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Ter Braake JG, Fleetwood KJ, Vos RC, Blackbourn L, McGurnaghan SJ, Wild SH, Jackson CA. Cardiovascular risk management among individuals with type 2 diabetes and severe mental illness: a cohort study. Diabetologia 2024; 67:1029-1039. [PMID: 38409440 PMCID: PMC11058755 DOI: 10.1007/s00125-024-06111-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 01/09/2024] [Indexed: 02/28/2024]
Abstract
AIMS/HYPOTHESIS The aim of this study was to compare cardiovascular risk management among people with type 2 diabetes according to severe mental illness (SMI) status. METHODS We used linked electronic data to perform a retrospective cohort study of adults diagnosed with type 2 diabetes in Scotland between 2004 and 2020, ascertaining their history of SMI from hospital admission records. We compared total cholesterol, systolic BP and HbA1c target level achievement 1 year after diabetes diagnosis, and receipt of a statin prescription at diagnosis and 1 year thereafter, by SMI status using logistic regression, adjusting for sociodemographic factors and clinical history. RESULTS We included 291,644 individuals with type 2 diabetes, of whom 1.0% had schizophrenia, 0.5% had bipolar disorder and 3.3% had major depression. People with SMI were less likely to achieve cholesterol targets, although this difference did not reach statistical significance for all disorders. However, people with SMI were more likely to achieve systolic BP targets compared to those without SMI, with effect estimates being largest for schizophrenia (men: adjusted OR 1.72; 95% CI 1.49, 1.98; women: OR 1.64; 95% CI 1.38, 1.96). HbA1c target achievement differed by SMI disorder and sex. Among people without previous CVD, statin prescribing was similar or better in those with vs those without SMI at diabetes diagnosis and 1 year later. In people with prior CVD, SMI was associated with lower odds of statin prescribing at diabetes diagnosis (schizophrenia: OR 0.54; 95% CI 0.43, 0.68, bipolar disorder: OR 0.75; 95% CI 0.56, 1.01, major depression: OR 0.92; 95% CI 0.83, 1.01), with this difference generally persisting 1 year later. CONCLUSIONS/INTERPRETATION We found disparities in cholesterol target achievement and statin prescribing by SMI status. This reinforces the importance of clinical review of statin prescribing for secondary prevention of CVD, particularly among people with SMI.
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Affiliation(s)
- Jonne G Ter Braake
- Department of Public Health and Primary Care, Leiden University Medical Centre, The Hague, the Netherlands
| | | | - Rimke C Vos
- Department of Public Health and Primary Care, Leiden University Medical Centre, The Hague, the Netherlands
| | - Luke Blackbourn
- MRC Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
| | | | - Sarah H Wild
- Usher Institute, University of Edinburgh, Edinburgh, UK
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Varela-Moreno E, Anarte-Ortiz MT, Jodar-Sanchez F, Garcia-Palacios A, Monreal-Bartolomé A, Gili M, García-Campayo J, Mayoral-Cleries F. Economic Evaluation of a Web Application Implemented in Primary Care for the Treatment of Depression in Patients With Type 2 Diabetes Mellitus: Multicenter Randomized Controlled Trial. JMIR Mhealth Uhealth 2024; 12:e55483. [PMID: 38754101 PMCID: PMC11140277 DOI: 10.2196/55483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/04/2024] [Accepted: 03/14/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Depressive disorder and type 2 diabetes mellitus (T2DM) are prevalent in primary care (PC). Pharmacological treatment, despite controversy, is commonly chosen due to resource limitations and difficulties in accessing face-to-face interventions. Depression significantly impacts various aspects of a person's life, affecting adherence to medical prescriptions and glycemic control and leading to future complications and increased health care costs. To address these challenges, information and communication technologies (eg, eHealth) have been introduced, showing promise in improving treatment continuity and accessibility. However, while eHealth programs have demonstrated effectiveness in alleviating depressive symptoms, evidence regarding glycemic control remains inconclusive. This randomized controlled trial aimed to test the efficacy of a low-intensity psychological intervention via a web app for mild-moderate depressive symptoms in individuals with T2DM compared with treatment as usual (TAU) in PC. OBJECTIVE This study aimed to analyze the cost-effectiveness and cost-utility of a web-based psychological intervention to treat depressive symptomatology in people with T2DM compared with TAU in a PC setting. METHODS A multicenter randomized controlled trial was conducted with 49 patients with T2DM, depressive symptoms of moderate severity, and glycosylated hemoglobin (HbA1c) of 7.47% in PC settings. Patients were randomized to TAU (n=27) or a web-based psychological treatment group (n=22). This web-based treatment consisted of cognitive behavioral therapy, improvement of diabetes self-care behaviors, and mindfulness. Cost-effectiveness analysis for the improvement of depressive symptomatology was conducted based on reductions in 3, 5, or 50 points on the Patient Health Questionnaire-9 (PHQ-9). The efficacy of diabetes control was estimated based on a 0.5% reduction in HbA1c levels. Follow-up was performed at 3 and 6 months. The cost-utility analysis was performed based on quality-adjusted life years. RESULTS Efficacy analysis showed that the web-based treatment program was more effective in improving depressive symptoms than TAU but showed only a slight improvement in HbA1c. Incremental cost-effectiveness ratios of 186.76 for a 3-point reduction in PHQ-9 and 206.31 for reductions of 5 and 50 percentage points were obtained. In contrast, the incremental cost-effectiveness ratio for improving HbA1c levels amounted to €1510.90 (€1=US $1.18 in 2018) per participant. The incremental cost-utility ratio resulted in €4119.33 per quality-adjusted life year gained. CONCLUSIONS The intervention, using web-based modules incorporating cognitive behavioral therapy tools, diabetes self-care promotion, and mindfulness, effectively reduced depressive symptoms and enhanced glycemic control in patients with T2DM. Notably, it demonstrated clinical efficacy and economic efficiency. This supports the idea that eHealth interventions not only benefit patients clinically but also offer cost-effectiveness for health care systems. The study emphasizes the importance of including specific modules to enhance diabetes self-care behaviors in future web-based psychological interventions, emphasizing personalization and adaptation for this population. TRIAL REGISTRATION ClinicalTrials.gov NCT03426709; https://clinicaltrials.gov/study/NCT03426709. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/S12888-019-2037-3.
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Affiliation(s)
- Esperanza Varela-Moreno
- Research and Innovation Unit, Costa del Sol University Hospital, Marbella, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Málaga, Spain
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Málaga, Málaga, Spain
- Biomedical Research Institute of Malaga, Malaga, Spain
| | - Maria Teresa Anarte-Ortiz
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Málaga, Málaga, Spain
- Biomedical Research Institute of Malaga, Malaga, Spain
| | - Francisco Jodar-Sanchez
- Department of Applied Economics, Faculty of Economics and Business Administration, University of Malaga, Malaga, Spain
- Pharmacoeconomics: Clinical and Economic Evaluation of Medications and Palliative Care, Malaga, Spain
| | - Azucena Garcia-Palacios
- Network Biomedical Research Center. Physiopathology Obesity and Nutrition (CIBERobn), Carlos III Health Institute, Madrid, Spain
- Department of Clinical and Basic Psychology and Biopsychology, Faculty of Health Sciences, University Jaume I, Castellon, Spain
| | - Alicia Monreal-Bartolomé
- Institute of Health Research of Aragon, Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - Margalida Gili
- Research Network on Preventive Activities and Health Promotion in Primary Health Care (RedIAPP), Madrid, Spain
- Institut Universitari d'Investigació en Ciències de la Salut, University Institute for Research in Health Sciences (IUNICS)- Palma Health Research Institute (IDISPA), University of the Balearic Islands, Palma, Spain
| | - Javier García-Campayo
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Málaga, Spain
- Institute of Health Research of Aragon, Zaragoza, Spain
| | - Fermin Mayoral-Cleries
- Biomedical Research Institute of Malaga, Malaga, Spain
- Mental Health Clinical Management Unit, University Regional Hospital of Malaga, Malaga, Spain
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Mosili P, Mkhize BC, Sibiya NH, Ngubane PS, Khathi A. Review of the direct and indirect effects of hyperglycemia on the HPA axis in T2DM and the co-occurrence of depression. BMJ Open Diabetes Res Care 2024; 12:e003218. [PMID: 38413177 PMCID: PMC10900365 DOI: 10.1136/bmjdrc-2022-003218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 03/24/2023] [Indexed: 02/29/2024] Open
Abstract
Type 2 diabetes mellitus (T2DM) is characterized by persistent hyperglycemia which is further associated with hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis. Several studies have shown that HPA axis hyperactivity is heightened in the chronic hyperglycemic state with severe hyperglycemic events more likely to result in a depressive disorder. The HPA axis is also regulated by the immune system. Upon stress, under homeostatic conditions, the immune system is activated via the sympatho-adrenal-medullary axis resulting in an immune response which secretes proinflammatory cytokines. These cytokines aid in the activation of the HPA axis during stress. However, in T2DM, where there is persistent hyperglycemia, the immune system is dysregulated resulting in the elevated concentrations of these cytokines. The HPA axis, already activated by the hyperglycemia, is further activated by the cytokines which all contribute to a diagnosis of depression in patients with T2DM. However, the onset of T2DM is often preceded by pre-diabetes, a reversible state of moderate hyperglycemia and insulin resistance. Complications often seen in T2DM have been reported to begin in the pre-diabetic state. While the current management strategies have been shown to ameliorate the moderate hyperglycemic state and decrease the risk of developing T2DM, research is necessary for clinical studies to profile these direct effects of moderate hyperglycemia in pre-diabetes on the HPA axis and the indirect effects moderate hyperglycemia may have on the HPA axis by investigating the components of the immune system that play a role in regulating this pathway.
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Affiliation(s)
- Palesa Mosili
- Human Physiology, University of KwaZulu-Natal College of Health Sciences, Durban, KwaZulu-Natal, South Africa
| | - Bongeka Cassandra Mkhize
- Human Physiology, University of KwaZulu-Natal College of Health Sciences, Durban, KwaZulu-Natal, South Africa
| | | | - Phikelelani Sethu Ngubane
- Human Physiology, University of KwaZulu-Natal College of Health Sciences, Durban, KwaZulu-Natal, South Africa
| | - Andile Khathi
- Human Physiology, University of KwaZulu-Natal College of Health Sciences, Durban, KwaZulu-Natal, South Africa
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Li YH, Cheng YC, Liu HC, Wu J, Lee IT. Depressive Symptoms Associated with Peripheral Artery Disease and Predicting Mortality in Type 2 Diabetes. Biomedicines 2023; 12:29. [PMID: 38275390 PMCID: PMC10813585 DOI: 10.3390/biomedicines12010029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 01/27/2024] Open
Abstract
This retrospective cohort study aimed to assess the mortality risk in patients with type 2 diabetes mellitus (DM) by screening for depressive symptoms and peripheral artery disease (PAD). We enrolled patients aged ≥60 years who had undergone assessments of both the ankle-brachial index (ABI) and the five-item Geriatric Depression Scale (GDS-5). PAD and depression were defined as ABI ≤ 0.90 and GDS-5 ≥ 1, respectively. The primary endpoint was total mortality. In 1673 enrolled patients, the prevalence of PAD was higher in those with depression than in those without depression (8.9% vs. 5.7%, p = 0.021). After a median follow-up of 56.6 months (interquartile range: 47.0-62.3 months), a total of 168 (10.0%) deaths occurred. The patients in the depression and PAD subgroup had the highest hazard ratio of mortality, followed by the PAD without depression subgroup and the depression without PAD subgroup (2.209, 95%CI: 1.158-4.217; 1.958, 95%CI: 1.060-3.618; and 1.576, 95%CI: 1.131-2.196; respectively) in comparison to the patients without depression and PAD after adjustment for associated factors. In conclusion, a combination of depression and PAD predicted the highest mortality risk. Screening for depression and PAD is recommended in patients aged ≥60 years with type 2 DM.
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Affiliation(s)
- Yu-Hsuan Li
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (Y.-H.L.); (Y.-C.C.); (J.W.)
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
- Department of Computer Science & Information Engineering, National Taiwan University, Taipei 10617, Taiwan
| | - Yu-Cheng Cheng
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (Y.-H.L.); (Y.-C.C.); (J.W.)
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
- Institute of Biomedical Sciences, National Chung Hsing University, Taichung 40227, Taiwan
| | - Hsiu-Chen Liu
- Department of Nursing, Taichung Veterans General Hospital, Taichung 40705, Taiwan;
| | - Junyi Wu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (Y.-H.L.); (Y.-C.C.); (J.W.)
| | - I-Te Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (Y.-H.L.); (Y.-C.C.); (J.W.)
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
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Shi‐Heng W, Hsu L, Lin M, Wu C. Associations between depression and cancer risk among patients with diabetes mellitus: A population-based cohort study. Cancer Med 2023; 12:19968-19977. [PMID: 37706606 PMCID: PMC10587979 DOI: 10.1002/cam4.6539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/28/2023] [Accepted: 09/02/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND The co-occurrence of depression and diabetes mellitus has been linked to an increased risk of developing cancer. This study aimed to investigate whether depression further amplifies the risk of cancer among individuals with diabetes. METHODS This population-based matched cohort study utilized Taiwan's National Health Insurance claims database. A total of 85,489 newly diagnosed diabetic patients with depressive disorders were selected, along with 427,445 comparison subjects. The matching process involved age, sex, and the calendar year of diabetes onset. The average follow-up duration for the two cohorts was 6.4 and 6.5 years, respectively. The primary outcome of interest was the occurrence of overall cancer or cancer at specific anatomical sites. RESULTS The adjusted hazard ratios for overall cancer incidence were 1.08 (95% CI, 1.05-1.11). For site-specific cancers, depression exhibited significant associations with oropharyngeal, esophageal, liver, gynecological, prostate, kidney, and hematologic malignancies among patients with diabetes. Notably, a severity-response relationship was observed, indicating that patients with recurrent episodes of major depressive disorders exhibited a higher incidence of cancer compared to those diagnosed with dysthymia or depressive disorder not otherwise specified. Furthermore, the strength of the association between depression and cancer risk was more pronounced among younger patients with diabetes as opposed to older adults. However, no significant relationship was observed between adherence to antidepressant treatment and cancer risk. CONCLUSIONS The findings of this study indicate a significant association between depression and an elevated risk of cancer among individuals diagnosed with diabetes. Future investigations should replicate our findings, explore the effects of pharmacological and non-pharmacological treatments on cancer risk, and identify the underlying mechanisms.
