing a 16-session educational curriculum focusing on weight loss through behavioral changes. At baseline, psychological distress and negative family support were linked to greater weight, whereas cultural spirituality was correlated with lower weight. Furthermore, psychological distress and negative family support predicted less weight loss, and positive family support predicted greater weight loss, over the course of the intervention. These bivariate relationships between psychosocial factors and weight remained statistically significant within a multivariate model, after controlling for sociodemographic characteristics. Conversely, coping skills and trauma exposure were not significantly associated with baseline weight or change in weight. These findings demonstrate the influence of psychosocial factors on weight loss in AI/AN communities and have substantial implications for incorporating adjunctive intervention components.
Collapse
|
57
|
Willborn RJ, Barnacle M, Maack B, Petry N, Werremeyer A, Strand MA. Use of the 9-Item Patient Health Questionnaire for Depression Assessment in Primary Care Patients With Type 2 Diabetes. J Psychosoc Nurs Ment Health Serv 2015; 54:56-63. [PMID: 26565416 DOI: 10.3928/02793695-20151109-01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2015] [Accepted: 10/13/2015] [Indexed: 11/20/2022]
Abstract
The purpose of the current study was to assess the frequency and distribution of the 9-Item Patient Health Questionnaire (PHQ-9) among individuals with type 2 diabetes with and without depression. The current case-control study used electronic medical record data from two primary care institutions. The sample was divided into cases with coexisting depression and type 2 diabetes and controls without depression. Data included demographics, biomarkers, number of services delivered, and clinic visits in 2013. Similar PHQ-9 use was seen between unique primary care practices. However, less than one third of patients at either site received depression screening with the PHQ-9 in 2013. Male and older adult patients were less likely to receive assessment. Guideline ambiguity and lack of accountability in primary care practice has made the use of depression metrics arbitrary in diabetic populations at risk for depression. To assure adequate care provision, it is imperative that proven tools for assessing depressive symptoms are used.
Collapse
|
58
|
Frisard C, Gu X, Whitcomb B, Ma Y, Pekow P, Zorn M, Sepavich D, Balasubramanian R. Marginal structural models for the estimation of the risk of Diabetes Mellitus in the presence of elevated depressive symptoms and antidepressant medication use in the Women's Health Initiative observational and clinical trial cohorts. BMC Endocr Disord 2015; 15:56. [PMID: 26458393 PMCID: PMC4603353 DOI: 10.1186/s12902-015-0049-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 09/18/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND We evaluate the combined effect of the presence of elevated depressive symptoms and antidepressant medication use with respect to risk of type 2 diabetes among approximately 120,000 women enrolled in the Women's Health Initiative (WHI), and compare several different statistical models appropriate for causal inference in non-randomized settings. METHODS Data were analyzed for 52,326 women in the Women's Health Initiative Clinical Trials (CT) Cohort and 68,169 women in the Observational Study (OS) Cohort after exclusions. We included follow-up to 2005, resulting in a median duration of 7.6 years of follow up after enrollment. Results from three multivariable Cox models were compared to those from marginal structural models that included time varying measures of antidepressant medication use, presence of elevated depressive symptoms and BMI, while adjusting for potential confounders including age, ethnicity, education, minutes of recreational physical activity per week, total energy intake, hormone therapy use, family history of diabetes and smoking status. RESULTS Our results are consistent with previous studies examining the relationship of antidepressant medication use and risk of type 2 diabetes. All models showed a significant increase in diabetes risk for those taking antidepressants. The Cox Proportional Hazards models using baseline covariates showed the lowest increase in risk , with hazard ratios of 1.19 (95 % CI 1.06 - 1.35) and 1.14 (95 % CI 1.01 - 1.30) in the OS and CT, respectively. Hazard ratios from marginal structural models comparing antidepressant users to non-users were 1.35 (95 % CI 1.21 - 1.51) and 1.27 (95 % CI 1.13 - 1.43) in the WHI OS and CT, respectively - however, differences among estimates from traditional Cox models and marginal structural models were not statistically significant in both cohorts. One explanation suggests that time-dependent confounding was not a substantial factor in these data, however other explanations exist. Unadjusted Cox Proportional Hazards models showed that women with elevated depressive symptoms had a significant increase in diabetes risk that remained after adjustment for confounders. However, this association missed the threshold for statistical significance in propensity score adjusted and marginal structural models. CONCLUSIONS Results from the multiple approaches provide further evidence of an increase in risk of type 2 diabetes for those on antidepressants.
Collapse
Affiliation(s)
- Christine Frisard
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA.
| | - Xiangdong Gu
- Division of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, 715 North Pleasant Street, Amherst, MA, 01003, USA.
| | - Brian Whitcomb
- Division of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, 715 North Pleasant Street, Amherst, MA, 01003, USA.
| | - Yunsheng Ma
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA.
| | - Penelope Pekow
- Division of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, 715 North Pleasant Street, Amherst, MA, 01003, USA.
| | - Martha Zorn
- Division of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, 715 North Pleasant Street, Amherst, MA, 01003, USA.
| | - Deidre Sepavich
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA.
| | - Raji Balasubramanian
- Division of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, 715 North Pleasant Street, Amherst, MA, 01003, USA.
| |
Collapse
|
59
|
Ratliff S, Mezuk B. Depressive symptoms, psychiatric medication use, and risk of type 2 diabetes: results from the Health and Retirement Study. Gen Hosp Psychiatry 2015; 37:420-6. [PMID: 26094130 PMCID: PMC4558325 DOI: 10.1016/j.genhosppsych.2015.05.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 05/15/2015] [Accepted: 05/22/2015] [Indexed: 12/16/2022]
Abstract
OBJECTIVE This prospective study investigates the relationships between depressive symptoms, psychiatric medication use, and their interaction on risk of developing type 2 diabetes. METHOD Data come from the 1998-2010 waves of the Health and Retirement Study, a US nationally representative cohort of adults aged 51 years and older. Analysis is restricted to participants <65 years old who did not have diabetes in 1998 (N=8704). Depressive symptoms were assessed using the 8-item Center for Epidemiologic Studies-Depression Scale. Risk of diabetes over the 12-year follow-up period was assessed using Cox proportional hazard models with time-varying covariates. RESULTS After adjusting for covariates, both depressive symptoms [hazard ratio (HR): 1.06, 95% confidence interval (CI): 1.02-1.09] and psychiatric medication use (HR: 1.57, 95% CI: 1.25-1.96) were associated with development of diabetes. The interaction between depressive symptoms and medication use was significant (beta=-0.240, P=.049), indicating that the association between elevated depressive symptoms and diabetes was higher among respondents not taking medications. The associations between depressive symptoms and medication use were also attenuated by increasing body mass index. CONCLUSION Findings highlight the complex relationship between depressive symptoms and psychiatric medications on diabetes risk and the need for a nuanced understanding of these factors.
Collapse
Affiliation(s)
- Scott Ratliff
- Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University School of Medicine, 830 East Main Street, Richmond, VA 23298, USA.
| | - Briana Mezuk
- Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University School of Medicine, 830 East Main Street, Richmond, VA 23298, USA; Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, 800 East Leigh Street, Richmond, VA 23219, USA; Research Center for Group Dynamics, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI 48106, USA.
| |
Collapse
|
60
|
Hasan SS, Clavarino AM, Mamun AA, Kairuz T. Anxiety symptoms and the risk of diabetes mellitus in Australian women: evidence from 21-year follow-up. Public Health 2015; 130:21-8. [PMID: 26321179 DOI: 10.1016/j.puhe.2015.07.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 04/07/2015] [Accepted: 07/13/2015] [Indexed: 01/08/2023]
Abstract
OBJECTIVES This study aimed to explore the association between transitions in anxiety symptoms and the risk of diabetes in women, using longitudinal data. STUDY DESIGN This longitudinal study measured diabetes, and transitions in anxiety symptoms, using validated instruments. METHODS Data obtained by the Mater-University of Queensland Study of Pregnancy were analysed. Anxiety was measured using the Delusion Symptoms States Inventory (DSSI). To examine possible transitions over different time periods, anxiety was grouped into four categories and assessed at different phases over a 21-year period. RESULTS Three hundred and one women reported diabetes 21 years after the index pregnancy. Almost half of the women who reported anxiety symptoms continued to report these at a subsequent follow-up (FU) phase. About 1 in 10 women who had not reported anxiety symptoms at 5-year FU did so at the subsequent 14-year FU. In prospective analyses, we did not find significant association of diabetes with negative transition (no anxiety to anxiety at subsequent phase) or with positive history of anxiety symptom, but an increasing risk was evident. Women with persistent symptoms had a 1.85-fold greater risk of diabetes (95% CI: 1.18-2.90). The cross-sectional analysis did not produce significant results. CONCLUSIONS Despite some limitations, this study provides insight into the long-term association between events of anxiety and the risk of diabetes across the reproductive life of women. However, the evidence is not strong enough to support a direct effect of anxiety in causing diabetes.
Collapse
Affiliation(s)
- S S Hasan
- School of Pharmacy, Woolloongabba, Queensland, Australia; School of Population Health, Herston, Queensland, Australia.
| | - A M Clavarino
- School of Pharmacy, Woolloongabba, Queensland, Australia
| | - A A Mamun
- School of Population Health, Herston, Queensland, Australia
| | - T Kairuz
- College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| |
Collapse
|
61
|
Depression, Help-Seeking and Self-Recognition of Depression among Dominican, Ecuadorian and Colombian Immigrant Primary Care Patients in the Northeastern United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:10450-74. [PMID: 26343691 PMCID: PMC4586621 DOI: 10.3390/ijerph120910450] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 08/07/2015] [Accepted: 08/19/2015] [Indexed: 12/31/2022]
Abstract
Latinos, the largest minority group in the United States, experience mental health disparities, which include decreased access to care, lower quality of care and diminished treatment engagement. The purpose of this cross-sectional study of 177 Latino immigrants in primary care is to identify demographic factors, attitudes and beliefs, such as stigma, perceived stress, and ethnic identity that are associated with depression, help-seeking and self-recognition of depression. Results indicated that 45 participants (25%) had depression by Patient Health Questionnaire (PHQ-9) criteria. Factors most likely to be associated with depression were: poverty; difficulty in functioning; greater somatic symptoms, perceived stress and stigma; number of chronic illnesses; and poor or fair self-rated mental health. Fifty-four people endorsed help-seeking. Factors associated with help-seeking were: female gender, difficulty in functioning, greater somatic symptoms, severity of depression, having someone else tell you that you have an emotional problem, and poor or fair self-rated mental health. Factors most likely to be associated with self-recognition were the same, but also included greater perceived stress. This manuscript contributes to the literature by examining attitudinal factors that may be associated with depression, help-seeking and self-recognition among subethnic groups of Latinos that are underrepresented in research studies.