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Affiliation(s)
- Wang Shi‐Heng
- National Center for Geriatrics and Welfare ResearchNational Health Research InstitutesMiaoliTaiwan
- Department of Public Health, College of Public HealthChina Medical UniversityTaichungTaiwan
| | - Le‐Yin Hsu
- Institute of Epidemiology and Preventive Medicine, College of Public HealthNational Taiwan UniversityTaipeiTaiwan
- Graduate Program of Data ScienceNational Taiwan University and Academia SinicaTaipeiTaiwan
| | - Mei‐Chen Lin
- National Center for Geriatrics and Welfare ResearchNational Health Research InstitutesMiaoliTaiwan
- Department of Public Health, College of Public HealthChina Medical UniversityTaichungTaiwan
| | - Chi‐Shin Wu
- National Center for Geriatrics and Welfare ResearchNational Health Research InstitutesMiaoliTaiwan
- Department of PsychiatryNational Taiwan University Hospital, Yunlin BranchDouliuTaiwan
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Possidente C, Fanelli G, Serretti A, Fabbri C. Clinical insights into the cross-link between mood disorders and type 2 diabetes: A review of longitudinal studies and Mendelian randomisation analyses. Neurosci Biobehav Rev 2023; 152:105298. [PMID: 37391112 DOI: 10.1016/j.neubiorev.2023.105298] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 05/15/2023] [Accepted: 06/26/2023] [Indexed: 07/02/2023]
Abstract
Mood disorders and type 2 diabetes mellitus (T2DM) are prevalent conditions that often co-occur. We reviewed the available evidence from longitudinal and Mendelian randomisation (MR) studies on the relationship between major depressive disorder (MDD), bipolar disorder and T2DM. The clinical implications of this comorbidity on the course of either condition and the impact of antidepressants, mood stabilisers, and antidiabetic drugs were examined. Consistent evidence indicates a bidirectional association between mood disorders and T2DM. T2DM leads to more severe depression, whereas depression is associated with more complications and higher mortality in T2DM. MR studies demonstrated a causal effect of MDD on T2DM in Europeans, while a suggestive causal association in the opposite direction was found in East Asians. Antidepressants, but not lithium, were associated with a higher T2DM risk in the long-term, but confounders cannot be excluded. Some oral antidiabetics, such as pioglitazone and liraglutide, may be effective on depressive and cognitive symptoms. Studies in multi-ethnic populations, with a more careful assessment of confounders and appropriate power, would be important.
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Affiliation(s)
- Chiara Possidente
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giuseppe Fanelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; Department of Human Genetics, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands
| | - Alessandro Serretti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
| | - Chiara Fabbri
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Chen YH, Wang HN, Lang XE, Zhang XY. Prevalence and clinical correlates of abnormal glucose metabolism in young, first- episode and medication-naïve outpatients with major depressive disorder. Psychiatry Res 2023; 325:115250. [PMID: 37207542 DOI: 10.1016/j.psychres.2023.115250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/02/2023] [Accepted: 05/10/2023] [Indexed: 05/21/2023]
Abstract
BACKGROUNDS The high co-morbidity of abnormal glucose metabolism in depressed patients has been extensively studied, but few studies have explored abnormal glucose metabolism in young patients with major depressive disorder (MDD). This study aimed to examine the prevalence and clinical correlates of abnormal glucose metabolism in young patients with first-episode medication-naïve (FEMN) MDD. METHODS A cross-sectional study was conducted on 1289 young Chinese outpatients with FEMN MDD. All subjects were assessed on the Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale (HAMA), Positive and Negative Syndrome Scale, and their sociodemographic information was collected, and blood pressure, blood glucose, lipid and thyroid hormone levels were measured. RESULTS The prevalence of abnormal glucose metabolism was 12.57% in young FEMN MDD outpatients. Thyroid stimulating hormone (TSH) levels and HAMA scale scores were associated with fasting blood glucose levels in patients with FEMN MDD (P<0.05), and TSH could differentiate patients with abnormal normal glucose metabolism from those without abnormal glucose metabolism (Area Under Curve of 0.774). CONCLUSIONS Our study showed a high prevalence of comorbid glucose metabolism abnormalities in young FEMN MDD outpatients. TSH may be a promising biomarker of abnormal glucose metabolism in young patients with FEMN MDD.
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Affiliation(s)
- Yi-Huan Chen
- Department of Psychiatry, Xijing Hospital, Air Force Military Medical University, Xi'an, China
| | - Hua-Ning Wang
- Department of Psychiatry, Xijing Hospital, Air Force Military Medical University, Xi'an, China
| | - Xiao-E Lang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Xiang-Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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Cleveland JC, Espinoza J, Holzhausen EA, Goran MI, Alderete TL. The impact of social determinants of health on obesity and diabetes disparities among Latino communities in Southern California. BMC Public Health 2023; 23:37. [PMID: 36609302 PMCID: PMC9817265 DOI: 10.1186/s12889-022-14868-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 12/14/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Social determinants of health (SDoH) describe the complex network of circumstances that impact an individual before birth and across the lifespan. SDoH contextualize factors in a community that are associated with chronic disease risk and certain health disparities. The main objective of this study was to explore the impact of SDoH on the prevalence of obesity and diabetes, and whether these factors explain disparities in these health outcomes among Latinos in Southern California. METHODS We utilized three composite indices that encompass different SDoH: the Healthy Places Index (HPI), Social Vulnerability Index (SVI), and CalEnviroScreen (CES). Univariate linear regression models explored the associations between index scores with adult obesity, adult diabetes, and childhood obesity. RESULTS Communities with lower HPI scores were associated with higher prevalence of metabolic disease and a greater proportion of Latino residents. Cities in the lowest decile of HPI scores had 71% of the population identifying as Latino compared to 12% in the highest decile. HPI scores explained 61% of the variability in adult obesity (p < 0.001), 41% of the variability in childhood obesity (p < 0.001), and 47% of the variability in adult diabetes (p < 0.001). Similar results were observed when examining SVI and CES with these health outcomes. CONCLUSIONS These results suggest that Latinos in Southern California live in communities with adverse SDoH and face a greater burden of adult obesity, diabetes, and childhood obesity.
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Affiliation(s)
- Joseph C Cleveland
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Juan Espinoza
- Department of Pediatrics, The Saban Research Institute, Children's Hospital Los Angeles, University of Southern California, Los Angeles, CA, USA
| | | | - Michael I Goran
- Department of Pediatrics, The Saban Research Institute, Children's Hospital Los Angeles, University of Southern California, Los Angeles, CA, USA
| | - Tanya L Alderete
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA.
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Zhang C, Jing L, Wang J. Does depression increase the risk of gestational diabetes mellitus? A systematic review and meta-analysis. Pak J Med Sci 2023; 39:285-292. [PMID: 36694731 PMCID: PMC9843022 DOI: 10.12669/pjms.39.1.6845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/04/2022] [Accepted: 10/12/2022] [Indexed: 12/05/2022] Open
Abstract
Objective Data on the relationship between depression and gestational diabetes mellitus (GDM) is scarce and conflicting. We, hereby, aimed to review evidence if prior depression increases the risk of GDM. Methods PubMed, Embase, CENTRAL, and Google Scholar databases were searched from inception to 11th September 2021 for English language studies reporting the relationship between depression and subsequent risk of GDM. Results Ten studies were included. Meta-analysis of data from nine studies including 127,195 patients indicated that prior depression was associated with a significantly increased risk of GDM (OR: 1.29 95% CI: 1.10, 1.52). There was no change in the significance of the results on sensitivity analysis. On subgroup analysis based on study location, we noted that the association between depression and GDM was seen only in USA-based studies with the pooled analysis of non-USA studies indicating no such relationship. Similar conflicting results were noted on subgroup analysis based on diagnostic criteria for GDM and depression. Conclusion Our study indicates that prior depression can lead to a 29% increased risk of GDM in pregnant females. Current evidence is derived from a limited number of studies with significant heterogeneity in the timing and diagnostic criteria for depression.
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Affiliation(s)
- Chuanjiang Zhang
- Chuanjiang Zhang, Department of Anxiety and Depression Treatment Center, The Third Hospital of Inner Mongolia Autonomous Region, Inner Mongolia, 010010 P.R. China
| | - Lan Jing
- Lan Jing, Department of Children’s Psychological Health Center, The Third Hospital of Inner Mongolia Autonomous Region, Inner Mongolia, 010010 P.R. China
| | - Juan Wang
- Juan Wang, Department of Endocrine, The Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia, 010050 P.R. China
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Ross RE, VanDerwerker CJ, Saladin ME, Gregory CM. The role of exercise in the treatment of depression: biological underpinnings and clinical outcomes. Mol Psychiatry 2023; 28:298-328. [PMID: 36253441 PMCID: PMC9969795 DOI: 10.1038/s41380-022-01819-w] [Citation(s) in RCA: 29] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 09/19/2022] [Accepted: 09/26/2022] [Indexed: 01/21/2023]
Abstract
Globally, depression is a leading cause of disability and has remained so for decades. Antidepressant medications have suboptimal outcomes and are too frequently associated with side effects, highlighting the need for alternative treatment options. Although primarily known for its robust physical health benefits, exercise is increasingly recognized for its mental health and antidepressant benefits. Empirical evidence indicates that exercise is effective in treating individuals with depression; however, the mechanisms by which exercise exerts anti-depressant effects are not fully understood. Acute bouts of exercise have been shown to transiently modulate circulating levels of serotonin and norepinephrine, brain-derived neurotrophic factor, and a variety of immuno-inflammatory mechanisms in clinical cohorts with depression. However, exercise training has not been demonstrated to consistently modulate such mechanisms, and evidence linking these putative mechanisms and reductions in depression is lacking. The complexity of the biological underpinnings of depression coupled with the intricate molecular cascade induced by exercise are significant obstacles in the attempt to disentangle exercise's effects on depression. Notwithstanding our limited understanding of these effects, clinical evidence uniformly argues for the use of exercise to treat depression. Regrettably, exercise remains underutilized despite being an accessible, low-cost alternative/adjunctive intervention that can simultaneously reduce depression and improve overall health. To address the gaps in our understanding of the clinical and molecular effects of exercise on depression, we propose a model that leverages systems biology and multidisciplinary team science with a large-scale public health investment. Until the science matches the scale of complexity and burden posed by depression, our ability to advance knowledge and treatment will continue to be plagued by fragmented, irreproducible mechanistic findings and no guidelines for standards of care.
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Affiliation(s)
- Ryan E. Ross
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC,Department of Health Sciences and Research, Medical University of South Carolina, Charleston, SC
| | | | - Michael E. Saladin
- Department of Health Sciences and Research, Medical University of South Carolina, Charleston, SC,Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Chris M. Gregory
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC,Department of Health Sciences and Research, Medical University of South Carolina, Charleston, SC
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Tang KR, Mo XW, Zhou XY, Chen YY, Liu DD, He LL, Ma QY, Li XJ, Chen JX. Xiaoyao San, a Chinese herbal formula, ameliorates depression-like behavior in mice through the AdipoR1/AMPK/ACC pathway in hypothalamus. JOURNAL OF INTEGRATIVE MEDICINE 2022; 20:442-452. [PMID: 35906133 DOI: 10.1016/j.joim.2022.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 06/05/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Depression and metabolic disorders have overlapping psychosocial and pathophysiological causes. Current research is focused on the possible role of adiponectin in regulating common biological mechanisms. Xiaoyao San (XYS), a classic Chinese medicine compound, has been widely used in the treatment of depression and can alleviate metabolic disorders such as lipid or glucose metabolism disorders. However, the ability of XYS to ameliorate depression-like behavior as well as metabolic dysfunction in mice and the underlying mechanisms are unclear. METHODS An in vivo animal model of depression was established by chronic social defeat stress (CSDS). XYS and fluoxetine were administered by gavage to the drug intervention group. Depression-like behaviors were analyzed by the social interaction test, open field test, forced swim test, and elevated plus maze test. Glucose levels were measured using the oral glucose tolerance test. The involvement of certain molecules was validated by immunofluorescence, histopathology, and Western blotting. In vitro, hypothalamic primary neurons were exposed to high glucose to induce neuronal damage, and the neuroprotective effect of XYS was evaluated by cell counting kit-8 assay. Immunofluorescence and Western blotting were used to evaluate the influences of XYS on adiponectin receptor 1 (AdipoR1), adenosine 5'-monophosphate-activated protein kinase (AMPK), acetyl-coenzyme A carboxylase (ACC) and other related proteins. RESULTS XYS ameliorated CSDS-induced depression-like behaviors and glucose tolerance impairment in mice and increased the level of serum adiponectin. XYS also restored Nissl bodies in hypothalamic neurons in mice that exhibited depression-like behaviors and decreased the degree of neuronal morphological damage. In vivo and in vitro studies indicated that XYS increased the expression of AdipoR1 in hypothalamic neurons. CONCLUSION Adiponectin may be a key regulator linking depression and metabolic disorders; regulation of the hypothalamic AdipoR1/AMPK/ACC pathway plays an important role in treatment of depression by XYS.
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Affiliation(s)
- Kai-Rui Tang
- Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Jinan University, Guangzhou 510632, Guangdong Province, China
| | - Xiao-Wei Mo
- Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Jinan University, Guangzhou 510632, Guangdong Province, China
| | - Xing-Yi Zhou
- Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Jinan University, Guangzhou 510632, Guangdong Province, China
| | - Yue-Yue Chen
- Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Jinan University, Guangzhou 510632, Guangdong Province, China
| | - Dong-Dong Liu
- Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Jinan University, Guangzhou 510632, Guangdong Province, China
| | - Liang-Liang He
- College of Pharmacy, Jinan University, Guangzhou 510632, Guangdong Province, China
| | - Qing-Yu Ma
- Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Jinan University, Guangzhou 510632, Guangdong Province, China
| | - Xiao-Juan Li
- Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Jinan University, Guangzhou 510632, Guangdong Province, China.
| | - Jia-Xu Chen
- Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Jinan University, Guangzhou 510632, Guangdong Province, China.
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Hoogendoorn CJ, Qin J, Wang C, Roque N, Laurenceau JP, Katz MJ, Derby CA, Lipton RB, Gonzalez JS. Depressive symptoms mediate the relationship between diabetes and cognitive performance in a community-based sample of older adults. J Diabetes Complications 2022; 36:108183. [PMID: 35718600 DOI: 10.1016/j.jdiacomp.2022.108183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/11/2022] [Accepted: 03/18/2022] [Indexed: 02/07/2023]
Abstract
AIMS To evaluate whether diabetes and prediabetes are associated with impaired cognitive performance among older adults and examine depressive symptoms as a mediator. METHODS We used cross-sectional data from the Einstein Aging Study, a systematically recruited, community-based cohort study of diverse older adults (N = 794; Age Mean (SD) = 78.9 (5.3); 64.4% Non-Hispanic White, 28.7% Non-Hispanic Black, 5.7% Hispanic). Diabetes status was established via self-reported diagnosis, prescribed medications, and fasting blood glucose. Depressive symptoms were assessed using the Geriatric Depression Scale. Cognitive tests included Digit Symbol, Trails-B, Free Recall, Category Fluency, Boston Naming, and Block Design. Linear regression and mediation analyses were applied. RESULTS Compared to those without diabetes, diabetes was associated with worse performance on all cognitive tests (ps < 0.05), except Trails-B (p = 0.53), and increased depressive symptoms (p < 0.01). For diabetes, mediation via increased depressive symptoms was observed for Free Recall (p = 0.044), Category Fluency (p = 0.033), and Boston Naming (p = 0.048). CONCLUSIONS Diabetes was consistently associated with worse cognitive performance and increased depressive symptoms among this older cohort, while prediabetes was not. Mediation findings suggest depressive symptoms may be a biobehavioral pathway linking diabetes and cognition, though the temporal sequence is unclear. If causal, addressing both diabetes and depressive symptoms among older adults may protect cognitive function.
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Affiliation(s)
| | - Jiyue Qin
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Cuiling Wang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA; Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Nelson Roque
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Jean-Philippe Laurenceau
- Department of Psychological & Brain Sciences, University of Delaware, Newark, DE, USA; New York-Regional Center for Diabetes Translation Research, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Mindy J Katz
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Carol A Derby
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA; New York-Regional Center for Diabetes Translation Research, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Medicine (Endocrinology), Albert Einstein College of Medicine, Bronx, NY, USA
| | - Richard B Lipton
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA; New York-Regional Center for Diabetes Translation Research, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Medicine (Endocrinology), Albert Einstein College of Medicine, Bronx, NY, USA; Department of Psychiatry and Behavioral Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jeffrey S Gonzalez
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA; New York-Regional Center for Diabetes Translation Research, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Medicine (Endocrinology), Albert Einstein College of Medicine, Bronx, NY, USA
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13
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Pal K, Sharma M, Mukadam NM, Petersen I. Initiation of antidepressant medication in people with type 2 diabetes living in the UK - a retrospective cohort study. Pharmacoepidemiol Drug Saf 2022; 31:892-900. [PMID: 35638365 PMCID: PMC9542279 DOI: 10.1002/pds.5484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 05/03/2022] [Accepted: 05/23/2022] [Indexed: 11/17/2022]
Abstract
Introduction Depression is a common comorbidity in people with type 2 diabetes and it is associated with poorer outcomes. There is limited data on the treatments used for depression in this population. The aim of this study was to explore the rates of initiation of antidepressant prescriptions in people with type 2 diabetes in the UK and identify those most at risk of needing such treatment. Research Design and Methods This was a retrospective cohort study using data from IQVIA Medical Research Data (IMRD)‐UK data. Data from general practices in IMRD‐UK between January 2008 and December 2017 were used for this study. Results The overall rates of antidepressant prescribing were stable over the study period. The rate of initiation of antidepressant medication in people with type 2 diabetes was 22.93 per 1000 person years at risk (PYAR) with a 95%CI 22.48 to 23.39 compared to 16.89 per 1000 PYAR (95%CI 16.77 to 17.01) in an age and gender matched cohort. The risk of being prescribed antidepressant medication with age had a U‐shaped distribution with the lowest risk in the 65–69 age group. The peak age for antidepressant initiation in men and women was 40–44, with a rate in men of 32.78 per 1000 PYAR (95% CI 29.57 to 36.34) and a rate in women of 46.80 per 1000 PYAR (95% CI 41.90 to 52.26). People with type 2 diabetes with in the least deprived quintile had an initiation rate of 19.66 per 1000 PYAR (95%CI 18.67 to 20.70) compared to 27.19 per 1000 PYAR (95%CI 25.50 to 28.93) in the most deprived quintile, with a 32% increase in the risk of starting antidepressant medication (95%CI 1.22 to 1.43). Conclusions People with type 2 diabetes were 30% more likely to be started on antidepressant medication than people without type 2 diabetes. Women with type 2 diabetes were 35% more likely than men to be prescribed antidepressants and the risks increased with deprivation and in younger or older adults, with the lowest rates in the 65–69 year age band. The rates of antidepressant prescribing were broadly stable over the 10‐year period in this study. The antidepressant medications prescribed changed slightly over time with sertraline becoming more widely used and fewer prescriptions of citalopram.
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Affiliation(s)
- Kingshuk Pal
- Department of Primary Care and Population Health, U3 Floor, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK
| | - Manuj Sharma
- Department of Primary Care and Population Health, U3 Floor, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK
| | | | - Irene Petersen
- Department of Primary Care and Population Health, U3 Floor, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK
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14
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Zou L, Li X, Chen Q, Lv F, Min S. Focal points of preanesthesia evaluations for electroconvulsive therapy in patients with depression: a retrospective analysis of clinical characteristics in nonremission. BMC Anesthesiol 2022; 22:163. [PMID: 35619081 PMCID: PMC9134596 DOI: 10.1186/s12871-022-01686-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 05/04/2022] [Indexed: 11/18/2022] Open
Abstract
Background This study explored the patient clinical characteristics that may affect electroconvulsive therapy (ECT) efficacy to enable improved focus during evaluations and preparation for ECT. Methods Patients were enrolled for ECT at the Department of Psychiatry and Anesthesiology of the First Affiliated Hospital of Chongqing Medical University from December 2017 to January 2019. The primary outcome in our study was defined as the development of nonremission. A multivariate logistic analysis was performed to identify the risk factors for nonremission. Results In total, 874 depressed patients were included in the study. After the ECT treatment, 255 cases (29.2%) exhibited nonremission. A multivariate logistic regression analysis of the variables was performed, and the results showed that atherosclerosis (OR 8.072, 95% CI 2.442 to 16.675; P = 0.001), COPD (OR 2.919, 95% CI 1.240 to 6.871; P = 0.014), diabetes (OR 2.202, 95% CI 1.115 to 4.348; P = 0.023) and smoking (OR 1.519, 95% CI 1.015 to 2.273; P = 0.042) were independent risk factors for nonremission. Conclusion In the retrospective analysis, we found that atherosclerosis, diabetes, COPD and smoking may be high-risk factors for nonremission. Supplementary Information The online version contains supplementary material available at 10.1186/s12871-022-01686-6.
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Affiliation(s)
- Lei Zou
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Xiao Li
- Departments of Psychiatry, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qibin Chen
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Feng Lv
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Su Min
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
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Vlachou E, Ntikoudi A, Owens DA, Nikolakopoulou M, Chalimourdas T, Cauli O. Effectiveness of cognitive behavioral therapy-based interventions on psychological symptoms in adults with type 2 diabetes mellitus: An update review of randomized controlled trials. J Diabetes Complications 2022; 36:108185. [PMID: 35367124 DOI: 10.1016/j.jdiacomp.2022.108185] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 03/22/2022] [Accepted: 03/22/2022] [Indexed: 02/07/2023]
Abstract
Cognitive Behavioral Therapy (CBT) has long been recognized as a type of psychotherapy for the management of glycemic control and comorbid psychological disorders and symptoms in adults with diabetes, and has been previously reported with varying outcomes. The aim of this scoping review is to evaluate the randomized controlled trials (RCTs) in order to determine the effects of CBT on Type 2 diabetes mellitus (T2DM) patients regarding depressive and anxiety symptoms, diabetes distress, and quality of life. An extensive literature search was conducted of the Pubmed, Scopus, Cinahl and Medline electronic databases. The search yielded 349 studies, of which 12 eventually met the entry requirements for RCTs. The majority of the studies included in the current scoping review demonstrated the benefits of CBT intervention in the amelioration of depressive symptoms, diabetes-related distress and quality of life in patients with T2DM. However, some studies reported limited evidence to support the use of CBT as an adjuvant therapy. The considerable levels of heterogeneity associated with most RCTs included warrant caution when interpreting results. The findings of this scoping review demonstrate the positive impact of CBT on depressive symptoms and other psychological aspects of everyday life in patients with T2DM.
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Affiliation(s)
- Eugenia Vlachou
- Department of Nursing, University of West Attica, Athens, Greece.
| | | | | | | | - Thodoris Chalimourdas
- 1st Department of Psychiatry, Eginition Hospital, Medical School-National and Kapodistrian University of Athens, Greece
| | - Omar Cauli
- Frailty and Cognitive Impairment Group (FROG), University of Valencia, 46010 Valencia, Spain; Department of Nursing, University of Valencia, 46010 Valencia, Spain.
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Farid D, Li P, Da Costa D, Afif W, Szabo J, Dasgupta K, Rahme E. Depression, diabetes and immigration status: a retrospective cohort study using the Canadian Longitudinal Study on Aging. CMAJ Open 2022; 10:E508-E518. [PMID: 35700994 PMCID: PMC9343120 DOI: 10.9778/cmajo.20210019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND A bidirectional association between depression and diabetes exists, but has not been evaluated in the context of immigrant status. Given that social determinants of health differ between immigrants and nonimmigrants, we evaluated the association between diabetes and depression incidence, depression and diabetes incidence, and whether immigrant status modified this association, among immigrants and nonimmigrants in Canada. METHODS We employed a retrospective cohort design using data from the Canadian Longitudinal Study on Aging Comprehensive cohort (baseline [2012-2015] and 3-year follow-up [2015-2018]). We defined participants as having diabetes if they self-reported it or if their glycated hemoglobin A1c level was 7% or more; we defined participants as having depression if their Center for Epidemiological Studies Depression score was 10 or higher or if they were currently undergoing depression treatment. We excluded those with baseline depression (Cohort 1) and baseline diabetes (Cohort 2) to evaluate the associations between diabetes and depression incidence, and between depression and diabetes incidence, respectively. We constructed logistic regression models with interaction by immigrant status. RESULTS Cohort 1 (n = 20 723; mean age 62.7 yr, standard deviation [SD] 10.1 yr; 47.6% female) included 3766 (18.2%) immigrants. Among immigrants, 16.4% had diabetes, compared with 15.6% among nonimmigrants. Diabetes was associated with an increased risk of depression in nonimmigrants (adjusted odds ratio [OR] 1.27, 95% confidence interval [CI] 1.08-1.49), but not in immigrants (adjusted OR 1.12, 95% CI 0.80-1.56). Younger age, female sex, weight change, poor sleep quality and pain increased depression risk. Cohort 2 (n = 22 054; mean age 62.1 yr, SD 10.1 yr; 52.2% female) included 3913 (17.7%) immigrants. Depression was associated with an increased risk of diabetes in both nonimmigrants (adjusted OR 1.39, 95% CI 1.16-1.68) and immigrants (adjusted OR 1.60, 95% CI 1.08-2.37). Younger age, male sex, waist circumference, weight change, hypertension and heart disease increased diabetes risk. INTERPRETATION We found an overall bidirectional association between diabetes and depression that was not significantly modified by immigrant status. Screening for diabetes for people with depression and screening for depression for those with diabetes should be considered.