Collapse
|
62
|
Depression and Risk for Diabetes: A Meta-Analysis. Can J Diabetes 2015; 39:266-72. [DOI: 10.1016/j.jcjd.2014.11.006] [Citation(s) in RCA: 115] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 11/28/2014] [Accepted: 11/28/2014] [Indexed: 12/20/2022]
|
63
|
Deschênes SS, Burns RJ, Schmitz N. Associations between depression, chronic physical health conditions, and disability in a community sample: A focus on the persistence of depression. J Affect Disord 2015; 179:6-13. [PMID: 25841076 DOI: 10.1016/j.jad.2015.03.020] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 03/09/2015] [Accepted: 03/12/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Previous research has demonstrated that comorbid depression and chronic physical health conditions are associated with disability. The distinction between persistent and transient depression in the relationship between physical health conditions and disability, however, is poorly understood. The present study examined the interactive effects of major depressive disorder (MDD) and chronic physical health conditions on disability in a community sample; the effects of persistent or transient depression on disability were also examined. METHODS Participants were from the Epidemiological Catchment Area of Montreal South-West Study (total N=2202). Past 12-month MDD, chronic physical conditions, functional disability, and disability days experienced within the past month were concurrently assessed. A subsample (n=1226) was used to examine the persistence of depression across three waves of data collection over approximately six years. RESULTS Individuals with comorbid MDD and chronic physical health conditions were approximately thirteen times more likely to have moderate to severe functional disability and had the highest mean number of disability days compared to those without MDD or a chronic physical health condition. Persistent MDD was most strongly associated with functional disability and disability days, and persistence of MDD interacted with physical health conditions to increase likelihood of concurrent disability. LIMITATIONS Our study is limited by a single assessment point for disability and chronic health conditions and by the use of self-report. CONCLUSIONS Our findings suggest that MDD, particularly when persistent, is associated with disability among individuals with a broad range of chronic physical health conditions.
Collapse
Affiliation(s)
- Sonya S Deschênes
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada.
| | - Rachel J Burns
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Norbert Schmitz
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada; Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
64
|
Chang TT, Lung FW, Yen YC. Depressive symptoms, cognitive impairment, and metabolic syndrome in community-dwelling elderly in Southern Taiwan. Psychogeriatrics 2015; 15:109-115. [PMID: 25521171 DOI: 10.1111/psyg.12080] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Revised: 08/07/2014] [Accepted: 09/02/2014] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Metabolic syndrome and depression are both thought to be associated with cognitive impairment in the elderly. Metabolic syndrome is also correlated with depression. We examined their possible pathways in a population-based sample. METHODS We recruited 300 older community participants from Southern Taiwan. Demographics, medical history, severity of depressive symptoms, cognitive function, apolipoprotein genotyping, and lipid profile were collected. The presence of metabolic syndrome was confirmed with the Third Report of the National Cholesterol Education Program's Adult Treatment Panel. Possible relationships between metabolic syndrome, depressive symptoms, and cognitive dysfunction were explored using logistic regression and structured equation modelling. RESULTS When gender, age, education, marital status, and apolipoprotein genotype were adjusted for logistic regression, metabolic syndrome and depressive symptoms were independent and significant predictors of cognitive dysfunction for community-dwelling elderly. In structural equation modelling, metabolic syndrome and depressive symptoms were correlated to each other, and both contributed to the presence of cognitive dysfunction. CONCLUSIONS Depressive symptoms and metabolic syndrome are independently associated with cognitive impairment among community-dwelling elderly.
Collapse
Affiliation(s)
| | - For-Wey Lung
- Songde Branch, Taipei City Hospital, Taipei, Taiwan.,Department of Psychiatry, National Defense Medical Center, Taipei, Taiwan.,Department of Neurology, Kaohsiung Medial University, Kaohsiung, Taiwan
| | - Yung-Chieh Yen
- Department of Psychiatry, E-Da Hospital, Taipei, Taiwan.,School of Medicine, I-Shou University, Taiwan
| |
Collapse
|
65
|
Rosedale M, Strauss SM, Knight C, Malaspina D. Awareness of Prediabetes and Diabetes among Persons with Clinical Depression. Int J Endocrinol 2015; 2015:839152. [PMID: 26060495 PMCID: PMC4427826 DOI: 10.1155/2015/839152] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 04/03/2015] [Indexed: 01/30/2023] Open
Abstract
Background. Major depressive disorder (MDD) is highly comorbid with diabetes, a relationship underappreciated by clinicians. Purpose. Examine the proportion of nonpregnant individuals ≥20 years with MDD and elevated glucose and the demographic and clinical characteristics associated with unrecognized elevated glucose. Methods. 14,373 subjects who participated in the National Health and Nutrition Examination Survey (2007-2012) completed the PHQ-9 depression screen and had hemoglobin A1C (HbA1c) measured. PHQ-9 scores ≥10 and HbA1c scores ≥5.7% were defined as MDD and elevated HbA1c, respectively. Data were analyzed using complex survey sampling software. Results. 38.4% of the sample with MDD had elevated HbA1c readings. Compared with nondepressed subjects, they were significantly more likely to have elevated glucose readings (P = 0.003) and to be aware of their elevated glucose levels if they had a higher body mass index, family history of diabetes, more doctor visits in the past year, a usual care source, health insurance, or were taking hypertension or hypercholesterolemia medications. Conclusions. Many adults with MDD have elevated HbA1c levels, have never been advised of elevated HbA1c, have not received diabetes screening, and have minimal contact with a healthcare provider. Additional opportunities for diabetes risk screening in people with MDD are needed.
Collapse
Affiliation(s)
- Mary Rosedale
- New York University College of Nursing, New York, NY 10010, USA
- NYU Langone Medical Center, New York, NY 10016, USA
| | | | - Candice Knight
- New York University College of Nursing, New York, NY 10010, USA
| | | |
Collapse
|
66
|
Koo BK, Kim SW, Yi KH, Moon MK. Low economic status is identified as an emerging risk factor for diabetes mellitus in korean men aged 30 to 59 years in korean national health and nutrition examination survey 2008 to 2010. Diabetes Metab J 2015; 39:137-46. [PMID: 25922808 PMCID: PMC4411545 DOI: 10.4093/dmj.2015.39.2.137] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 09/16/2014] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND We compared the association between economic status and the prevalence of diabetes mellitus (DM) using large nationwide datasets covering the previous 10 years in Korea. METHODS We analyzed the association between economic status and DM using Korean National Health and Nutrition Examination Survey (KNHANES) data from 2001 to 2010 weighted to represent the Korean population between 30 and 59 years of age. The economic status of participants was classified into quartiles according to monthly family income with an equivalence scale. RESULTS In men, the prevalence of diabetes in the lowest income quartile (Q1) was significantly higher than that in the other quartiles in 2008 (age and body mass index-adjusted odds ratio [OR], 1.846; 95% confidence interval [CI], 1.126 to 3.027; P=0.015), 2009 (OR, 1.706; 95% CI, 1.094 to 2.661; P=0.019), and 2010 (OR, 1.560; 95% CI, 1.024 to 2.377; P=0.039) but not in 2001 or 2005. The data indicated that classification in the lowest economic status was an independent risk factor for diabetes even after adjusting for abdominal obesity, dyslipidemia, hypertension and education level in men of KNHANES 2008 to 2010. Although economic status was significantly associated with abdominal obesity, hypertriglyceridemia, and hypertension in women (P<0.001), there was no significant association between economic status and DM in women. CONCLUSION Korean men between 30 and 59 years of age with the lowest economic status had a significantly higher prevalence of DM in 2008 to 2010 even after adjusting for other risk factors.
Collapse
Affiliation(s)
- Bo Kyung Koo
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Wan Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Ka Hee Yi
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Min Kyong Moon
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
67
|
|
68
|
Davis TME, Hunt K, Bruce DG, Starkstein S, Skinner T, McAullay D, Davis WA. Prevalence of depression and its associations with cardio-metabolic control in Aboriginal and Anglo-Celt patients with type 2 diabetes: the Fremantle Diabetes Study Phase II. Diabetes Res Clin Pract 2015; 107:384-91. [PMID: 25656760 DOI: 10.1016/j.diabres.2014.12.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 10/14/2014] [Accepted: 12/26/2014] [Indexed: 01/23/2023]
Abstract
AIMS To determine the prevalence and associates of depression in Aboriginal and Anglo-Celt (AC) Australians with type 2 diabetes. METHODS Community-based patients were screened using the Patient Health Questionnaire (PHQ-9) as part of detailed assessment. The prevalence of any current depression, major depression and antidepressant use by racial group was compared after adjustment for age, sex, educational attainment and marital status. Multiple logistic regression was used to determine associates of current depression. RESULTS The 107 Aboriginal participants were younger (mean±SD 54.3±11.8 vs. 67.2±10.6 years), less often male (34.6% vs. 50.9%) and married (39.3% vs. 61.7%), and more likely to smoke (44.6% vs. 8.1%) than the 793 AC subjects (P≤0.002). Fifty-two Aboriginal (48.5%) and 772 AC participants (97.4%) completed the PHQ-9; these Aboriginals had similar socio-demographic, anthropometric and diabetes-related characteristics to those without PHQ-9 data. A quarter of the Aboriginals had current depression vs 10.6% of ACs (P=0.16), 15.4% vs. 4.1% had major depression (P=0.029), and 68.8% vs. 29.7% had untreated depression (P=0.032). Compared with non-depressed participants, patients with current depression were younger and more likely to smoke, to be overweight/obese and to have worse glycaemic control (P≤0.024). Significant independent associates of current depression were educational attainment (inversely), smoking status, body mass index and fasting plasma glucose in the AC group and alcohol use in the Aboriginal group. CONCLUSIONS Although prevalence of depression was not significantly increased in the Aboriginal patients, it was more likely to be major and untreated. Depression complicating type 2 diabetes is associated with adverse cardiovascular risk.