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Affiliation(s)
- Doaa Farid
- Department of Family Medicine (Farid, Szabo), McGill University; Centre for Outcomes Research and Evaluation (Farid, Li, Da Costa, Dasgupta, Rahme), Research Institute of the McGill University Health Centre; Department of Pediatrics (Li), and Division of Clinical Epidemiology (Da Costa, Rahme), Department of Medicine, McGill University; Division of Gastroenterology (Afif), Department of Medicine, and Chronic Viral Illnesses Service (Szabo), McGill University Health Centre; Division of General Internal Medicine (Dasgupta), Department of Medicine, McGill University, Montréal, Que
| | - Patricia Li
- Department of Family Medicine (Farid, Szabo), McGill University; Centre for Outcomes Research and Evaluation (Farid, Li, Da Costa, Dasgupta, Rahme), Research Institute of the McGill University Health Centre; Department of Pediatrics (Li), and Division of Clinical Epidemiology (Da Costa, Rahme), Department of Medicine, McGill University; Division of Gastroenterology (Afif), Department of Medicine, and Chronic Viral Illnesses Service (Szabo), McGill University Health Centre; Division of General Internal Medicine (Dasgupta), Department of Medicine, McGill University, Montréal, Que
| | - Deborah Da Costa
- Department of Family Medicine (Farid, Szabo), McGill University; Centre for Outcomes Research and Evaluation (Farid, Li, Da Costa, Dasgupta, Rahme), Research Institute of the McGill University Health Centre; Department of Pediatrics (Li), and Division of Clinical Epidemiology (Da Costa, Rahme), Department of Medicine, McGill University; Division of Gastroenterology (Afif), Department of Medicine, and Chronic Viral Illnesses Service (Szabo), McGill University Health Centre; Division of General Internal Medicine (Dasgupta), Department of Medicine, McGill University, Montréal, Que
| | - Waqqas Afif
- Department of Family Medicine (Farid, Szabo), McGill University; Centre for Outcomes Research and Evaluation (Farid, Li, Da Costa, Dasgupta, Rahme), Research Institute of the McGill University Health Centre; Department of Pediatrics (Li), and Division of Clinical Epidemiology (Da Costa, Rahme), Department of Medicine, McGill University; Division of Gastroenterology (Afif), Department of Medicine, and Chronic Viral Illnesses Service (Szabo), McGill University Health Centre; Division of General Internal Medicine (Dasgupta), Department of Medicine, McGill University, Montréal, Que
| | - Jason Szabo
- Department of Family Medicine (Farid, Szabo), McGill University; Centre for Outcomes Research and Evaluation (Farid, Li, Da Costa, Dasgupta, Rahme), Research Institute of the McGill University Health Centre; Department of Pediatrics (Li), and Division of Clinical Epidemiology (Da Costa, Rahme), Department of Medicine, McGill University; Division of Gastroenterology (Afif), Department of Medicine, and Chronic Viral Illnesses Service (Szabo), McGill University Health Centre; Division of General Internal Medicine (Dasgupta), Department of Medicine, McGill University, Montréal, Que
| | - Kaberi Dasgupta
- Department of Family Medicine (Farid, Szabo), McGill University; Centre for Outcomes Research and Evaluation (Farid, Li, Da Costa, Dasgupta, Rahme), Research Institute of the McGill University Health Centre; Department of Pediatrics (Li), and Division of Clinical Epidemiology (Da Costa, Rahme), Department of Medicine, McGill University; Division of Gastroenterology (Afif), Department of Medicine, and Chronic Viral Illnesses Service (Szabo), McGill University Health Centre; Division of General Internal Medicine (Dasgupta), Department of Medicine, McGill University, Montréal, Que
| | - Elham Rahme
- Department of Family Medicine (Farid, Szabo), McGill University; Centre for Outcomes Research and Evaluation (Farid, Li, Da Costa, Dasgupta, Rahme), Research Institute of the McGill University Health Centre; Department of Pediatrics (Li), and Division of Clinical Epidemiology (Da Costa, Rahme), Department of Medicine, McGill University; Division of Gastroenterology (Afif), Department of Medicine, and Chronic Viral Illnesses Service (Szabo), McGill University Health Centre; Division of General Internal Medicine (Dasgupta), Department of Medicine, McGill University, Montréal, Que.
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Liu W, Yang C, Liu L, Kong G, Zhang L. Bidirectional associations of vision loss, hearing loss, and dual sensory loss with depressive symptoms among the middle-aged and older adults in China. J Affect Disord 2022; 301:225-232. [PMID: 35038482 DOI: 10.1016/j.jad.2022.01.066] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 01/09/2022] [Accepted: 01/13/2022] [Indexed: 01/08/2023]
Abstract
BACKGROUND Most studies on the relationship between sensory loss and depression focus on the unidirectional association between sensory loss and the risk of depression based on cross-sectional designs. The present study aimed to explore the bidirectional longitudinal associations of vison loss (VL), 1 hearing loss (HL), 2 and dual sensory loss (DSL)3 with depressive symptoms among Chinese population. METHODS A longitudinal study was conducted among 13,690 participants aged 45 years and older over four years. VL, HL, and DSL were identified through self-reporting, and depressive symptoms were assessed using a 10-item Center for Epidemiologic Studies Depression Scale. Multivariable Cox proportional hazards regression models were constructed to estimate the bidirectional associations of VL, HL, and DSL with depressive symptoms. RESULTS Participants with self-reported VL (HR: 1.14, 95%CI: 1.04-1.24), HL (HR: 1.22, 95%CI: 1.07-1.37), and DSL (HR: 1.27, 95%CI: 1.08-1.49) were associated with higher risk of developing depressive symptoms, compared with those without VL, HL, and DSL, respectively. In comparison with those without depressive symptoms, participants with depressive symptoms in the baseline had higher risk of developing VL (HR: 1.43, 95%CI: 1.33-1.54), HL (HR: 1.49, 95%CI: 1.36-1.63), and DSL (HR: 1.76, 95%CI: 1.59-1.95). LIMITATIONS Sensory loss was defined only based on participants' self-report. CONCLUSIONS Significant bidirectional associations exist between self-reported VL, HL, or DSL and depressive symptoms. The mental health of people with VL and HL should be focused on, and regular assessments of vision and hearing in people with depressive symptoms are recommended.
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Affiliation(s)
- Wenwen Liu
- National Institute of Health Data Science at Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Chao Yang
- Renal Division, Department of Medicine at Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China
| | - Lili Liu
- Renal Division, Department of Medicine at Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China
| | - Guilan Kong
- National Institute of Health Data Science at Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China; Advanced Institute of Information Technology, Peking University, Hangzhou, China.
| | - Luxia Zhang
- National Institute of Health Data Science at Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China; Renal Division, Department of Medicine at Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China; Advanced Institute of Information Technology, Peking University, Hangzhou, China
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Oyedeji AD, Ullah I, Weich S, Bentall R, Booth A. Effectiveness of non-specialist delivered psychological interventions on glycemic control and mental health problems in individuals with type 2 diabetes: a systematic review and meta-analysis. Int J Ment Health Syst 2022; 16:9. [PMID: 35120528 PMCID: PMC8817494 DOI: 10.1186/s13033-022-00521-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 01/13/2022] [Indexed: 11/15/2022] Open
Abstract
Background Typically, specialist mental health professionals deliver psychological interventions for individuals with poorly controlled type 2 diabetes mellitus (T2DM) and related mental health problems. However, such interventions are not generalizable to low- and middle-income countries, due to the dearth of trained mental health professionals. Individuals with little or no experience in the field of mental health (referred to as non-specialists) may have an important role to play in bridging this treatment gap. Aim To synthesise evidence for the effectiveness of non-specialist delivered psychological interventions on glycaemic control and mental health problems in people with T2DM. Methods Eight databases and reference lists of previous reviews were systematically searched for randomized controlled trials (RCTs). Outcome measures were glycated hemoglobin (HbA1c), diabetes distress and depression. The Cochrane Collaboration Risk of Bias Tool was used for risk of bias assessment. Data from the included studies were synthesized using narrative synthesis and random effects meta-analysis. Results 16 RCTs were eligible for inclusion in the systematic review. The 11 studies that were pooled in the meta-analysis demonstrated a reduction in HbA1c in favor of non-specialist delivered psychological interventions when compared with control groups (pooled mean difference = − 0.13; 95% CI − 0.22 to − 0.04, p = 0.005) with high heterogeneity across studies (I2 = 71%, p = 0.0002). The beneficial effects of the interventions on diabetes distress and depression were not consistent across the different trials. Conclusion Non-specialist delivered psychological interventions may be effective in improving HbA1c. These interventions have some promising benefits on diabetes distress and depression, although the findings are inconclusive. More studies of non-specialist delivered psychological interventions are needed in low- and middle-income countries to provide more evidence of the potential effectiveness of these interventions for individuals living with T2DM.
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Affiliation(s)
- Ayodeji D Oyedeji
- School of Health and Related Research, University of Sheffield, Sheffield, S1 4DA, UK.
| | - Ibrahim Ullah
- Centre for Assistive Technology and Connected Healthcare, School of Health and Related Research, University of Sheffield, Sheffield, S1 4DA, UK
| | - Scott Weich
- School of Health and Related Research, University of Sheffield, Sheffield, S1 4DA, UK
| | - Richard Bentall
- Department of Psychology, University of Sheffield, Sheffield, S1 4DA, UK
| | - Andrew Booth
- School of Health and Related Research, University of Sheffield, Sheffield, S1 4DA, UK
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Farooqi A, Gillies C, Sathanapally H, Abner S, Seidu S, Davies MJ, Polonsky WH, Khunti K. A systematic review and meta-analysis to compare the prevalence of depression between people with and without Type 1 and Type 2 diabetes. Prim Care Diabetes 2022; 16:1-10. [PMID: 34810141 DOI: 10.1016/j.pcd.2021.11.001] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 10/12/2021] [Accepted: 11/07/2021] [Indexed: 01/21/2023]
Abstract
AIMS Diabetes can significantly impact quality of life and mental health. However, inconsistencies have been reported in the prevalence of depression in those with Type 1 and Type 2 diabetes, and those without. Systematic reviews also included studies without adequate control subjects. We update existing literature, by comparing depression prevalence between individuals with and without Type 1 and Type 2 diabetes. METHODS A systematic review and meta-analysis. We searched MEDLINE, EMBASE and PSYCHINFO, from January 1985 to August 2021. Studies were excluded if they failed to have an adequate control group, specified type of diabetes, or reported depression prevalence by type of diabetes. RESULTS 44 studies were selected for inclusion. The prevalence of depression was significantly higher in people with Type 1 (22% vs 13%, OR = 2.10 (95% CI: 1.23, 3.52)), or Type 2 diabetes (19% vs 11%, OR = 1.76 (1.55, 2.01)) compared to those without diabetes. There was no association between study effect size and mean age or gender. Findings did not significantly differ between methods of depression assessment. Prevalence of depression in people with diabetes was higher in studies carried out in specialist care (36%, OR = 3.14 (2.12, 4.63)) compared to those in community or primary care (12%, OR = 1.51 (1.35, 1.70) and in low- and middle-income countries (OR = 2.58 (1.91, 3.50) compared to countries with high income economies (OR = 1.59 (1.39, 1.82)). CONCLUSIONS Depression prevalence remains significant in those with type 1 and type 2 diabetes. Effective chronic disease management in people with diabetes is important, particularly screening and managing depression and diabetes distress in specialist care settings.
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Affiliation(s)
- Aaisha Farooqi
- Department of Psychology, Birmingham City University, UK.
| | - Clare Gillies
- Leicester Real World Evidence Unit, University of Leicester, UK
| | | | - Sophia Abner
- Leicester Real World Evidence Unit, University of Leicester, UK
| | - Sam Seidu
- Leicester Real World Evidence Unit, University of Leicester, UK; Diabetes Research Centre, University of Leicester, UK
| | - Melanie J Davies
- Diabetes Research Centre, University of Leicester, UK; NIHR Leicester Biomedical Research Centre, Leicester General Hospital, UK
| | | | - Kamlesh Khunti
- Leicester Real World Evidence Unit, University of Leicester, UK; Diabetes Research Centre, University of Leicester, UK
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20
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Messina R, Iommi M, Rucci P, Reno C, Fantini MP, Lunghi C, Altini M, Bravi F, Rosa S, Nicolucci A, Di Bartolo P. Is it time to consider depression as a major complication of type 2 diabetes? Evidence from a large population-based cohort study. Acta Diabetol 2022; 59:95-104. [PMID: 34495396 PMCID: PMC8758621 DOI: 10.1007/s00592-021-01791-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/19/2021] [Indexed: 12/26/2022]
Abstract
AIMS Depression in type 2 diabetes may heavily affect the course of the disease. In this study, we investigated, among new cases with type 2 diabetes, the incidence and clinical predictors of depression and determined the extent to which depression constitutes a risk factor for acute and long-term diabetes complications and mortality. METHODS In this population-based retrospective cohort study, incident cases of type 2 diabetes without a prior history of depression were identified from the administrative databases of the Emilia-Romagna Region, Italy, between 2008 and 2017 and followed up until 2020. Logistic regression models were used to identify the predictors of depression. Cox regression models were used to estimate the risk of acute complications over three years, and the risk of long-term complications and mortality over ten years. RESULTS Incident cases with type 2 diabetes were 30,815, of whom 5146 (16.7%) developed depression. The predictors of depression onset were as follows: female sex, age > 65 years, living in rural areas and comorbid diseases. Depression in type 2 diabetes was associated with a 2.3-fold risk of developing acute complications, 1.6-fold risk of developing long-term complications and 2.8-fold mortality risk. CONCLUSIONS Our findings highlight that depression is associated with an increased risk for complications in type 2 diabetes and mortality and should not be neglected. Therefore, it is important to promote screening activities and introduce targeted and personalized treatment for depression in order to reduce the risk of poor short- and long-term outcomes of diabetes.
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Affiliation(s)
- Rossella Messina
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum-University of Bologna, Via San Giacomo, 12, 40126, Bologna, BO, Italy
| | - Marica Iommi
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum-University of Bologna, Via San Giacomo, 12, 40126, Bologna, BO, Italy.
| | - Paola Rucci
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum-University of Bologna, Via San Giacomo, 12, 40126, Bologna, BO, Italy
| | - Chiara Reno
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum-University of Bologna, Via San Giacomo, 12, 40126, Bologna, BO, Italy
| | - Maria Pia Fantini
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum-University of Bologna, Via San Giacomo, 12, 40126, Bologna, BO, Italy
| | - Carlotta Lunghi
- Department of Health Sciences, Université du Québec À Rimouski, Rimouski, Canada
- Santé Des Populations Et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec, Québec, Canada
| | - Mattia Altini
- Health Directorate, Romagna Local Health Authority, Bologna, Emilia-Romagna Region, Italy
| | - Francesca Bravi
- Health Directorate, Romagna Local Health Authority, Bologna, Emilia-Romagna Region, Italy
| | - Simona Rosa
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum-University of Bologna, Via San Giacomo, 12, 40126, Bologna, BO, Italy
| | - Antonio Nicolucci
- Center for Outcomes Research and Clinical Epidemiology (CORESEARCH), Pescara, Italy
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21
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Parikh R, Bhargava Y. Lower Socio-Economic Position Associated With Higher Odds Of Diabetes-Depression Comorbidity. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:2087-2090. [PMID: 34891700 DOI: 10.1109/embc46164.2021.9631050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Diabetes-depression comorbidity (DDC) adversely affects the quality of life of diabetic patients, complicates the clinical treatment and makes diabetes management very challenging. Therefore, early identification and diagnosis of DDC is crucial to prevent complications and improve the health outcomes among the diabetic patients. This work explores the association between demographic, lifestyle, social economic factors and DDC. The analysis is based on data obtained from the Behavioral Risk Factor Surveillance System (BRFSS), Centers for Disease Control and Prevention (CDC), USA. Logistic Regression was used to explore this association. Women were found to have higher odds of DDC as compared to men [OR 1.30, 95%CI(1.17-1.44), p <0.001]. Additionally, sedentary behaviour and lower socio-economic position was found to be associated with higher odds of DDC. Moreover, a gradient association was observed between socio-economic position (SEP) and DDC. The odds of DDC tend to reduce with improvement in SEP. Our findings underscore the importance of examining and addressing the disproportionate burden of DDC among the lower socio-economic groups.
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22
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Chard S, Henderson L, Wallace BH, Roth EG, Eckert JK. 'How I Can Help Me': Self-Care Priorities and Structural Pressures Among Black Older Adults With Diabetes. THE GERONTOLOGIST 2021; 62:751-761. [PMID: 34698832 DOI: 10.1093/geront/gnab157] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Disparities in Type 2 diabetes mellitus (diabetes) represent an ongoing public health challenge. Black older adults are at high risk of diabetes and diabetes' complications. Diet, physical activity, and medication can control these risks, yet disease rates remain elevated. Utilizing an Intersectionality framework, we seek to extend understanding of the social dimensions of diabetes through an examination of the diabetes self-care process from the perspective of Black older adults. RESEARCH DESIGN AND METHODS This project involved a thematic analysis of diabetes illness narrative interviews with Black participants (N=41) in our National Institute on Aging-funded study of diabetes. In a narrative approach, the participant communicates the significance of actions and events. RESULTS The findings suggest that diabetes self-care involves interconnected struggles across four domains of care: 1) multimorbidity management, 2) financial well-being, 3) family support, and 4) formal health care. DISCUSSION AND IMPLICATIONS Black older adult self-care reflects an active process of pursuing meaningful social goals and critical health needs. An Intersectional framework, however, reveals the ongoing histories of inequity that shape this process. Further intervention to address the racist policies and practices found in Black older adults' communities and clinical care is needed to make true progress on diabetes disparities.
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Affiliation(s)
- Sarah Chard
- Department of Sociology, Anthropology and Public Health, University of Maryland Baltimore County, Baltimore, Maryland, USA
| | - Loren Henderson
- Department of Sociology, Anthropology and Public Health, University of Maryland Baltimore County, Baltimore, Maryland, USA
| | - Brandy Harris Wallace
- Department of Sociology, Anthropology and Public Health, University of Maryland Baltimore County, Baltimore, Maryland, USA
| | - Erin G Roth
- PATIENTS Program, Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, Maryland, USA
| | - J Kevin Eckert
- Department of Sociology, Anthropology and Public Health, Center for Aging Studies, University of Maryland Baltimore County, Baltimore, Maryland, USA
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23
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Nuyen J, Bos EH, de Jonge P, van Dorsselaer S, Tuithof M, Kleinjan M, de Graaf R, Ten Have M. Longitudinal bidirectional associations between internalizing mental disorders and cardiometabolic disorders in the general adult population. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1611-1621. [PMID: 33399884 DOI: 10.1007/s00127-020-02007-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 12/07/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE This prospective population-based study investigated whether having any internalizing mental disorder (INT) was associated with the presence and onset of any cardiometabolic disorder (CM) at 3-year follow-up; and vice versa. Furthermore, we examined whether observed associations differed when using longer time intervals of respectively 6 and 9 years. METHODS Data were used from the four waves (baseline and 3-, 6- and 9-year follow-up) of the Netherlands Mental Health Survey and Incidence Study-2, a prospective study of a representative cohort of adults. At each wave, the presence and first onset of INT (i.e. any mood or anxiety disorder) were assessed with the Composite International Diagnostic Interview 3.0; the presence and onset of CM (i.e. hypertension, diabetes, heart disease, and stroke) were based on self-report. Multilevel logistic autoregressive models were controlled for previous-wave INT and CM, respectively, and sociodemographic, clinical, and lifestyle covariates. RESULTS Having any INT predicted both the presence (OR 1.28, p = 0.029) and the onset (OR 1.46, p = 0.003) of any CM at the next wave (3-year intervals). Having any CM was not significantly related to the presence of any INT at 3-year follow-up, while its association with the first onset of any INT reached borderline significance (OR 1.64, p = 0.06), but only when examining 6-year intervals. CONCLUSIONS Our findings indicate that INTs increase the risk of both the presence and the onset of CMs in the short term, while CMs may increase the likelihood of the first onset of INTs in the longer term. Further research is needed to better understand the mechanisms underlying the observed associations.
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Affiliation(s)
- Jasper Nuyen
- Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS, Utrecht, The Netherlands.
| | - Elisabeth H Bos
- Department of Developmental Psychology, Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Peter de Jonge
- Department of Developmental Psychology, Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Saskia van Dorsselaer
- Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS, Utrecht, The Netherlands
| | - Marlous Tuithof
- Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS, Utrecht, The Netherlands
| | - Marloes Kleinjan
- Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS, Utrecht, The Netherlands.,Department of Interdisciplinary Social Sciences, Utrecht University, Utrecht, The Netherlands
| | - Ron de Graaf
- Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS, Utrecht, The Netherlands
| | - Margreet Ten Have
- Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS, Utrecht, The Netherlands
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24
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Jacob L, Rathmann W, Koyanagi A, Haro JM, Kostev K. Association between type 2 diabetes and chronic low back pain in general practices in Germany. BMJ Open Diabetes Res Care 2021; 9:9/1/e002426. [PMID: 34266855 PMCID: PMC8286747 DOI: 10.1136/bmjdrc-2021-002426] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 06/30/2021] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION There are conflicting results on the association between type 2 diabetes and chronic low back pain (CLBP). Therefore, the goal was to investigate the relationship between type 2 diabetes and CLBP in individuals followed in general practices in Germany. RESEARCH DESIGN AND METHODS Adults diagnosed for the first time with type 2 diabetes in 809 general practices in Germany between 2005 and 2018 (index date) were included. Adults without type 2 diabetes were matched (1:1) to those with type 2 diabetes by sex, age, index year, and the annual number of medical consultations (index date: a randomly selected visit date). The association between type 2 diabetes and the 10-year incidence of CLBP was analyzed in conditional Cox regression models adjusted for a wide range of comorbidities, including hypertension, lipid metabolism disorders, and obesity. RESULTS There were 139 002 individuals included in this study (women: 58.0%; mean (SD) age 62.5 (13.4) years). There was a positive association between type 2 diabetes and the incidence of CLBP in the overall sample (HR=1.23, 95% CI: 1.13 to 1.35). Sex-stratified analyses showed a higher risk of CLBP in women (HR=1.68, 95% CI: 1.43 to 1.90) and a lower risk in men with than in their counterparts without type 2 diabetes (HR=0.83, 95% CI: 0.71 to 0.97). CONCLUSIONS Newly diagnosed type 2 diabetes was associated with an increased risk of CLBP. There were important sex differences in the type 2 diabetes-CLBP relationship, and more research is warranted to investigate the underlying factors explaining these differences.
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Affiliation(s)
- Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Wolfgang Rathmann
- German Diabetes Center, Institute for Biometrics and Epidemiology, Leibniz Institute for Diabetes Research at Heinrich Heine University, Duesseldorf, Germany
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
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25
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Bui LN, Yoon J, Hynes DM. A Reduction in Health Care Expenditures Linked to Mental Health Service Use Among Adults With Chronic Physical Conditions. Psychiatr Serv 2021; 72:766-775. [PMID: 33940945 PMCID: PMC11164411 DOI: 10.1176/appi.ps.202000161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim was to examine the impact of receipt of mental health services on health care expenditures for U.S. adults with major chronic physical conditions. METHODS Medical Expenditure Panel Survey data for 2004-2014 were analyzed for adults ages ≥18 with at least one of six chronic physical conditions (cardiovascular diseases, cancer, diabetes, emphysema, asthma, and arthritis) who were followed up for 2 years (N=33,419). Outcomes included overall health care spending and expenditure by service type (inpatient services, outpatient services, emergency department visits, office-based physician visits, and prescribed medication). A difference-in-differences model compared a change in health care costs in the subsequent year for those who did and did not receive mental health services in the preceding year. RESULTS On average, the increase in overall health care expenditure in the subsequent year among adults receiving mental health services in the preceding year was smaller by 12.6 percentage points (p<0.05) than for those who did not receive such services. The difference was equivalent to $1,146 in 2014 constant U.S. dollars (p=0.05). Medication treatment alone did not have a meaningful effect on overall costs. The combination of psychotherapy and medication was associated with a per-capita reduction in overall health care expenditure of 21.7 percentage points, or $2,690 (p<0.01). The combination was also associated with reduced costs for office-based visits (p<0.05) and medication (p<0.05). CONCLUSIONS Receipt of mental health services was associated with a reduction in overall health care costs, particularly for office-based visits and prescribed medication, among adults with chronic physical conditions.
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Affiliation(s)
- Linh N Bui
- Center for Healthcare Organizational and Innovation Research, University of California, Berkeley, and Sutter Health Center for Health Systems Research, Berkeley (Bui); Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Yoon); Health Management and Policy, College of Public Health and Human Sciences, and Health Data and Informatics, Center for Genome Research and Biocomputing, Oregon State University, Corvallis, and Center to Improve Veteran Involvement in Care, U.S. Department of Veterans Affairs Portland Healthcare System, Portland (Hynes)
| | - Jangho Yoon
- Center for Healthcare Organizational and Innovation Research, University of California, Berkeley, and Sutter Health Center for Health Systems Research, Berkeley (Bui); Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Yoon); Health Management and Policy, College of Public Health and Human Sciences, and Health Data and Informatics, Center for Genome Research and Biocomputing, Oregon State University, Corvallis, and Center to Improve Veteran Involvement in Care, U.S. Department of Veterans Affairs Portland Healthcare System, Portland (Hynes)
| | - Denise M Hynes
- Center for Healthcare Organizational and Innovation Research, University of California, Berkeley, and Sutter Health Center for Health Systems Research, Berkeley (Bui); Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Yoon); Health Management and Policy, College of Public Health and Human Sciences, and Health Data and Informatics, Center for Genome Research and Biocomputing, Oregon State University, Corvallis, and Center to Improve Veteran Involvement in Care, U.S. Department of Veterans Affairs Portland Healthcare System, Portland (Hynes)
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26
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Khassawneh AH, Alzoubi A, Khasawneh AG, Abdo N, Abu-Naser D, Al-Mistarehi AH, Albattah MF, Kheirallah KA. The relationship between depression and metabolic control parameters in type 2 diabetic patients: A cross-sectional and feasibility interventional study. Int J Clin Pract 2021; 75:e13777. [PMID: 33098211 DOI: 10.1111/ijcp.13777] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 10/13/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Substantial evidence supports a bidirectional relationship between diabetes and clinical depression. However, little is known about the effect of treating one condition on the control of the other. Thus, this study aimed to determine the prevalence of depression among Type II diabetes mellitus (T2DM) patients and to assess the efficacy and feasibility of escitalopram treatment of depression on their metabolic control parameters. METHODS T2DM patients attending primary care clinics in the North of Jordan were enrolled in a cross-sectional study during the period from February to December 2019 (n = 157). Depressive symptoms were screened utilising the patient health questionnaire-9 (PHQ-9) tool. Metabolic control was assessed by measurement of glycated haemoglobin (HbA1c), triglycerides, cholesterol, low-density lipoprotein (LDL) and high-density lipoprotein (HDL). Patients with moderate to severe depressive symptoms by PHQ-9 (n = 58) were interviewed by a psychiatrist to confirm a clinical diagnosis of depression. Eligible depressed patients were administered escitalopram 10 mg orally once daily for 3 months (n = 12). Thereafter, depressive symptoms and metabolic control measures were reassessed. RESULTS The prevalence of moderate to severe depressive symptoms among T2DM patients, according to PHQ-9, was 36.94%, while the prevalence of clinical depression based on interview was 7.64%. Baseline PHQ-9 scores correlated significantly with baseline levels of HbA1c, HDL, cholesterol and triglycerides. Escitalopram treatment intervention resulted in significant improvement of PHQ-9 scores without significantly improving any of the metabolic control measures. CONCLUSION The relationship between depression and T2DM in the context of metabolic syndrome is plausible. However, our results show that escitalopram treatment may not be associated with significant improvement in metabolic control parameters among these patients. Our study has laid the groundwork for future randomised clinical trials with larger sample size and longer follow-up.