Collapse
Affiliation(s)
- Timothy M E Davis
- University of Western Australia, School of Medicine & Pharmacology, Fremantle Hospital, Fremantle, Western Australia, Australia.
| | - Kerry Hunt
- University of Western Australia, School of Medicine & Pharmacology, Fremantle Hospital, Fremantle, Western Australia, Australia
| | - David G Bruce
- University of Western Australia, School of Medicine & Pharmacology, Fremantle Hospital, Fremantle, Western Australia, Australia
| | - Sergio Starkstein
- University of Western Australia, School of Psychiatry and Clinical Neurosciences, Fremantle Hospital, Fremantle, Western Australia, Australia
| | - Timothy Skinner
- Charles Darwin University, School of Psychological and Clinical Sciences, Casuarina, Northern Territory, Australia
| | - Daniel McAullay
- Edith Cowan University, Kurongkurl Katitjin Centre for Indigenous Australian Education and Research, Mt Lawley, Western Australia, Australia; Australian National University, Australian Primary Health Care Research Institute, Canberra, Australian Capital Territory, Australia
| | - Wendy A Davis
- University of Western Australia, School of Medicine & Pharmacology, Fremantle Hospital, Fremantle, Western Australia, Australia
| |
Collapse
|
69
|
Chang HY, Keyes KM, Mok Y, Jung KJ, Shin YJ, Jee SH. Depression as a risk factor for overall and hormone-related cancer: the Korean cancer prevention study. J Affect Disord 2015; 173:1-8. [PMID: 25462388 PMCID: PMC4402221 DOI: 10.1016/j.jad.2014.10.064] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 10/27/2014] [Accepted: 10/29/2014] [Indexed: 11/17/2022]
Abstract
Depression has been hypothesized to be a risk factor of cancer, especially hormone-related cancers. However, few studies have been conducted with large enough sample size and sufficient follow-up period to rigorously estimate these associations. We aim to examine the relationship between depression and risk of registry-documented overall and hormone-related cancers. In this 19 year prospective cohort study of general population, 601,775 Koreans aged 30-64 years had a biennial medical evaluation by the National Health Insurance Service in either 1992 or 1994. Major and minor depression was ascertained by a 9-item depression questionnaire. At baseline, major depression was identified in 7.4% and 10.2% and minor depression in 19.3% and 21.4% in men and women, respectively. During the follow-up, 49,744 cancers were identified in men and 7860 in women. Prostate cancer in men was positively related to minor depression (HR 1.13, 95% CI 1.05, 1.23), and cervical cancer in women was inversely related to major depression (HR 0.90, 95% CI 0.83, 0.98) after adjusting for potential confounders. Regarding overall cancer, major depression was positively related to overall cancer in men (HR 1.04, 95% CI 1.00, 1.08) and inversely related in women (HR 0.90, 95% CI 0.83, 0.98). There was no association between breast cancer and depression. Different direction and magnitude of association among gender and cancer subtypes suggest different psycho-behavioral and biological pathways in which depression may affect later cancer development. Further studies on the association of depression and cancer and the underlying mechanisms should be conducted on specific cancer subtypes.
Collapse
Affiliation(s)
- Hyoung Yoon Chang
- Department of Psychiatry, Ajou University College of Medicine, Gyeonggi-do, South Korea
| | - Katherine M. Keyes
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, USA
| | - Yejin Mok
- Institute for Health Promotion, Department of Epidemiology and Health Promotion, Graduate School of Health Promotion, Yonsei University, Seoul, South Korea
| | - Keum Ji Jung
- Institute for Health Promotion, Department of Epidemiology and Health Promotion, Graduate School of Health Promotion, Yonsei University, Seoul, South Korea
| | - Yee-Jin Shin
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, South Korea
| | - Sun Ha Jee
- Institute for Health Promotion, Department of Epidemiology and Health Promotion, Graduate School of Health Promotion, Yonsei University, Seoul, South Korea.
| |
Collapse
|
70
|
Lopez-de-Andrés A, Jiménez-Trujillo MI, Hernández-Barrera V, de Miguel-Yanes JM, Méndez-Bailón M, Perez-Farinos N, de Burgos Lunar C, Cárdenas-Valladolid J, Salinero-Fort MÁ, Jiménez-García R, Carrasco-Garrido P. Trends in the prevalence of depression in hospitalized patients with type 2 diabetes in Spain: analysis of hospital discharge data from 2001 to 2011. PLoS One 2015; 10:e0117346. [PMID: 25706646 PMCID: PMC4338183 DOI: 10.1371/journal.pone.0117346] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 12/21/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND This study aims to describe trends in the prevalence of depression among hospitalized patients with type 2 diabetes in Spain, 2001-2011. METHODS We selected patients with a discharge diagnosis of type 2 diabetes using national hospital discharge data. Discharges were grouped by depression status. Prevalence of depression globally and according to primary diagnoses based on the Charlson comorbidity index (CCI) were analyzed. We calculated length of stay (LOHS) and in-hospital mortality (IHM). Multivariate analysis was adjusted by age, year and comorbidity. RESULTS From 2001 to 2011, 4,723,338 discharges with type 2 diabetes were identified (4.93% with depression). Prevalence of depression in diabetic patients increased from 3.54% in 2001 to 5.80% in 2011 (p<0.05). The prevalence of depression was significantly higher in women than in men in each year studied and increased from 5.22% in 2001 to 9.24% in 2011 (p<0.01). The highest prevalence was observed in the youngest age group (35-59 years). The median LOHS decreased significantly over this period. Men with diabetes and depression had higher IHM than women in all the years studied (p<0.05). Older age and greater comorbidity were significantly associated with a higher risk of dying, among diabetic patients with concomitant depression. CONCLUSIONS Prevalence of depression increased significantly among hospitalized diabetic patients from 2001 to 2011 even if the health profile and LOHS have improved over this period. Programs targeted at preventing depression among persons with diabetes should be reinforced in Spain.
Collapse
Affiliation(s)
- Ana Lopez-de-Andrés
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcon, Comunidad de Madrid, Spain
- * E-mail:
| | - Mª Isabel Jiménez-Trujillo
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcon, Comunidad de Madrid, Spain
| | - Valentín Hernández-Barrera
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcon, Comunidad de Madrid, Spain
| | - José Mª de Miguel-Yanes
- Medicine Department, Hospital Universitario del Sureste, Arganda, Comunidad de Madrid, Spain
| | - Manuel Méndez-Bailón
- Medicine Department, Hospital Clínico San Carlos, Madrid, Comunidad de Madrid, Spain
| | | | | | - Juan Cárdenas-Valladolid
- Dirección Técnica de Docencia e Investigación, Gerencia Atención Primaria, Madrid, Comunidad de Madrid, Spain
| | - Miguel Ángel Salinero-Fort
- Dirección Técnica de Docencia e Investigación, Gerencia Atención Primaria, Madrid, Comunidad de Madrid, Spain
| | - Rodrigo Jiménez-García
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcon, Comunidad de Madrid, Spain
| | - Pilar Carrasco-Garrido
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcon, Comunidad de Madrid, Spain
| |
Collapse
|
71
|
Choo J, Turk MT, Jae SY, Choo IH. Factors associated with health-related quality of life among overweight and obese Korean women. Women Health 2015; 55:152-66. [PMID: 25706685 DOI: 10.1080/03630242.2014.979966] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Health-related quality of life (HRQOL) tends to be lower among individuals who are overweight and obese than those of normal weight, and women may be more vulnerable to lower HRQOL associated with obesity than men. Identifying factors associated with HRQOL may be crucial for improving HRQOL for overweight/obese women. We aimed to determine the factors associated with obesity-specific HRQOL among overweight/obese Korean women. A cross-sectional study was conducted with 125 women aged 20-64 years, who comprised a baseline sample in the Community-based Heart and Weight Management Trial. The data were collected from September 2010 to November 2011. The Weight Efficacy Lifestyle, Beck Depression Inventory-II, Interpersonal Social Evaluation List, and Impact of Weight on Quality of Life (IWQOL)-Lite scales were used to measure self-efficacy for weight control, depressive symptoms, social support, and HRQOL, respectively. Increased body mass index, lower self-efficacy for weight control, and higher levels of depressive symptoms were significantly associated with greater impairment in total IWQOL in the regression models. However, social support was not significantly associated with IWQOL. Along with weight loss strategies, other strategies for improving self-efficacy and alleviating depressive symptoms may be essential for improving HRQOL among overweight and obese women.
Collapse
Affiliation(s)
- Jina Choo
- a Department of Community Health Nursing, College of Nursing , Korea University , Seoul , South Korea
| | | | | | | |
Collapse
|
72
|
Fiore V, Marci M, Poggi A, Giagulli VA, Licchelli B, Iacoviello M, Guastamacchia E, De Pergola G, Triggiani V. The association between diabetes and depression: a very disabling condition. Endocrine 2015; 48:14-24. [PMID: 24927794 DOI: 10.1007/s12020-014-0323-x] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Accepted: 05/27/2014] [Indexed: 12/29/2022]
Abstract
Rates of depression are significantly increased in diabetic patients, and even more in the elderly. About 20-30% of patients with diabetes suffer from clinically relevant depressive disorders, 10% of which being affected by the major depression disorder. Moreover, people with depression seem to be more prone to develop an associated diabetes mellitus, and depression can worsen glycemic control in diabetes, with higher risk to develop complications and adverse outcomes, whereas improving depressive symptoms is generally associated with a better glycemic control. Thus, the coexistence of depression and diabetes has a negative impact on both lifestyle and quality of life, with a reduction of physical activity and an increase in the request for medical care and prescriptions, possibly increasing the healthcare costs and the susceptibility to further diseases. These negative aspects are particularly evident in the elderly, with further decrease in the mobility, worsening of disability, frailty, geriatric syndromes and increased mortality. Healthcare providers should be aware of the possible coexistence of depression and diabetes and of the related consequences, to better manage the patients affected by these two pathological conditions.
Collapse
Affiliation(s)
- Vincenzo Fiore
- Unit of Internal Medicine-Geriatrics, "S. Giovanni Evangelista" Hospital, Via Parrozzani 3, 00019, Tivoli (RM), Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
73
|
Pomytkin IA, Cline BH, Anthony DC, Steinbusch HW, Lesch KP, Strekalova T. Endotoxaemia resulting from decreased serotonin tranporter (5-HTT) function: A reciprocal risk factor for depression and insulin resistance? Behav Brain Res 2015; 276:111-7. [DOI: 10.1016/j.bbr.2014.04.049] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2014] [Revised: 04/25/2014] [Accepted: 04/28/2014] [Indexed: 12/31/2022]
|
74
|
3-Hydroxykynurenic Acid and Type 2 Diabetes: Implications for Aging, Obesity, Depression, Parkinson’s Disease, and Schizophrenia. TRYPTOPHAN METABOLISM: IMPLICATIONS FOR BIOLOGICAL PROCESSES, HEALTH AND DISEASE 2015. [DOI: 10.1007/978-3-319-15630-9_8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
|
75
|
Lobo A. Psychosomatic and liaison psychiatry in Zaragoza: philosophy, objectives and results in a four decade experience: the 2014 EAPM 'Frits Huyse Award' lecture. J Psychosom Res 2014; 77:435-7. [PMID: 25281168 DOI: 10.1016/j.jpsychores.2014.08.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 08/22/2014] [Accepted: 08/24/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Antonio Lobo
- Department of Medicine and Psychiatry, University of Zaragoza, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain.
| |
Collapse
|
76
|
Is the association between depressive symptoms and glucose metabolism bidirectional? Evidence from the English Longitudinal Study of Ageing. Psychosom Med 2014; 76:555-61. [PMID: 25077428 PMCID: PMC4458700 DOI: 10.1097/psy.0000000000000082] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To examine whether the prospective association between depressive symptoms and glucose metabolism is bidirectional. METHODS We used a national sample of 4238 community-dwelling individuals 50 years or older from the English Longitudinal Study of Ageing. Participants were categorized into normoglycemic, impaired glucose metabolism (IGM), and undiagnosed and diagnosed diabetes using glycated hemoglobin and self-reported doctor diagnosis. Subthreshold and elevated depressive symptoms were defined by a score between 2 and 3 and 4 or higher, respectively, on the eight-item Center for Epidemiological Studies-Depression scale. RESULTS In the age-adjusted model, categories of depressive symptoms were associated with incident undiagnosed (odds ratio [OR] = 1.54 [95% confidence interval {CI} = 0.86-2.73] and OR = 1.91 [95% CI = 1.03-3.57] for subthreshold and elevated depressive symptoms, respectively) and diagnosed diabetes (OR = 1.53 [95% CI = 0.80-2.93] and OR = 3.03 [95% CI = 1.66-5.54], respectively) for 6 years of follow-up. The latter association remained significant after adjustment for covariates. Depressive symptoms were not associated with future IGM. Diagnosed diabetes was associated with future elevated depressive symptoms in participants aged 52 to 64 years (OR = 2.17, [95% CI = 1.33-3.56]), but not those 65 years and older (OR = 0.96, [95% CI = 0.59-1.57]) for 4 years of follow-up. Adjustment for covariates partially explained this association. IGM and undiagnosed diabetes were not associated with subsequent elevated depressive symptoms. CONCLUSIONS These data suggest that there is a bidirectional association between depressive symptoms and diagnosed diabetes in people aged 52 to 64 years but not in people 65 years and older.
Collapse
|
77
|
Cukić I, Weiss A. Personality and diabetes mellitus incidence in a national sample. J Psychosom Res 2014; 77:163-8. [PMID: 25149025 DOI: 10.1016/j.jpsychores.2014.07.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Revised: 06/18/2014] [Accepted: 07/06/2014] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To test whether personality traits were prospectively associated with type 2 diabetes incidence. METHODS The sample (n=6798) was derived from the National Health and Nutrition Examination Survey Epidemiological Follow-up Study cohort. We fit four logistic regression models to test whether neuroticism, extraversion, openness to experience, or the Type A behavior pattern predicted type 2 diabetes incidence. Model 1 included sex, age, and race/ethnicity. Model 2 added personality traits, Model 3 added depressive symptoms, and Model 4 added body mass index (BMI), hypertension, and cigarette smoking status as predictors. RESULTS In Model 1 age was associated with increased risk of diabetes (2% per year); being black as opposed to white was associated with a three-fold increase in risk. In Model 2 age and being black were still significant and extraversion was associated with decreased risk (17% per standard deviation [SD]). In Model 3 age, being black, and extraversion were still significant. In addition, neuroticism was associated with decreased risk (26% per SD) and depressive symptoms were associated with increased risk (28% per SD). In Model 4 age, being black, neuroticism, and depressive symptoms were still significant. BMI was associated with increased risk (14% per SD) and extraversion was no longer significant. CONCLUSIONS Higher neuroticism was associated with reduced type 2 diabetes risk even after controlling for race/ethnicity, age, depressive symptoms, and BMI. Extraversion and Type A behavior were not significant after including covariates.
Collapse
Affiliation(s)
- Iva Cukić
- Department of Psychology, School of Philosophy, Psychology and Language Sciences, The University of Edinburgh, UK.
| | - Alexander Weiss
- Department of Psychology, School of Philosophy, Psychology and Language Sciences, The University of Edinburgh, UK
| |
Collapse
|
78
|
Hasan SS, Clavarino AM, Mamun AA, Kairuz T. Incidence and risk of diabetes mellitus associated with depressive symptoms in adults: evidence from longitudinal studies. Diabetes Metab Syndr 2014; 8:82-87. [PMID: 24907171 DOI: 10.1016/j.dsx.2014.04.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS We estimated the incidence and risk of diabetes associated with depressive symptoms using data from longitudinal studies. MATERIALS AND METHODS Databases were systematically searched for relevant studies. Incidence of diabetes is presented as cumulative incident proportion (CIP). Pooled effect sizes were calculated using random-effects model. The data were reconstructed to compute relative risk (RR). RESULTS The 16 studies selected for review generated 16 datasets of which 8 studies reporting binary estimates (RR) and 8 studies reporting time-to-event estimates (hazard ratio (HR)). Both RR and HR were significant at 1.67 (95% CI: 1.30-2.15) and 1.45 (95% CI: 1.12-1.87) for incident diabetes associated with depressive symptoms. CONCLUSION Our observations revealed greater cumulative incidence of diabetes in depressed than in non depressed groups. Depression should be included among risk factors that required regular screening for diabetes.
Collapse
Affiliation(s)
- Syed Shahzad Hasan
- The University of Queensland, 20 Cornwall Street, Woolloongabba 4102, Queensland, Australia.
| | - Alexandra M Clavarino
- The University of Queensland, 20 Cornwall Street, Woolloongabba 4102, Queensland, Australia.
| | - Abdullah A Mamun
- The University of Queensland, Herston Road, Herston 4006, Queensland, Australia.
| | - Therese Kairuz
- The University of Queensland, 20 Cornwall Street, Woolloongabba 4102, Queensland, Australia.
| |
Collapse
|
79
|
Liu W, Zhai X, Li H, Ji L. Depression-like behaviors in mice subjected to co-treatment of high-fat diet and corticosterone are ameliorated by AICAR and exercise. J Affect Disord 2014; 156:171-7. [PMID: 24388462 DOI: 10.1016/j.jad.2013.11.025] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 11/30/2013] [Accepted: 11/30/2013] [Indexed: 12/20/2022]
Abstract
Major depressive disorder (MDD) and type II diabetes mellitus (T2DM) are highly co-morbid, and there may be a bi-directional connection between the two. Herein, we have described a mouse model of a depression-like and insulin-resistant (DIR) state induced by the co-treatment of high-fat diet (HFD) and corticosterone (CORT). 5-Aminoimidazole-4-carboxamide-1-β-d- ribofuranoside (AICAR), a pharmacological activator of AMP-activated protein kinase (AMPK), was originally used to improve insulin resistance (IR). Interestingly, our results show a clear potential for AICAR as a putative antidepressant with a chronic action on the DIR mice. In contrast to the traditional antidepressants, AICAR as a promising antidepressant avoids reducing insulin actions of skeletal muscle in the context of long-term HFD. Exercise also produced antidepressant effects. Our data suggest that the effects of AICAR and exercise on DIR may further increase our understanding on the link between depression and diabetes.