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Affiliation(s)
- Adi H Khassawneh
- Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Abdallah Alzoubi
- Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
- College of Medicine, Ajman University, Ajman, United Arab Emirates
| | - Aws G Khasawneh
- Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Nour Abdo
- Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Dania Abu-Naser
- Department of Applied Sciences, Irbid University College, Al-Balqa' Applied University, Irbid, Jordan
| | - Abdel-Hameed Al-Mistarehi
- Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Malak F Albattah
- Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Khalid A Kheirallah
- Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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27
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Magee MF, Kaltman SI, Mete M, Nassar CM. A Prospective, Non-randomized Feasibility and Preliminary Efficacy Study of a Telemedicine-Enabled Co-management Intervention for Adults With Type 2 Diabetes and Moderate Anxiety and/or Depression. Sci Diabetes Self Manag Care 2021; 47:144-152. [PMID: 34078174 DOI: 10.1177/0145721721996305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The primary aim of this pilot study was to examine the feasibility of codelivering a mental health intervention with an evidence-based type 2 diabetes (T2DM) boot camp care management program. The preliminary impact of participation on symptom scores for depression and anxiety and A1C was also examined. METHODS This was a 12-week, non-randomized pilot intervention conducted with a convenience sample of adults with uncontrolled T2DM and moderate depression and/or anxiety at an urban teaching hospital. Co-management intervention delivery was via in-person and telehealth visits. Participants were assessed at baseline and 90 days. RESULTS Participants (n = 18) were African American, majority female (83%), and age 50.7 ± 13.4 years. Significant improvements in mental health outcomes were demonstrated, as measured by a reduction in Patient Health Questionnaire - 9 scores of 2.4 ± 2.9 (P = .01) and in Generalized Anxiety Disorder - 7 scores of 2.3 ± 1.9 (P = .001). The pre-post intervention mean A1C improved by 3.4 ± 2.1 units from 12% ± 1.4% to 8.5% ± 1.7% (P < .001). CONCLUSION The data generated in this pilot support the feasibility of delivering a diabetes and mental health co-management intervention using a combination of in-person and telemedicine visits to engage adults with T2DM and coexisting moderate depression and/or anxiety. Further research is warranted.
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Affiliation(s)
- Michelle F Magee
- MedStar Diabetes Institute, Washington, DC.,Department of Medicine, Georgetown University School of Medicine, Washington, DC.,MedStar Health Research Institute, Hyattsville, Maryland
| | | | - Mihriye Mete
- Department of Psychiatry, Georgetown University, Washington, DC
| | - Carine M Nassar
- MedStar Diabetes Institute, Washington, DC.,MedStar Health Research Institute, Hyattsville, Maryland
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28
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Cheval B, Maltagliati S, Sieber S, Beran D, Chalabaev A, Sander D, Cullati S, Boisgontier MP. Why Are Individuals With Diabetes Less Active? The Mediating Role of Physical, Emotional, and Cognitive Factors. Ann Behav Med 2021; 55:904-917. [PMID: 33491067 DOI: 10.1093/abm/kaaa120] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Despite the key role of physical activity in the management of diabetes, many individuals with diabetes do not engage in the recommended levels of physical activity. However, our knowledge of the mechanisms underlying the relationship between diabetes and physical inactivity is limited. PURPOSE To investigate the associations between diabetes and the levels and evolution of physical activity across aging, and to determine whether physical, emotional, and cognitive factors mediate these associations. METHODS Data from 105,622 adults aged 50-96 years from the Survey of Health, Ageing and Retirement in Europe (SHARE) were used in adjusted linear mixed models to examine whether diabetes was associated with physical activity levels and variations across aging. The potential mediators were subjective energy, muscle strength, physical and cognitive disability, sleep problems, depressive symptoms, and cognitive functions. The variables were measured up to seven times over a 13-year period. RESULTS Individuals with diabetes demonstrated a lower level and a steeper decrease in physical activity across aging than individual without diabetes. Mediators explained ~53% and 94% of the association of diabetes with the level of physical activity and with the linear evolution of physical activity across aging, respectively. All mediators were significantly associated with physical activity. Physical and cognitive disability as well as depressive symptoms were the strongest mediators, while sleep was the lowest one. CONCLUSIONS These findings suggest that the etiology of physical inactivity in individuals with diabetes can result from several physical, emotional, and cognitive changes associated with the emergence of this disease.
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Affiliation(s)
- Boris Cheval
- Swiss Center for Affective Sciences, University of Geneva, Switzerland.,Laboratory for the Study of Emotion Elicitation and Expression (E3Lab), Department of Psychology, University of Geneva, Switzerland
| | | | - Stefan Sieber
- Swiss NCCR "LIVES - Overcoming Vulnerability: Life Course Perspectives," University of Geneva, Switzerland
| | - David Beran
- Division of Tropical and Humanitarian Medicine, University of Geneva and Geneva University Hospitals, Switzerland
| | | | - David Sander
- Swiss Center for Affective Sciences, University of Geneva, Switzerland.,Laboratory for the Study of Emotion Elicitation and Expression (E3Lab), Department of Psychology, University of Geneva, Switzerland
| | - Stéphane Cullati
- Population Health Laboratory, University of Fribourg, Switzerland.,Department of Readaptation and Geriatrics, University of Geneva, Switzerland
| | - Matthieu P Boisgontier
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.,Bruyère Research Institute, Ottawa, ON, Canada
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29
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Antidepressants and Risk of Type 2 Diabetes Mellitus: A Population-Based Nested Case-Control Study. J Clin Psychopharmacol 2021; 40:359-365. [PMID: 32639288 DOI: 10.1097/jcp.0000000000001228] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE/BACKGROUND The increased risk of type 2 diabetes mellitus (T2DM) among users of antidepressants (ADs) might be mediated by depression. We investigated whether ADs are associated with increased risk of T2DM in patients with depression. Moreover, the relationship between binding affinities of serotonin transporter (SERT) of ADs and the risk of T2DM is examined. METHODS/PROCEDURES We conducted a retrospective nested case-control study using data from Taiwan's National Health Insurance Research Database between 2000 and 2013. A total of 3038 patients with depression, 1519 cases of T2DM, and 1519 controls matched for age, sex, and index date, were included. Exposure to ADs was categorized by type and SERT. The association between AD exposure and T2DM development was assessed using conditional logistic regression analysis. FINDINGS/RESULTS No association between T2DM development and selective serotonin reuptake inhibitors (adjusted odds ratio [AOR], 1.01; 95% confidence interval [CI], 0.87-1.19; P = 0.962), serotonin-norepinephrine reuptake inhibitors (AOR, 1.13; 95% CI, 0.94-1.37; P = 1.196), tricyclic antidepressants (AOR, 1.01; 95% CI, 0.85-1.21; P = 0.906), or others (AOR, 0.88; 95% CI, 0.75-1.03; P = 0.104) was found. Alternatively, no association between individual ADs and potency of affinity to SERT and the risk of T2DM was found. IMPLICATIONS/CONCLUSIONS No association between ADs and increase risk of T2DM was found in patients with depression. However, regular metabolic evaluations are recommended for patients with depression regularly taking ADs.
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Alvarez-Cisneros T, Roa-Rojas P, Garcia-Peña C. Longitudinal relationship of diabetes and depressive symptoms in older adults from Mexico: a secondary data analysis. BMJ Open Diabetes Res Care 2020; 8:8/2/e001789. [PMID: 33177041 PMCID: PMC7661381 DOI: 10.1136/bmjdrc-2020-001789] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/25/2020] [Accepted: 09/28/2020] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Several studies have argued a causal relationship between diabetes and depression, while others have highlighted that their association is a result of common risk factors. Because Mexico is a country with a high prevalence of diabetes, and diabetes and depression are a frequent comorbidity, we chose this country to investigate the longitudinal relationship of these two conditions, focusing on the influence of demographic, health, and socioeconomic factors which could act as common risk factors for both conditions. RESEARCH DESIGN AND METHODS Using the harmonized Mexican Health and Aging Study, a nationally representative sample of adults older than 50 with a response rate of 93%, we analyzed the longitudinal relationship of diabetes and depressive symptoms using 'between-within' random-effects models, focusing on the effect of demographic, socioeconomic and health factors. RESULTS While older adults with diabetes reported a higher prevalence of depressive symptoms in the four waves of the study, there was no causal longitudinal association between them once controlling for demographic, socioeconomic and health factors (between-effect OR=0.88, 95% CI 0.77 to 1.01; within-effect OR=0.87, 95% CI 0.69 to 1.11). CONCLUSIONS There is no causal longitudinal association between diabetes and depression; the higher prevalence of depression among older adults with diabetes seems a result of socioeconomic and health factors that are not exclusive to respondents with diabetes but are more frequent in this group. Our results highlight the importance of prevention and control of chronic conditions as well as the role of socioeconomic inequalities in mental health.
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Affiliation(s)
- Teresa Alvarez-Cisneros
- Research, Instituto Nacional de Geriatria, Ciudad de Mexico, Mexico
- Institute of Gerontology, King's College London, London, UK
| | - Paloma Roa-Rojas
- Research, Instituto Nacional de Geriatria, Ciudad de Mexico, Mexico
| | - Carmen Garcia-Peña
- Head of the Research Department, Instituto Nacional de Geriatria, Ciudad de Mexico, Mexico
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Sang YM, Wang LJ, Mao HX, Lou XY, Zhu YJ, Zhu YH. Correlation of lower 2 h C-peptide and elevated evening cortisol with high levels of depression in type 2 diabetes mellitus. BMC Psychiatry 2020; 20:490. [PMID: 33023555 PMCID: PMC7539383 DOI: 10.1186/s12888-020-02901-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 09/28/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND A number of studies have explored the association between depression and ghrelin, leptin, and cortisol; further, postprandial C-peptide levels have a therapeutic effect on type 2 diabetes mellitus (T2DM). However, the relationship between C-peptide and depression in patients with diabetes, remains unclear. The aim of this study was to explore the association between depression and ghrelin, leptin, cortisol, and C-peptide in patients with diabetes. METHODS We enrolled 50 adults without T2DM, 77 non-depressed adults with T2DM (free of Axis-I psychiatric disorders as assessed using the Mental Illness Needs Index (MINI), Patient Health Questionnaire (PHQ-9 score ≤ 4)) and 59 patients with T2DM and depression (PHQ-9 ≥ 7 and positive by the Structured Clinical Interview for DSM-5). The age range of the participants was 45-59 years of age. We compared the above three groups and explored the association between ghrelin, leptin, cortisol, C-peptide, and depression in patients with diabetes. A post-hoc power-analysis was finished. RESULTS Compared with the non-depression T2DM group, the depression T2DM group had significantly higher blood glucose fluctuations. Further, compared with the non-depression T2DM and non-diabetic groups, the depression T2DM group had significantly lower levels of post-meal 2-h C-peptide and elevated evening cortisol (p < 0.01). Regression analysis revealed a significant negative correlation between depression severity and 2-h postprandial C-peptide in patients with diabetes (p < 0.01) and a significant positive correlation with midnight cortisol levels (p < 0.01). A post hoc power analysis showed that we had an adequate sample size and met the minimum requirement to attain 80% power. A post hoc power calculation also demonstrated that this study basically achieved power of 80% at 5% alpha level. CONCLUSIONS Our findings indicate a correlation of low fasting levels of 2-h C-peptide as well as higher midnight cortisol levels with higher depression severity in middle-aged patients with T2DM.
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Affiliation(s)
- Yu Ming Sang
- grid.452555.60000 0004 1758 3222Department of Endocrinology, Jinhua Central Hospital, 351 Mingyue Street, Jinhua City, 321000 Zhejiang Province China
| | - Li Jun Wang
- Department of Psychology, Zhejiang Normal University, 688 Yingbin Road, Jinhua, 321004, Zhejiang Province, China.
| | - Hong Xian Mao
- grid.452555.60000 0004 1758 3222Department of Endocrinology, Jinhua Central Hospital, 351 Mingyue Street, Jinhua City, 321000 Zhejiang Province China
| | - Xue Yong Lou
- grid.452555.60000 0004 1758 3222Department of Endocrinology, Jinhua Central Hospital, 351 Mingyue Street, Jinhua City, 321000 Zhejiang Province China
| | - Yi Jun Zhu
- The Central Laboratory, Jinhua Central Hospital, 351 Mingyue Street, Jinhua City, 321000 Zhejiang Province China
| | - Yue Hua Zhu
- grid.452555.60000 0004 1758 3222Department of Psychiatry, Jinhua Central Hospital, 351 Mingyue Street, Jinhua City, 321000 Zhejiang Province China
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Kao KL, Sung FC, Tzang RF, Huang HC, Lin CL, Fang CK, Wu SI, Stewart R. Associations of diabetes severity and risk of depression: a population-based cohort study. J Affect Disord 2020; 273:476-481. [PMID: 32560943 DOI: 10.1016/j.jad.2020.04.066] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 04/28/2020] [Accepted: 04/30/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Previous literature investigating effects of diabetes complications on subsequent depression have been inconsistent. We aim to investigate associations of diabetes, complication severity, and depression. DESIGN This study used a nationwide database to establish an 11-year cohort comprised of people with new onset Type II diabetes mellitus (DM) aged 20 and above. METHOD Severity of DM was measured using the adapted Diabetes Complication Severity Index (aDCSI). Status of depression was determined by having one recorded depression diagnosis from the inpatient setting or three recorded depression diagnoses from the outpatient setting. The risk of depression was analyzed by multivariate Cox proportional models. RESULTS In 50,590 cases with new onset DM from years 2000 to 2011, the incidence of depression increased with severity and rates of progressions in diabetes complications regardless of demographic status, comorbidities, or medication compliance. Adjusted hazard ratios (aHR) of depression were 1.21, 1.25, 1.48 (p<0.001 for trend) in patients with a total aDCSI score of 1, 2, and > 3, respectively. Risks of depression were the highest in subgroup with the most serious progression (change of aDCSI score >2 per year) (aHR ranged between 11.6~26.0). Elevated risks of depression (aHR: 1.59~4.36) were also observed in the slower progression subgroups throughout the disease course. CONCLUSIONS Risks of depression were associated with multiple DM-related complications and rates of progression in severity.