Collapse
Affiliation(s)
- Weina Liu
- Key Laboratory of Adolescent Health Assessment and Exercise Intervention of Ministry of Education, East China Normal University, Shanghai 200241, China; School of Physical Education & Health Care, East China Normal University, Shanghai 200241, China.
| | - Xiaofeng Zhai
- Department of Traditional Chinese Medicine, Changhai Hospital, Shanghai 200438, China
| | - Haipeng Li
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai 200438, China
| | - Liu Ji
- Key Laboratory of Adolescent Health Assessment and Exercise Intervention of Ministry of Education, East China Normal University, Shanghai 200241, China; School of Physical Education & Health Care, East China Normal University, Shanghai 200241, China.
| |
Collapse
|
80
|
|
81
|
Fejfarová V, Jirkovská A, Dragomirecká E, Game F, Bém R, Dubský M, Wosková V, Křížová M, Skibová J, Wu S. Does the diabetic foot have a significant impact on selected psychological or social characteristics of patients with diabetes mellitus? J Diabetes Res 2014; 2014:371938. [PMID: 24791012 PMCID: PMC3984852 DOI: 10.1155/2014/371938] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 01/27/2014] [Accepted: 02/19/2014] [Indexed: 12/15/2022] Open
Abstract
UNLABELLED The aim of our case-control study was to compare selected psychological and social characteristics between diabetic patients with and without the DF (controls). METHODS 104 patients with and 48 without DF were included into our study. Both study groups were compared in terms of selected psychosocial characteristics. RESULTS Compared to controls, patients with DF had a significantly worse quality of life in the area of health and standard of living as shown by lower physical health domain (12.7 ± 2.8 versus 14.7 ± 2.5; P < 0.001) and environment domain (14.1 ± 2.2 versus 15 ± 1.8; P < 0.01) that negatively correlated with diabetes duration (r = -0.061; P = 0.003). Patients with DF subjectively felt more depressed in contrast to controls (24.5 versus 7.3%; P < 0.05); however, the depressive tuning was objectively proven in higher percentage in both study groups (83.2 versus 89.6; NS). We observed a significantly lower level of achieved education (P < 0.01), more patients with disability pensions (P < 0.01), and low self-support (P < 0.001) in patients with the DF compared to controls. In the subgroup of patients with a previous major amputation and DF (n = 6), there were significantly worse outcomes as in the environment domain (P < 0.01), employment status, and stress readaptation (P < 0.01) in contrast to the main study groups. CONCLUSIONS Patients with DF had a predominantly worse standard of living. In contrast to our expectations, patients with DF appeared to have good stress tolerability and mental health (with the exception of patients with previous major amputation) and did not reveal severe forms of depression or any associated consequences.
Collapse
MESH Headings
- Activities of Daily Living/psychology
- Adaptation, Psychological
- Aged
- Amputation, Surgical/adverse effects
- Amputation, Surgical/economics
- Amputation, Surgical/psychology
- Amputation, Surgical/rehabilitation
- Case-Control Studies
- Cost of Illness
- Czech Republic/epidemiology
- Depression/complications
- Depression/economics
- Depression/epidemiology
- Depressive Disorder, Major/complications
- Depressive Disorder, Major/economics
- Depressive Disorder, Major/epidemiology
- Diabetes Mellitus/economics
- Diabetes Mellitus/physiopathology
- Diabetes Mellitus/psychology
- Diabetic Foot/complications
- Diabetic Foot/physiopathology
- Diabetic Foot/psychology
- Diabetic Foot/surgery
- Female
- Humans
- Incidence
- Male
- Middle Aged
- Neuritis/complications
- Neuritis/epidemiology
- Psychiatric Status Rating Scales
- Quality of Life/psychology
- Severity of Illness Index
- Socioeconomic Factors
- Stress, Psychological/complications
- Stress, Psychological/economics
- Stress, Psychological/epidemiology
- Stress, Psychological/rehabilitation
Collapse
Affiliation(s)
- Vladimíra Fejfarová
- Diabetes Center, Institute for Clinical and Experimental Medicine, Vídeňská 1958, 140 21 Prague, Czech Republic
- *Vladimíra Fejfarová:
| | - Alexandra Jirkovská
- Diabetes Center, Institute for Clinical and Experimental Medicine, Vídeňská 1958, 140 21 Prague, Czech Republic
| | - Eva Dragomirecká
- Department of Social Work, Faculty of Arts, Charles University, 116 42 Prague, Czech Republic
| | - Frances Game
- Diabetes Unit, Derby Hospitals NHS Foundation Trust, Derby DU22 3NE, UK
| | - Robert Bém
- Diabetes Center, Institute for Clinical and Experimental Medicine, Vídeňská 1958, 140 21 Prague, Czech Republic
| | - Michal Dubský
- Diabetes Center, Institute for Clinical and Experimental Medicine, Vídeňská 1958, 140 21 Prague, Czech Republic
| | - Veronika Wosková
- Diabetes Center, Institute for Clinical and Experimental Medicine, Vídeňská 1958, 140 21 Prague, Czech Republic
| | - Marta Křížová
- Diabetes Center, Institute for Clinical and Experimental Medicine, Vídeňská 1958, 140 21 Prague, Czech Republic
| | - Jelena Skibová
- Diabetes Center, Institute for Clinical and Experimental Medicine, Vídeňská 1958, 140 21 Prague, Czech Republic
| | - Stephanie Wu
- Center for Lower Extremity Ambulatory Research, Dr. William M. Scholl College of Podiatric Medicine, Rosalind Franklin University of Medicine and Science, Chicago, IL 60064, USA
| |
Collapse
|
82
|
Schumann G, Binder EB, Holte A, de Kloet ER, Oedegaard KJ, Robbins TW, Walker-Tilley TR, Bitter I, Brown VJ, Buitelaar J, Ciccocioppo R, Cools R, Escera C, Fleischhacker W, Flor H, Frith CD, Heinz A, Johnsen E, Kirschbaum C, Klingberg T, Lesch KP, Lewis S, Maier W, Mann K, Martinot JL, Meyer-Lindenberg A, Müller CP, Müller WE, Nutt DJ, Persico A, Perugi G, Pessiglione M, Preuss UW, Roiser JP, Rossini PM, Rybakowski JK, Sandi C, Stephan KE, Undurraga J, Vieta E, van der Wee N, Wykes T, Haro JM, Wittchen HU. Stratified medicine for mental disorders. Eur Neuropsychopharmacol 2014; 24:5-50. [PMID: 24176673 DOI: 10.1016/j.euroneuro.2013.09.010] [Citation(s) in RCA: 115] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 09/09/2013] [Accepted: 09/26/2013] [Indexed: 12/13/2022]
Abstract
There is recognition that biomedical research into the causes of mental disorders and their treatment needs to adopt new approaches to research. Novel biomedical techniques have advanced our understanding of how the brain develops and is shaped by behaviour and environment. This has led to the advent of stratified medicine, which translates advances in basic research by targeting aetiological mechanisms underlying mental disorder. The resulting increase in diagnostic precision and targeted treatments may provide a window of opportunity to address the large public health burden, and individual suffering associated with mental disorders. While mental health and mental disorders have significant representation in the "health, demographic change and wellbeing" challenge identified in Horizon 2020, the framework programme for research and innovation of the European Commission (2014-2020), and in national funding agencies, clear advice on a potential strategy for mental health research investment is needed. The development of such a strategy is supported by the EC-funded "Roadmap for Mental Health Research" (ROAMER) which will provide recommendations for a European mental health research strategy integrating the areas of biomedicine, psychology, public health well being, research integration and structuring, and stakeholder participation. Leading experts on biomedical research on mental disorders have provided an assessment of the state of the art in core psychopathological domains, including arousal and stress regulation, affect, cognition social processes, comorbidity and pharmacotherapy. They have identified major advances and promising methods and pointed out gaps to be addressed in order to achieve the promise of a stratified medicine for mental disorders.
Collapse
Affiliation(s)
- Gunter Schumann
- MRC-Social Genetic Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, PO80, 16 De Crespigny Park, London SE5 8AF, UK.
| | | | - Arne Holte
- Norwegian Institute of Public Health, Oslo, Norway
| | - E Ronald de Kloet
- Department of Endocrinology and Metabolism, Leiden University Medical Centre and Medical Pharmacology, LACDR, Leiden University, The Netherlands
| | - Ketil J Oedegaard
- Department of Clinical Medicine, Section of Psychiatry, University of Bergen and Psychiatric division, Health Bergen, Norway
| | - Trevor W Robbins
- Behavioural and Clinical Neuroscience Institute and Department of Psychology, Cambridge University, Cambridge, UK
| | - Tom R Walker-Tilley
- MRC-Social Genetic Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, PO80, 16 De Crespigny Park, London SE5 8AF, UK
| | - Istvan Bitter
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Verity J Brown
- Department of Psychology, University of St Andrews, St Andrews, UK
| | - Jan Buitelaar
- Department of Cognitive Neuroscience, University Medical Center, St Radboud and Karakter Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands
| | - Roberto Ciccocioppo
- Department of Experimental Medicine and Public Health, University of Camerino, Camerino, Macerata, Italy
| | | | - Carles Escera
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
| | - Wolfgang Fleischhacker
- Department of Psychiatry and Psychotherapy, Medical University Innsbruck, Innsbruck, Austria
| | - Herta Flor
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Chris D Frith
- Wellcome Trust Centre for Neuroimaging, University College London, London, UK
| | - Andreas Heinz
- Berlin School of Mind and Brain, Bernstein Center for Computational Neuroscience (BCCN), Clinic for Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany
| | - Erik Johnsen
- Department of Clinical Medicine, Section of Psychiatry, University of Bergen and Psychiatric division, Health Bergen, Norway
| | - Clemens Kirschbaum
- Technische Universität Dresden, Department of Psychology, Dresden, Germany
| | | | - Klaus-Peter Lesch
- Division of Molecular Psychiatry, Laboratory of Translational Neuroscience, University of Würzburg, Würzburg, Germany and Department of Neuroscience, School of Mental Health and Neuroscience (MHENS), Maastricht University, Maastricht, The Netherlands
| | - Shon Lewis
- University of Manchester, Manchester, UK
| | - Wolfgang Maier
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Karl Mann
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Mannheim, Germany
| | - Jean-Luc Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM CEA Unit 1000 "Imaging & Psychiatry", University Paris Sud, Orsay; AP-HP Department of Adolescent Psychopathology and Medicine, Maison de Solenn, University Paris Descartes, Paris, France
| | - Andreas Meyer-Lindenberg
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Christian P Müller
- Psychiatric University Hospital, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Walter E Müller
- Department of Pharmacology, Biocenter Niederursel, University of Frankfurt, Frankfurt, Germany
| | - David J Nutt
- Neuropsychopharmacology Unit, Division of Brain Sciences, Imperial College, London, UK
| | - Antonio Persico
- Child and Adolescent Neuropsychiatry Unit & Laboratory of Molecular Psychiatry and Neurogenetics, University Campus Bio-Medico, Rome, Italy
| | - Giulio Perugi
- Department of Psychiatry, University of Pisa, Pisa, Italy
| | - Mathias Pessiglione
- Institut du Cerveau et de la Moelle épinière (ICM), Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Ulrich W Preuss
- Department of Psychiatry, Psychotherapy and Psychosomatics, Martin-Luther-University of Halle-Wittenberg, Halle/Saale, Germany
| | - Jonathan P Roiser
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Paolo M Rossini
- Department of Geriatrics, Neuroscience & Orthopaedics, Catholic University of Sacred Heart, Policlinico A. Gemelli, Rome, Italy
| | - Janusz K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Carmen Sandi
- Laboratory of Behavioural Genetics, Brain Mind Institute, EPFL, Lausanne, Switzerland
| | - Klaas E Stephan
- Translational Neuromodeling Unit (TNU), Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Juan Undurraga
- Translational Neuromodeling Unit (TNU), Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Eduard Vieta
- Bipolar Disorders Programme, Institute of Neuroscience, Hospital Clínic Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
| | - Nic van der Wee
- Leiden Institute for Brain and Cogntion/Psychiatric Neuroimaging, Dept. of Psychiatry, Leiden University Medical Center, The Netherlands
| | - Til Wykes
- Department of Psychology, Institute of Psychiatry, King's College London, UK
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, University of Barcelona, CIBERSAM, Barcelona, Spain
| | - Hans Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany
| |
Collapse
|
83
|
Bruce DG, Davis WA, Cetrullo V, Starkstein SE, Davis TME. Clinical impact of the temporal relationship between depression and type 2 diabetes: the Fremantle diabetes study phase II. PLoS One 2013; 8:e81254. [PMID: 24324682 PMCID: PMC3852722 DOI: 10.1371/journal.pone.0081254] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 10/04/2013] [Indexed: 12/19/2022] Open
Abstract
Background The clinical features of type 2 diabetes may differ depending on whether first depression episode precedes or follows the diagnosis of diabetes. Methods Type 2 patients from the observational community-based Fremantle Diabetes Study Phase II underwent assessment of lifetime depression using the Brief Lifetime Depression Scale (developed and validated for this study) supplemented by information on current depression symptoms (Patient Health Questionnaire, 9-item version) and use of antidepressants. Patients were categorized as never depressed (Group 1), having had depression before diabetes diagnosis (Group 2), diagnosed with depression and diabetes within 2 years of each other (Group 3) and having depression after diabetes diagnosis (Group 4). Results Of 1391 patients, 20.8% were assigned to Group 2, 6.0% to Group 3 and 14.5% to Group 4. In Group 2, depression occurred a median 15.6 years before diabetes onset at age 37.2±14.7 years. These patients had similar clinical characteristics to never depressed patients except for reduced self-care behaviours and having more symptomatic peripheral arterial disease. In Group 4, depression occurred a median 9.9 years after diabetes onset at age 59.8±13.0 years. These patients had long duration diabetes, poor glycaemic control, more intensive management and more diabetic complications. Group 4 patients had more current depression than Group 2 but were less likely to be receiving antidepressants. Conclusions/Interpretation The clinical features of depression and type 2 diabetes are heterogeneous depending on their temporal relationship. There may be corresponding differences in the pathogenesis of depression in diabetes that have implications for diagnosis and management.
Collapse
Affiliation(s)
- David G. Bruce
- School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia
- * E-mail:
| | - Wendy A. Davis
- School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia
| | - Violetta Cetrullo
- School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia
| | - Sergio E. Starkstein
- School of Psychiatry and Neuroscience, University of Western Australia, Crawley, Western Australia, Australia
| | - Timothy M. E. Davis
- School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia
| |
Collapse
|
84
|
Population impact of depression either as a risk factor or consequence of type 2 diabetes in adults: a meta-analysis of longitudinal studies. Asian J Psychiatr 2013; 6:460-72. [PMID: 24309855 DOI: 10.1016/j.ajp.2013.09.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 09/09/2013] [Accepted: 09/15/2013] [Indexed: 11/21/2022]
Abstract
This meta-analysis examined the reciprocal relationship between depression and diabetes mellitus type 2 (T2DM) by conducting a bias adjusted meta-analysis of longitudinal studies using relative and absolute risk estimates. Specifically, the data were reconstructed to compute relative risk (RR), risk difference (RD), and the number needed to be exposed for one additional person to be harmed (NNEH) or benefited (NNEB). The 25 studies selected for review generated 29 datasets of which 15 examined endpoint A (depression as a risk factor for T2DM), and 14 examined endpoint B (T2DM as a risk factor for depression). For both endpoints, there was a small relative risk increase (for both the RR and hazard ratio (HR)) though with significant heterogeneity between studies. This however translated to a non-significant NNEH of 87 (NNEB 161 to ∞ to NNEH 35) and NNEH of 233 (NNEB 28 to ∞ to NNEH 23) for studies examining endpoint A and endpoint B respectively. This study suggests that the magnitude of the relative risk increase for depression as a risk factor or consequence of T2DM is small without significant impact on absolute risk indices. While these risks may be considered in terms of individual patient management, they are unlikely to have an impact on a population perspective.
Collapse
|
85
|
Unantenne N, Warren N, Canaway R, Manderson L. The strength to cope: spirituality and faith in chronic disease. JOURNAL OF RELIGION AND HEALTH 2013; 52:1147-61. [PMID: 22083464 DOI: 10.1007/s10943-011-9554-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The lifelong management of a chronic condition requires considerable mental fortitude and commitment in social adjustment and adherence to medical advice. In examining strategies of adaptation, we draw on ethnographic research, including interviews with 69 people with type 2 diabetes and/or cardiovascular disease. We explore how they incorporate spirituality into their self-management routines, with positive impact on their health and wellbeing, and highlight the role of spiritual practices in supporting people with chronic conditions mentally, physically and socially, so encouraging personal responsibility for one's health and wellbeing.
Collapse
Affiliation(s)
- Nalika Unantenne
- Social Science and Health Research Unit, School of Psychology and Psychiatry, Monash University, PO Box 197, Caulfield East, VIC, 3145, Australia
| | | | | | | |
Collapse
|
86
|
Oxenkrug G. Serotonin-kynurenine hypothesis of depression: historical overview and recent developments. Curr Drug Targets 2013; 14:514-21. [PMID: 23514379 DOI: 10.2174/1389450111314050002] [Citation(s) in RCA: 112] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Revised: 03/14/2013] [Accepted: 03/15/2013] [Indexed: 12/17/2022]
Abstract
This mini-review focuses on the studies of late Prof. IP Lapin (1903 - 2012) and his research team on the role of methoxyindole and kynurenine (KYN) pathways of tryptophan (TRP) metabolism in the pathogenesis of depression and action mechanisms of antidepressant effect. In the late 60s of the last century Prof. IP Lapin suggested that "intensification of central serotoninergic processes is a determinant of the thymoleptic (mood elevating) component" while "activation of noradrenergic processes is responsible for psychoenergetic and motor-stimulating component of the clinical antidepressant effect". The cause of serotonin deficiency in depression was attributed to the shunt of TRP "metabolism away from serotonin production towards KYN production" due to cortisol-induced activation of liver enzyme, tryptophan 2,3- dioxygenase, the rate-limiting enzyme of TRP - KYN pathway. Prof. Lapin suggested and discovered that KYN and its metabolites affect brain functions, and proposed the role of neurokynurenines in pathogenesis of depression and action mechanisms of antidepressant effect (kynurenine hypothesis). Further research suggested the antidepressant and cognition- enhancing effects of post-serotonin metabolite, N-acetylserotonin (NAS), an agonist to tyrosine kinase B (TrkB) receptor; and link between depression and chronic inflammation-associated disorders (e.g., insulin resistance, hepatitis C virus) via inflammation-induced activation of indoleamine 2,3- dioxygenase, brain located rate-limiting enzyme of TRY - KYN metabolism. NAS and kynurenines might be the targets for prevention and treatment of depression and associated conditions.
Collapse
Affiliation(s)
- Gregory Oxenkrug
- Department of Psychiatry, Tufts University School of Medicine, Director, Psychiatry and Inflammation Program, Tufts Medical Center, Boston, MA 02111, USA.
| |
Collapse
|
87
|
Barnard K, Peveler RC, Holt RIG. Antidepressant medication as a risk factor for type 2 diabetes and impaired glucose regulation: systematic review. Diabetes Care 2013; 36:3337-45. [PMID: 24065841 PMCID: PMC3781547 DOI: 10.2337/dc13-0560] [Citation(s) in RCA: 121] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Antidepressant use has risen sharply over recent years. Recent concerns that antidepressants may adversely affect glucose metabolism require investigation. Our aim was to assess the risk of type 2 diabetes associated with antidepressants through a systematic review. RESEARCH DESIGN AND METHODS Data sources were MEDLINE, Embase, PsycINFO, The Cochrane Library, Web of Science, meeting abstracts of the European Association for the Study of Diabetes, American Diabetes Association, and Diabetes UK, Current Controlled Trials, ClinicalTrials.gov, U.K. Clinical Research Network, scrutiny of bibliographies of retrieved articles, and contact with relevant experts. Relevant studies of antidepressant effects were included. Key outcomes were diabetes incidence and change in blood glucose (fasting and random). RESULTS Three systemic reviews and 22 studies met the inclusion criteria. Research designs included 1 case series and 21 observational studies comprising 4 cross-sectional, 5 case-control, and 12 cohort studies. There was evidence that antidepressant use is associated with type 2 diabetes. Causality is not established, but rather, the picture is confused, with some antidepressants linked to worsening glucose control, particularly with higher doses and longer duration, others linked with improved control, and yet more with mixed results. The more recent, larger studies, however, suggest a modest effect. Study quality was variable. CONCLUSIONS Although evidence exists that antidepressant use may be an independent risk factor for type 2 diabetes, long-term prospective studies of the effects of individual antidepressants rather than class effects are required. Heightened alertness to potential risks is necessary until these are complete.