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Affiliation(s)
- Kai-Liang Kao
- Far Eastern Memorial Hospital, Department of Pediatrics, Taipei, Taiwan
| | - Fung-Chang Sung
- Department of Health Services Administration, China Medical University, College of Public Health, Taichung, Taiwan; Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Ruu-Feng Tzang
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan; Section of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Hui-Chun Huang
- Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan; Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan
| | - Chun-Kai Fang
- Section of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan
| | - Shu-I Wu
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan; Section of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan.
| | - Robert Stewart
- King's College London (Institute of Psychiatry, Psychology & Neuroscience), Department of Psychological Medicine, London, UK
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Tang B, Yuan S, Xiong Y, He Q, Larsson SC. Major depressive disorder and cardiometabolic diseases: a bidirectional Mendelian randomisation study. Diabetologia 2020; 63:1305-1311. [PMID: 32270255 PMCID: PMC7286869 DOI: 10.1007/s00125-020-05131-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 02/19/2020] [Indexed: 11/03/2022]
Abstract
AIMS/HYPOTHESIS Observational studies have shown a bidirectional association between major depressive disorder (MDD) and cardiometabolic diseases. We conducted a two-sample bidirectional Mendelian randomisation (MR) study to assess the causal associations of MDD with type 2 diabetes, coronary artery disease (CAD) and heart failure and vice versa. METHODS We extracted summary-level data for MDD, type 2 diabetes, CAD and heart failure from corresponding published large genome-wide association studies of individuals mainly of European-descent. In total, 96 SNPs for MDD, 202 SNPs for type 2 diabetes, 44 SNPs for CAD and 12 SNPs for heart failure were proposed as instrumental variables at the genome-wide significance level (p < 5 × 10-8). The random-effects inverse-variance weighted method was used for the main analyses. RESULTS Genetic liability to MDD was significantly associated with type 2 diabetes and CAD at the Bonferroni-corrected significance level. The ORs of type 2 diabetes and CAD were respectively 1.26 (95% CI 1.10, 1.43; p = 6 × 10-4) and 1.16 (95% CI 1.05, 1.29; p = 0.0047) per one-unit increase in loge odds of MDD. There was a suggestive association between MDD and heart failure (OR 1.11 [95% CI 1.01, 1.21]; p = 0.033). We found limited evidence supporting causal effects of cardiometabolic diseases on MDD risk in the reverse MR analyses. CONCLUSIONS/INTERPRETATION The present study strengthened the evidence that MDD is a potential risk factor for type 2 diabetes and CAD. Whether MDD is causally related to heart failure needs further study. DATA AVAILABILITY All data included in this study were uploaded as supplements and are also publicly available through published GWASs and open GWAS datasets (UK Biobank, 23andMe and Psychiatric Genomics: https://datashare.is.ed.ac.uk/handle/10283/3203; DIAGRAM: http://diagram-consortium.org/downloads.html; CARDIoGRAMplusCD4: www.cardiogramplusc4d.org/; HERMES: http://www.kp4cd.org/datasets/mi). Graphical abstract.
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Affiliation(s)
- Bowen Tang
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Shuai Yuan
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Surgical Sciences, Uppsala University, Epihubben, Dag Hammarskjölds väg 14 B, 75185, Uppsala, Sweden
| | - Ying Xiong
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Qiqiang He
- Department of Nutrition and Food Hygiene, School of Health Sciences, Wuhan University, Wuhan, China
| | - Susanna C Larsson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
- Department of Surgical Sciences, Uppsala University, Epihubben, Dag Hammarskjölds väg 14 B, 75185, Uppsala, Sweden.
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Hadj-Abo A, Enge S, Rose J, Kunte H, Fleischhauer M. Individual differences in impulsivity and need for cognition as potential risk or resilience factors of diabetes self-management and glycemic control. PLoS One 2020; 15:e0227995. [PMID: 31995586 PMCID: PMC6988919 DOI: 10.1371/journal.pone.0227995] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 01/03/2020] [Indexed: 01/14/2023] Open
Abstract
Objective Impulsivity is marked by insufficient reflection and forethought, whereas Need for Cognition (NFC) also referred to as cognitive motivation or intellectual engagement is marked by elaborated thinking. The aim of this study was to investigate the potential role of these personality traits as resilience or risk factors, respectively, in diabetes self-management and glycaemic control. Further, it was examined whether diabetes-specific self-efficacy could serve as a mediator of these relationships. Design/Measures Data of 77 participants with type 2 diabetes was ascertained, using self-report instruments for NFC, impulsivity, diabetes-specific self-efficacy, and diabetes self-management. Glycemic control was assessed by the biomarker HbA1c. Results While NFC was strongly positively associated with diabetes self-management and glycemic control, impulsivity showed a reverse pattern. Results of simple and serial mediation models showed that the effects on diabetes self-management and HbA1c of both, impulsivity and NFC, were mediated by self-efficacy. Conclusion The moderate to high standardized coefficients suggests that NFC might be an important protective factor and impulsivity a possible risk factor for effective diabetes self-management and glycemic control. These traits could be applied for an easy-to-use questionnaire-based patient screening, enabling trait-tailored treatments and programs which in turn may lower economic and health costs associated with poor diabetes-care.
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Affiliation(s)
- Alexander Hadj-Abo
- Department of Psychology, Faculty of Natural Sciences, Medical School Berlin, Berlin, Germany
| | - Sören Enge
- Department of Psychology, Faculty of Natural Sciences, Medical School Berlin, Berlin, Germany
| | - Jörn Rose
- Diabetes Centrum Berlin, Berlin, Germany
| | - Hagen Kunte
- Department of Psychology, Faculty of Natural Sciences, Medical School Berlin, Berlin, Germany
| | - Monika Fleischhauer
- Department of Psychology, Faculty of Natural Sciences, Medical School Berlin, Berlin, Germany
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Abstract
AIMS Several studies suggested that depression might worsen the clinical outcome of diabetes mellitus; however, such association was confounded by duration of illness and baseline complications. This study aimed to assess whether depression increases the risk of diabetes complications and mortality among incident patients with diabetes. METHODS This was a population-based matched cohort study using Taiwan's National Health Insurance Research Database. A total of 38 537 incident patients with diabetes who had depressive disorders and 154 148 incident diabetes patients without depression who were matched by age, sex and cohort entry year were randomly selected. The study endpoint was the development of macrovascular and microvascular complications, all-cause mortality and cause-specific mortality. RESULTS Among participants, the mean (±SD) age was 52.61 (±12.45) years, and 39.63% were male. The average duration of follow-up for mortality was 5.5 years, ranging from 0 to 14 years. The adjusted hazard ratios were 1.35 (95% confidence interval [CI], 1.32-1.37) for macrovascular complications and 1.08 (95% CI, 1.04-1.12) for all-cause mortality. However, there was no association of depression with microvascular complications, mortality due to cardiovascular diseases or mortality due to diabetes mellitus. The effect of depression on diabetes complications and mortality was more prominent among young adults than among middle-aged and older adults. CONCLUSIONS Depression was associated with macrovascular complications and all-cause mortality in our patient cohort. However, the magnitude of association was less than that in previous studies. Further research should focus on the benefits and risks of treatment for depression on diabetes outcome.
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Dolan C, Glynn R, Lawlor B. A Systematic Review and Delphi Study to Ascertain Common Risk Factors for Type 2 Diabetes Mellitus and Dementia and Brain-Related Complications of Diabetes in Adults. Can J Diabetes 2020; 44:628-635. [PMID: 32127297 DOI: 10.1016/j.jcjd.2020.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 11/11/2019] [Accepted: 01/06/2020] [Indexed: 12/09/2022]
Abstract
OBJECTIVES Both type 2 diabetes (T2DM) and dementia have multifactorial etiologies. Both are associated with aging and have well-recognized lifestyle, cardiovascular and psychosocial risk factors. However, uncertainty exists in the literature with regard to: 1) the potentially modifiable risk factors common to both dementia and T2DM, and 2) the risk of brain-related complications in those with established diabetes. In this study, we address this uncertainty and inform design of a survey questionnaire to assess knowledge about diabetes and brain health among at-risk groups. METHODS This investigation consisted of a mixed-methods approach, including a Delphi consensus study preceded by a systematic literature review. The review was conducted using MEDLINE, EMBASE and Cochrane Library databases. A 2-round online Delphi study, informed by the review, invited international experts to rate their agreement with proposed risk factors and complications. RESULTS Of 7,337 abstracts retrieved, 13 were included in the final review. Among 46 international experts invited to take part in the Delphi study, 14 (32%) responded. In the Delphi study, hypertension, obesity, physical inactivity and heavy alcohol consumption reached consensus as risk factors common to both T2DM and dementia. Proposed brain-related diabetes complications, depression and dementia were also identified. CONCLUSIONS Results revealed expert consensus and literature review agreement on a number of common modifiable risk factors for T2DM and dementia, as well as agreement on brain-related complications of diabetes. A number of other proposed shared risk factors did not reach consensus agreement, suggesting a need for more high-quality studies to add to the evidence base.
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Affiliation(s)
- Catherine Dolan
- Psychiatry of Old Age Department, Sligo Leitrim Mental Health Services, Sligo, Ireland.
| | | | - Brian Lawlor
- Department of Psychiatry, University of Dublin Trinity College, Dublin, Ireland
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Presley CA, White RO, Bian A, Schildcrout JS, Rothman RL. Factors associated with antidepressant use among low-income racially and ethnically diverse patients with type 2 diabetes. J Diabetes Complications 2019; 33:107405. [PMID: 31405797 PMCID: PMC6736726 DOI: 10.1016/j.jdiacomp.2019.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 06/26/2019] [Accepted: 07/09/2019] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Depression is common in patients with type 2 diabetes and associated with poor diabetes-related outcomes. We evaluated the factors associated with antidepressant use in a low-income, racially and ethnically diverse sample of patients with type 2 diabetes. RESEARCH DESIGN AND METHODS We performed a cross-sectional study of baseline data from participants in a cluster randomized trial evaluating a health literacy intervention for diabetes care in safety net clinics. Depressive symptoms were measured by the Center for Epidemiological Studies Depression Scale (CES-D); antidepressant use was abstracted from medication lists. Multivariable mixed effects logistic regression was used to evaluate the relationship between antidepressant use and race/ethnicity adjusting for depressive symptoms, age, gender, income, and health literacy. RESULTS Of 403 participants, 58% were non-Hispanic White, 18% were non-Hispanic Black, and 24% were Hispanic. Median age was 51 years old; 60% were female, 52% of participants had a positive screen for depression, and 18% were on antidepressants. Black and Hispanic participants were significantly less likely to be on an antidepressant compared with white participants, adjusted odds ratios 0.31(95% CI: 0.12 to 0.80) and 0.26 (95% CI: 0.10 to 0.74), respectively. CONCLUSIONS In this vulnerable population with type 2 diabetes, we found a high prevalence of depressive symptoms, and a small proportion of participants were on an antidepressant. Black and Hispanic participants were significantly less likely to be treated with an antidepressant. Our findings suggest depression may be inadequately treated in low-income, uninsured patients with type 2 diabetes, especially racial and ethnic minorities.
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Affiliation(s)
- Caroline A Presley
- Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center, 2525 West End Ave, Suite 450, Nashville, TN 37203, United States of America; Geriatric Research Education and Clinical Center, VA Tennessee Valley Healthcare System, 1310 24th Avenue South, Nashville, TN 37212, United States of America.
| | - Richard O White
- Division of Community Internal Medicine, Mayo Clinic, Cannaday Building, 3 West 4500 San Pablo Road, Jacksonville, FL 32224, United States of America.
| | - Aihua Bian
- Department of Biostatistics, Vanderbilt University Medical Center, 2525 West End, Suite 1100, Nashville, TN 37203, United States of America.
| | - Jonathan S Schildcrout
- Department of Biostatistics, Vanderbilt University Medical Center, 2525 West End, Suite 1100, Nashville, TN 37203, United States of America; Department of Anesthesiology, Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN 37232, United States of America.
| | - Russell L Rothman
- Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center, 2525 West End Ave, Suite 450, Nashville, TN 37203, United States of America.
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Jin H, Wu S. Use of Patient-Reported Data to Match Depression Screening Intervals With Depression Risk Profiles in Primary Care Patients With Diabetes: Development and Validation of Prediction Models for Major Depression. JMIR Form Res 2019; 3:e13610. [PMID: 31573900 PMCID: PMC6774232 DOI: 10.2196/13610] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 06/10/2019] [Accepted: 08/31/2019] [Indexed: 11/13/2022] Open
Abstract
Background Clinical guidelines recommend screening for depression in the general adult population but recognizes that the optimum interval for screening is unknown. Ideal screening intervals should match the patient risk profiles. Objective This study describes a predictive analytics approach for mining clinical and patient-reported data from a large clinical study for the identification of primary care patients at high risk for depression to match depression screening intervals with patient risk profiles. Methods This paper analyzed data from a large safety-net primary care study for diabetes and depression. A regression-based data mining technique was used to examine 53 demographics, clinical variables, and patient-reported variables to develop three prediction models for major depression at 6, 12, and 18 months from baseline. Predictors with the strongest predictive power that require low information collection efforts were selected to develop the prediction models. Predictive accuracy was measured by the area under the receiver operating curve (AUROC) and was evaluated by 10-fold cross-validation. The effectiveness of the prediction algorithms in supporting clinical decision making for six “typical” types of patients was demonstrated. Results The analysis included 923 patients who were nondepressed at the study baseline. Five patient-reported variables were selected in the prediction models to predict major depression at 6, 12, and 18 months: (1) Patient Health Questionnaire 2-item score; (2) the Sheehan Disability Scale; (3) previous problems with depression; (4) the diabetes symptoms scale; and (5) emotional burden of diabetes. All three depression prediction models had an AUROC>0.80, comparable with published depression prediction studies. Among the 6 “typical” types of patients, the algorithms suggest that patients who reported impaired daily functioning by health status are at an elevated risk for depression in all three periods. Conclusions This study demonstrated that leveraging patient-reported data and prediction models can help improve identification of high-risk patients and clinical decisions about the depression screening interval for diabetes patients. Implementation of this approach can be coupled with application of modern technologies such as telehealth and mobile health assessment for collecting patient-reported data to improve privacy, reducing stigma and costs, and promoting a personalized depression screening that matches screening intervals with patient risk profiles.