Collapse
|
88
|
Oxenkrug G. Insulin resistance and dysregulation of tryptophan-kynurenine and kynurenine-nicotinamide adenine dinucleotide metabolic pathways. Mol Neurobiol 2013; 48:294-301. [PMID: 23813101 PMCID: PMC3779535 DOI: 10.1007/s12035-013-8497-4] [Citation(s) in RCA: 168] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 06/16/2013] [Indexed: 11/25/2022]
Abstract
Insulin resistance (IR) underlines aging and aging-associated medical (diabetes, obesity, dyslipidemia, hypertension) and psychiatric (depression, cognitive decline) disorders. Molecular mechanisms of IR in genetically or metabolically predisposed individuals remain uncertain. Current review of the literature and our data presents the evidences that dysregulation of tryptophan (TRP)-kynurenine (KYN) and KYN-nicotinamide adenine dinucleotide (NAD) metabolic pathways is one of the mechanisms of IR. The first and rate-limiting step of TRP-KYN pathway is regulated by enzymes inducible by pro-inflammatory factors and/or stress hormones. The key enzymes of KYN-NAD pathway require pyridoxal-5-phosphate (P5P), an active form of vitamin B6, as a cofactor. Deficiency of P5P diverts KYN-NAD metabolism from production of NAD to the excessive formation of xanthurenic acid (XA). Human and experimental studies suggested that XA and some other KYN metabolites might impair production, release, and biological activity of insulin. We propose that one of the mechanisms of IR is inflammation- and/or stress-induced upregulation of TRP-KYN metabolism in combination with P5P deficiency-induced diversion of KYN-NAD metabolism towards formation of XA and other KYN derivatives affecting insulin activity. Monitoring of KYN/P5P status and formation of XA might help to identify subjects at risk for IR. Pharmacological regulation of the TRP-KYN and KYN-NAD pathways and maintaining of adequate vitamin B6 status might contribute to prevention and treatment of IR in conditions associated with inflammation/stress-induced excessive production of KYN and deficiency of vitamin B6, e.g., type 2 diabetes, obesity, cardiovascular diseases, aging, menopause, pregnancy, and hepatitis C virus infection.
Collapse
Affiliation(s)
- Gregory Oxenkrug
- Psychiatry and Inflammation Program, Department of Psychiatry, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA,
| |
Collapse
|
89
|
Mezuk B, Johnson-Lawrence V, Lee H, Rafferty JA, Abdou CM, Uzogara EE, Jackson JS. Is ignorance bliss? Depression, antidepressants, and the diagnosis of prediabetes and type 2 diabetes. Health Psychol 2013; 32:254-63. [PMID: 23437855 DOI: 10.1037/a0029014] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
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.
Collapse
Affiliation(s)
- Briana Mezuk
- Department of Epidemiology and Community Health, Virginia Commonwealth University, Richmond, VA 23298, USA.
| | | | | | | | | | | | | |
Collapse
|
90
|
Sambamoorthi U, Ma Y, Findley PA, Rust G. Antidepressant use, depression, and new-onset diabetes among elderly Medicare beneficiaries. J Diabetes 2013; 5:327-35. [PMID: 23173757 PMCID: PMC3594455 DOI: 10.1111/1753-0407.12014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Revised: 10/10/2012] [Accepted: 11/05/2012] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The aim of the present study was to examine the association between antidepressant use, diagnosed depression, and new-onset diabetes among elderly Medicare beneficiaries. METHODS Longitudinal data from merged survey and claims from the nationally representative Medicare Current Beneficiary Survey(MCBS) from 1999 to 2005 were used. Diabetes incidence was extracted from claims and survey data over a 3-year period. Data regarding depression and antidepressant use over time were obtained. Multivariate logistic regression analysis was used to examine associations between antidepressant use, depression, and new-onset diabetes, adjusted for demographic, socioeconomic, and lifestyle risk factors. Analyses accounted for the complex design of the MCBS. RESULTS The incident diabetes rate was 4.8% for those "without depression and without antidepressants" and 9.5% for those with any antidepressant use in all 3 years and diagnosed depression". Compared with Medicare beneficiaries who did not report any antidepressant use, beneficiaries reporting antidepressant use in all 3 years were 50% more likely to have new-onset diabetes. However, when diagnosed depression was entered in the model, there was no significant association between long-term antidepressant use and new-onset diabetes. Medicare beneficiaries with any depression were twice as likely as those without depression to develop diabetes (adjusted odds ratio 2.04; 95% confidence interval 1.51, 2.75). CONCLUSIONS Depression independently increased the risk of developing diabetes in the MCBS population, although there is no evidence of an association between antidepressant use and new-onset diabetes. If replicated, these results have significant clinical implications.
Collapse
Affiliation(s)
- Usha Sambamoorthi
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, West Virginia, USA
| | | | | | | |
Collapse
|
91
|
Abstract
Comorbidity of depression and diabetes is common, and each disorder has a negative impact on the outcome of the other. The direction of causality is not certain as each disorder seems to act as both a risk factor and consequence for the other in longitudinal studies. This bidirectional association is possibly mediated by shared environmental and genetic risk factors. Comorbid depression is associated with reduced adherence to medication and self-care management, poor glycaemic control, increased health care utilization, increased costs and elevated risk of complications, as well as mortality in patients with diabetes. Psychological and pharmacological interventions are shown to be effective in improving depression symptoms; however, collaborative care programs that simultaneously manage both disorders seem to be most effective in improving diabetes-related outcomes.
Collapse
Affiliation(s)
- Bibilola D Oladeji
- Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria.
| | | |
Collapse
|
92
|
Yoon JM, Cho EG, Lee HK, Park SM. Antidepressant use and diabetes mellitus risk: a meta-analysis. Korean J Fam Med 2013; 34:228-40. [PMID: 23904952 PMCID: PMC3726790 DOI: 10.4082/kjfm.2013.34.4.228] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Accepted: 06/07/2013] [Indexed: 11/19/2022] Open
Abstract
Background Epidemiologic studies have reported inconsistent findings regarding the association between the use of antidepressants and type 2 diabetes mellitus (DM) risk. We performed a meta-analysis to systematically assess the association between antidepressants and type 2 DM risk. Methods We searched MEDLINE (PubMed), EMBASE, and the Cochrane Library (through Dec 31, 2011), including references of qualifying articles. Studies concerning the use of tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), or other antidepressants and the associated risk of diabetes mellitus were included. Results Out of 2,934 screened articles, 3 case-control studies, 9 cohort studies, and no clinical trials were included in the final analyses. When all studies were pooled, use of antidepressants was significantly associated with an increased risk of DM in a random effect model (relative risk [RR], 1.49; 95% confidence interval [CI], 1.29 to 1.71). In subgroup analyses, the risk of DM increased among both SSRI users (RR, 1.35; 95% CI, 1.15 to 1.58) and TCA users (RR, 1.57; 95% CI, 1.26 to 1.96). The subgroup analyses were consistent with overall results regardless of study type, information source, country, duration of medication, or study quality. The subgroup results considering body weight, depression severity, and physical activity also showed a positive association (RR, 1.14; 95% CI, 1.01 to 1.28). A publication bias was observed in the selected studies (Egger's test, P for bias = 0.09). Conclusion Our results suggest that the use of antidepressants is associated with an increased risk of DM.
Collapse
Affiliation(s)
- Jae Moon Yoon
- Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | | | | | | |
Collapse
|
93
|
Abstract
RATIONALE Past research on the association of antidepressant medication use with glycemic control abnormalities has produced mixed results. OBJECTIVE To examine the association of antidepressant use with glycemic control abnormalities and screen-positive diabetes in a representative population sample of US adults without a diagnosis of diabetes. METHODS Using data from adult participants of the National Health and Nutrition Examination Survey (NHANES, 2005-2010), the association of antidepressant use with continuous measures of HbA1c, fasting blood sugar, 2-h oral glucose tolerance test, insulin sensitivity and screen-positive diabetes according to HbA1c, fasting blood sugar and 2-h oral glucose tolerance test were assessed. RESULTS Antidepressant use was not associated with increased levels of HbA1c, fasting blood sugar, 2-h oral glucose tolerance test, reduced insulin sensitivity or increased prevalence of screen-positive diabetes. Results were mostly consistent across sociodemographic groups and across different lengths of exposure, different classes of antidepressants and levels of body mass index. CONCLUSIONS In this representative population sample, antidepressant use was not associated with an increased risk of abnormalities in glycemic control or undetected diabetes. Positive findings from past research may be attributable to detection bias, in that individuals prescribed antidepressants may be more likely to be tested and diagnosed with diabetes.
Collapse
|
94
|
Depression, neighborhood deprivation and risk of type 2 diabetes. Health Place 2013; 23:63-9. [PMID: 23771166 DOI: 10.1016/j.healthplace.2013.05.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Revised: 04/22/2013] [Accepted: 05/04/2013] [Indexed: 11/23/2022]
Abstract
Neighborhood characteristics have been associated with both depression and diabetes, but to date little attention has been paid to whether the association between depression and diabetes varies across different types of neighborhoods. This prospective study examined the relationship between depression, neighborhood deprivation, and risk of type 2 diabetes among 336,340 adults from a national-representative sample of primary care centers in Sweden (2001-2007). Multi-level logistic regression models were used to assess associations between depression and risk of type 2 diabetes across affluent and deprived neighborhoods. After accounting for demographic, individual-level socioeconomic, and health characteristics, depression was significantly associated with risk of diabetes (odds ratio (OR): 1.10, 95% confidence interval (CI): 1.06-1.14), as was neighborhood deprivation (OR for high vs. low deprivation: 1.66, 95% CI: 1.22-1.34). The interaction term between depression and neighborhood deprivation was non-significant, indicating that the relationship between depression and diabetes risk is similar across levels of neighborhood socioeconomic deprivation.
Collapse
|
95
|
Ghosh S, Chatterjee S. Should depressive patients undergo a regular diabetes screening test? Indian J Endocrinol Metab 2013; 17:537-538. [PMID: 23869324 PMCID: PMC3712398 DOI: 10.4103/2230-8210.111692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
|
96
|
Antidepressant Prescription Medication Use Patterns among Insured, Low Income Pregnant Women. ACTA ACUST UNITED AC 2013. [DOI: 10.12691/ajphr-1-3-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
97
|
Chen PC, Chan YT, Chen HF, Ko MC, Li CY. Population-based cohort analyses of the bidirectional relationship between type 2 diabetes and depression. Diabetes Care 2013; 36:376-82. [PMID: 23150281 PMCID: PMC3554286 DOI: 10.2337/dc12-0473] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This study addresses the strength of association for the bidirectional relationship between type 2 diabetes and depression. RESEARCH DESIGN AND METHODS We used two cohort studies with the same source of database to determine the link between depression and type 2 diabetes. The data analyzed included a random sample of 1 million beneficiaries selected from the National Health Insurance claims in 2000. The analysis of diabetes predicting the depression onset consisted of 16,957 diabetic patients and the same number of sex- and age-matched nondiabetic control subjects. The analysis of depression predicting diabetes onset included 5,847 depressive patients and 5,847 sex- and age-matched nondepressive control subjects. The follow-up period was between 2000 and 2006, and onset of end points was identified from ambulatory care claims. The Cox proportional hazards regression model adjusted for potential confounders was used to estimate relative hazards. RESULTS The first cohort analysis noted an incidence density (ID) of 7.03 per 1,000 person-years (PY) and 5.04 per 1,000 PY for depression in diabetic and nondiabetic subjects, respectively, representing a covariate-adjusted hazard ratio (HR) of 1.43 (95% CI 1.16-1.77). The second cohort analysis noted an ID of 27.59 per 1,000 PY and 9.22 per 1,000 PY for diabetes in depressive and nondepressive subjects, respectively. The covariate-adjusted HR was stronger at 2.02 (1.80-2.27) for incident diabetes associated with baseline depression. CONCLUSIONS The two cohort studies provided evidence for the bidirectional relationship between diabetes and depression, with a stronger association noted for the depression predicting onset of diabetes.
Collapse
Affiliation(s)
- Pei-Chun Chen
- Institute of Epidemiology and Preventive Medicine, National Taiwan University College of Public Health, Taipei, Taiwan
| | | | | | | | | |
Collapse
|
98
|
Icks A, Albers B, Haastert B, Pechlivanis S, Bokhof B, Slomiany U, Erbel R, Jöckel KH, Kruse J, Nowotny B, Herder C, Giani G, Moebus S. Diabetes incidence does not differ between subjects with and without high depressive symptoms--5-year follow-up results of the Heinz Nixdorf Recall Study. Diabet Med 2013; 30:65-9. [PMID: 22672118 DOI: 10.1111/j.1464-5491.2012.03724.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIMS Cross-sectional studies have consistently reported evidence for an association between diabetes and depressive disorders. However, only limited prospective studies have examined this association, reporting conflicting results. In a population-based cohort study, we compared cumulative incidences of diabetes between participants with and without high depressive symptoms. METHOD We analysed the 5-year follow-up data from the German Heinz Nixdorf Recall study of 3547 participants without diabetes at baseline [mean age 58.8 (sd 7.6) years, 47.5% male]. Depressive symptoms were defined using the Centre for Epidemiologic Studies Depression scale (cut point ≥ 17). Diabetes (diagnosed or previously undetected) was identified by self-reported physician-diagnosed diabetes, medication and high blood glucose levels. We estimated 5-year cumulative incidences with 95% confidence intervals and fitted multiple logistic regression models to calculate the odds ratios, adjusted for age, sex, physical activity, smoking, living with or without partner, and educational level. RESULTS The cumulative incidence of diabetes was 9.2% (95% CI 6.3-12.8) in participants with high depressive symptoms at baseline and 9.0% (95% CI 8.0-10.0) in participants without these symptoms. The age- and sex-adjusted odds ratio of diabetes in participants with depressive symptoms compared with those without was 1.13 [95% CI 0.77-1.68; fully adjusted 1.11 (95% CI 0.74-1.65)]. These results did not substantially change in several additional sensitivity analyses. CONCLUSION Our study did not show a significantly increased risk of developing diabetes in individuals with high depressive symptoms compared with those without high depressive symptoms during a 5-year follow-up period.
Collapse
Affiliation(s)
- A Icks
- Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at the Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
99
|
Pan Y, Hong Y, Zhang QY, Kong LD. Impaired hypothalamic insulin signaling in CUMS rats: restored by icariin and fluoxetine through inhibiting CRF system. Psychoneuroendocrinology 2013; 38:122-34. [PMID: 22663897 DOI: 10.1016/j.psyneuen.2012.05.007] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2012] [Revised: 05/16/2012] [Accepted: 05/16/2012] [Indexed: 01/27/2023]
Abstract
Epidemiological evidence demonstrates the neuroendocrine link between stress, depression and diabetes. This study observed glucose intolerance of rats exposed to chronic unpredictable mild stress (CUMS) in oral glucose tolerance test (OGTT). CUMS procedure significantly up-regulated corticotropin-releasing factor (CRF)-related peptide urocortin 2 expression and elevated cAMP production, resulting in over-expression of suppressor of cytokine signaling 3 (SOCS3) in hypothalamic arcuate nucleus (ARC) of rats. Furthermore, SOCS3 activation blocked insulin signaling pathway through the suppression of insulin receptor substrate 2 (IRS2) phosphotyrosine and phosphatidylinositol-3-kinase (PI3-K) activation in hypothalamic ARC of CUMS rats after high-level of insulin stimulation. These data indicated that CUMS procedure induced the hyperactivity of CRF system, and subsequently produced conditional loss of insulin signaling in hypothalamic ARC of rats. More importantly, icariin and fluoxetine with the ability to restrain CRF system hyperactivity improved insulin signaling in hypothalamic ARC of CUMS rats, which were consistent with the enhancement of glucose tolerance in OGTT, showing anti-diabetic efficacy. Although effective in OGTT, anti-diabetic drug pioglitazone failed to restore hypothalamic ARC CRF system hyperactivity, paralleling with its inability to ameliorate the loss of insulin signaling and depression-like behavior in CUMS rats. These observations support the hypothesis that signal cross-talk between hypothalamic CRF system and insulin may be impaired in depression with glucose intolerance and suggest that icarrin and fluoxetine aiming at CRF system may have great potential in the prevention and treatment of depression with comorbid diabetes.
Collapse
Affiliation(s)
- Ying Pan
- State Key Laboratory of Pharmaceutical Biotechnology, School of Life Sciences, Nanjing University, Nanjing 210093, PR China
| | | | | | | |
Collapse
|
100
|
Rabenda V, Nicolet D, Beaudart C, Bruyère O, Reginster JY. Relationship between use of antidepressants and risk of fractures: a meta-analysis. Osteoporos Int 2013; 24:121-37. [PMID: 22638709 DOI: 10.1007/s00198-012-2015-9] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Accepted: 04/27/2012] [Indexed: 10/28/2022]
Abstract
UNLABELLED It has been shown that antidepressants would have a direct action on bone metabolism and would be associated with increased fracture risk. Results from this large meta-analysis show that both SSRIs and TCAs are associated with a moderate and clinically significant increase in the risk of fractures of all types. INTRODUCTION This study seeks to investigate the relationship between use of antidepressants and the risk of fracture. METHODS An exhaustive systematic research of case-control and cohort studies published or performed between 1966 and April 2011 that reported risk estimates of fracture associated with use of antidepressants was performed using MEDLINE, PsycINFO, and the Cochrane Systematic Review Database, manual review of the literature, and congressional abstracts. Inclusion, quality scoring, and data abstraction were performed systematically by three independent reviewers. RESULTS A total of 34 studies (n = 1,217,464 individuals) were identified. Compared with non-users, the random effects pooled RR of fractures of all types, among antidepressant users, were 1.39 (95%CI 1.32-1.47). Use of antidepressants were associated with a 42 %, 47 %, and 38 % risk increase in non-vertebral, hip, and spine fractures, respectively ([For non-vertebral fractures: RR = 1.42, 95%CI 1.34-1.51]; [For hip fractures: RR = 1.47, 95%CI 1.36-1.58]; [For spine fractures: RR = 1.38, 95%CI 1.19-1.61]). Studies examining SSRI use showed systematically a higher increase in the risk of fractures of all types, non-vertebral, and hip fractures than studies evaluating TCA use. CONCLUSIONS Results from this large meta-analysis show that both SSRIs and TCAs are associated with a moderate and clinically significant increase in the risk of fractures of all types.
Collapse
Affiliation(s)
- V Rabenda
- Department of Public Health, Epidemiology and Health Economics, University of Liège, CHU-Bât. B23, 4000, Liège, Belgium.
| | | | | | | | | |
Collapse
|