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Affiliation(s)
- Haomiao Jin
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States.,Edward R Roybal Institute on Aging, University of Southern California, Los Angeles, CA, United States
| | - Shinyi Wu
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States.,Edward R Roybal Institute on Aging, University of Southern California, Los Angeles, CA, United States.,Daniel J Epstein Department of Industrial and Systems Engineering, University of Southern California, Los Angeles, CA, United States
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Zhao F, Pan A, Yang X, Meng R, Ye Y, Wang Y, Xie Y, Pan XF, Yang CX. Bidirectional association between depressive symptoms and type 2 diabetes mellitus: The China Health and Retirement Longitudinal Study. J Diabetes Complications 2019; 33:107387. [PMID: 31331733 DOI: 10.1016/j.jdiacomp.2019.05.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 05/22/2019] [Accepted: 05/23/2019] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To prospectively examine the bidirectional relationship between depressive symptoms and type 2 diabetes mellitus (T2DM) among middle-aged and elderly Chinese. METHODS Participants were enrolled in 2011-2012 (Wave 1) and followed up in 2013-2014 (Wave 2) and 2015-2016 (Wave 3) in the China Health and Retirement Longitudinal Study. Depressive symptoms were evaluated by the Chinese language version of 10-item Center for Epidemiological Studies Depression Scale (CESD-10) at three waves. T2DM was assessed by biochemical biomarkers at Wave 1 and reported physician-diagnosis at Wave 2 and 3. Cox proportional hazards regression was applied to calculate hazard ratio (HR) and 95% confidence intervals (CIs) for the bidirectional association. RESULTS Participants with baseline depressive symptoms were 1.33 times as likely to develop T2DM (HR, 1.33; 95% CI: 1.06, 1.66), compared to their counterparts after adjusting for demographic characteristics and T2DM risk factors. The risk of T2DM increased linearly with higher severity of depression as determined by a higher CESD-10 score (P for trend ≪ 0.001). In addition, baseline T2DM was associated with increased risk of incident depressive symptoms (1.15; 1.00, 1.31) and persistent depressive symptoms (1.35; 1.03, 1.77). CONCLUSION There is a positive bidirectional association between depressive symptoms and T2DM in middle-aged and elderly Chinese.
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Affiliation(s)
- Fei Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, China
| | - An Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xue Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, China
| | - Ruiwei Meng
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yi Ye
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yi Wang
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yue Xie
- West China School of Public Health and West China Fourth Hospital, Sichuan University, China
| | - Xiong-Fei Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; The George Institute for Global Health, University of New South Wales, Sydney, Australia.
| | - Chun-Xia Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, China.
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Li HQ, Chi S, Dong Q, Yu JT. Pharmacotherapeutic strategies for managing comorbid depression and diabetes. Expert Opin Pharmacother 2019; 20:1589-1599. [PMID: 31149850 DOI: 10.1080/14656566.2019.1622090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Introduction: The increasing prevalence of comorbid depression and diabetes exerts a heavy burden on global health. Co-occurrence of depression and diabetes is common, affecting 14% to 35.8% of patients with diabetes, leading to a higher mortality and morbidity rate, more micro- and macro-vascular diseases and more cognitive decline. Areas covered: In this paper, the authors address various areas from epidemiology, the association between depression and diabetes, treatment strategies and future directions based on the currently available literature to provide novel insight into the pharmacotherapeutic management of comorbid depression and diabetes. Expert opinion: Pharmacotherapy can help patients with comorbid depression and diabetes by relieving depressive symptoms and improving glycemic control. When combined with psychological therapy, as a collaborative care effort, pharmacological therapy based on selective serotonin reuptake inhibitors (SSRIs) is recommended for comorbid depression with diabetes. Furthermore, studies with larger sample sizes that can help to define different subtypes of diabetes and severity of depression are needed so that clinicians can draw up a precise and applicable management guidelines for the personalized therapy of these diseases.
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Affiliation(s)
- Hong-Qi Li
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University , Shanghai , China
| | - Song Chi
- Department of Neurology, The Affiliated Hospital of Qingdao University , Qingdao , China
| | - Qiang Dong
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University , Shanghai , China
| | - Jin-Tai Yu
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University , Shanghai , China
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Chiu C, Du Y. Longitudinal investigation of the reciprocal relationship between depressive symptoms and glycemic control: The moderation effects of sex and perceived support. J Diabetes Investig 2019; 10:801-808. [PMID: 30390387 PMCID: PMC6497597 DOI: 10.1111/jdi.12969] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 10/15/2018] [Accepted: 10/31/2018] [Indexed: 12/31/2022] Open
Abstract
AIMS/INTRODUCTION The present study investigated the longitudinal associations between depressive symptoms and glycemic control in nationally representative adults with type 2 diabetes, and tested the effects of sex and perceived family support in moderating this association. MATERIALS AND METHODS In this longitudinal study of middle-aged and older adults who participated in the 2002 and 2006 Health and Retirement Study, and the 2003 and 2006 Diabetes Study (n = 398), we applied a cross-lagged structural equation model to examine the reciprocal relationship between depressive symptoms and glycemic control over a 3-year period. RESULTS Men and women were not different in terms of the depressive symptoms and glycemic control relationship, with a stronger association noted for higher depressive symptom scores predicting worse glycemic control (β = 0.22, critical ratio 3.03), as opposed to worse glycemic control predicting higher depressive symptom scores. Family and friend support for diabetes self-management serves as an important buffer. In patients with low family and friend support, more depressive symptoms at baseline were associated with subsequent worse glycemic levels (β = 0.36, critical ratio 4.03). In contrast, in individuals who had strong support, depressive symptoms did not predict subsequent glycemic control. CONCLUSIONS The present study provided evidence for the relationship between glycemic control and depression, finding that depressive symptoms predicted poorly controlled glycemic status, especially when the participants perceived inadequate support from their family or friends. A quick survey in clinics to assess the level of family or friend support for diabetes management and depressive symptoms might be an important part of individualized diabetic care.
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Affiliation(s)
- Ching‐Ju Chiu
- Institute of GerontologyCollege of MedicineNational Cheng Kung UniversityTainanTaiwan
| | - Ye‐Fong Du
- Division of Endocrinology and MetabolismDepartment of Internal MedicineNational Cheng Kung University HospitalTainanTaiwan
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Yang YC, Lin MH, Wang CS, Lu FH, Wu JS, Cheng HP, Lin SI. Geriatric syndromes and quality of life in older adults with diabetes. Geriatr Gerontol Int 2019; 19:518-524. [PMID: 30957935 DOI: 10.1111/ggi.13654] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 01/28/2019] [Accepted: 02/15/2019] [Indexed: 12/18/2022]
Abstract
AIM To describe geriatric syndromes and their relationships with quality of life in older adults with diabetes. METHODS Community-dwelling older adults (aged >60 years) with diabetes (n = 316) participated in the present study. Eight geriatric syndromes, including polypharmacy (number of medications), pain (Brief Pain Inventory), urinary incontinence (International Consultation on Incontinence Questionnaire), sleep disturbance (hours of sleep), lower cognitive level (Mini-Mental State Examination), falls, depressive symptoms (Geriatric Depression Scale short form) and functional limitation (Barthel Index and Instrumental Activity of Daily Living), were assessed. The WHOQOL-BREF Taiwan version was used to measure physical, psychological, social and environmental domains of quality of life. RESULTS Polypharmacy was the most common geriatric syndrome (46.6%), followed by pain (41.5%). Participants with any of the geriatric syndromes, except for polypharmacy and sleep disturbance, had significantly poorer quality of life than those without. The Geriatric Depression Scale score was the only common and significant contributor to all four domains of quality of life, explaining 16~29% of the variance. Number of medications, pain level and cognitive level were also significant contributors, although they explained a small amount (<5%) of the variance. The number of geriatric syndromes (mode = 2) was significantly correlated with all four domains of quality of life (partial correlation r = -0.278~0.460, all P < 0.001). CONCLUSIONS Geriatric syndromes, especially polypharmacy and pain, were common among older adults with diabetes. A greater number of geriatric syndromes or a higher Geriatric Depression Scale score were associated with poorer quality of life. Further studies focusing on combinations of different geriatric syndromes or comorbidities are required. Geriatr Gerontol Int 2019; 19: 518-524.
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Affiliation(s)
- Yi-Ching Yang
- Department of Family Medicine, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan.,Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ming-Hsing Lin
- Department of Family Medicine, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan
| | - Chong-Shan Wang
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Alian Health Clinic, Kaohsiung County, Taiwan
| | - Feng-Hwa Lu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jin-Shang Wu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hui-Ping Cheng
- Institute of Allied Health Science, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Sang-I Lin
- Institute of Allied Health Science, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Chireh B, Li M, D'Arcy C. Diabetes increases the risk of depression: A systematic review, meta-analysis and estimates of population attributable fractions based on prospective studies. Prev Med Rep 2019; 14:100822. [PMID: 30815337 PMCID: PMC6378921 DOI: 10.1016/j.pmedr.2019.100822] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 01/25/2019] [Accepted: 02/06/2019] [Indexed: 12/27/2022] Open
Abstract
We aim to examine the relationship between diabetes and depression risk in longitudinal cohort studies and by how much the incidence of depression in a population would be reduced if diabetes was reduced. Medline/PubMed, EMBASE, PsycINFO, and Cochrane Library databases were searched for English-language published literature from January 1990 to December 2017. Longitudinal studies with criteria for depression and self-report doctors' diagnoses or diagnostic blood test measurement of diabetes were assessed. Systematic review with meta-analysis synthesized the results. Study quality, heterogeneity, and publication bias were examined. Pooled odds ratios were calculated using random effects models. Population attributable fractions (PAFs) were used to estimate potential preventive impact. Twenty high-quality articles met inclusion criteria and were analyzed. The pooled odds ratio (OR) between diabetes and depression was 1.33 (95% CI, 1.18–1.51). For the various study types the ORs were as follows: prospective studies (OR 1.34, 95% CI 1.14–1.57); retrospective studies (OR 1.30, 95% CI 1.05–1.62); self-reported diagnosis of diabetes (OR 1.37, 95% CI 1.17–1.60); and diagnostic diabetes blood test (OR 1.25, 95% CI 1.04–1.52). PAFs suggest that over 9.5 million of global depression cases are potentially attributable to diabetes. A 10–25% reduction in diabetes could potentially prevent 930,000 to 2.34 million depression cases worldwide. Our systematic review provides fairly robust evidence to support the hypothesis that diabetes is an independent risk factor for depression while also acknowledging the impact of risk factor reduction, study design and diagnostic measurement of exposure which may inform preventive interventions. Depression risk is 1.33 times higher in people with diabetes. Prospective studies likely to report depression incidence Self-reported diabetes diagnoses likely to report depression A 10–25% diabetes reduction could prevent 930,000–2.34 million depression.
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Affiliation(s)
- Batholomew Chireh
- University of Saskatchewan School of Public Health, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
| | - Muzi Li
- The Douglas Hospital Research Centre, 6875 boulevard LaSalle, Montreal H4H 1R3, Canada
| | - Carl D'Arcy
- University of Saskatchewan, Department of Psychiatry and, School of Public Health, 103 Hospital drive, Ellis Hall, Room 107, Saskatoon, SK S7N 0W8, Canada
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Risk of Depression and Suicidality among Diabetic Patients: A Systematic Review and Meta-Analysis. J Clin Med 2018; 7:jcm7110445. [PMID: 30453557 PMCID: PMC6262418 DOI: 10.3390/jcm7110445] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 11/14/2018] [Accepted: 11/14/2018] [Indexed: 12/19/2022] Open
Abstract
The purpose of this study is to conduct a systematic review and meta-analysis to evaluate the risk of depression and suicidality among diabetic patients. METHODS Medline, PubMed, EMBASE, Cochrane library, and Psych INFO were searched for studies published from 2008 onwards. Meta-analysis was conducted to estimate the pooled effect size. Sources of heterogeneity were investigated by subgroup analysis and meta-regression. RESULTS In total, 5750 articles were identified and of those, 17 studies on suicidality and 36 on depression were included in this study. Our analysis suggests a positive relationship between diabetes and depression (cohort studies odds ratio (OR) 1.49, 95% confidence interval (CI): 1.36⁻1.64 and cross-sectional studies OR 2.04, 95% CI, 1.73⁻2.42). Pooled OR values for suicidal ideation, attempted suicide, and completed suicide were 1.89 (95% CI: 1.36⁻2.63), 1.45 (95% CI: 1.07⁻1.96), and 1.85 (95% CI: 0.97⁻3.52), respectively. All findings were statistically significant except for completed suicide. CONCLUSIONS The increased risk of depression and suicidality in diabetic patients highlights the importance of integrating the evaluation and treatment of depression with diabetes management in primary healthcare settings. Further research in this area is needed.
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Sweileh WM. Analysis of global research output on diabetes depression and suicide. Ann Gen Psychiatry 2018; 17:44. [PMID: 30386407 PMCID: PMC6198430 DOI: 10.1186/s12991-018-0214-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 10/16/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Diabetic patients, during the course of the disease, are most likely to experience depressive symptoms that might ultimately lead to suicidal ideation or suicide. The size of literature in diabetes depression/suicide is a good indicator of national and international efforts to address psychological co-morbidities associated with diabetes mellitus (DM). Therefore, the objective of this study was to give a comprehensive analysis, both quantitative and qualitative, of scientific literature in diabetes depression/suicide. METHODS SciVerse Scopus was used to retrieve relevant literature up to 2016. RESULTS In total, 1664 journal documents were retrieved with an average of 26.9 citations per article and an h-index of 98. Publications started in 1949 but showed a steep and noticeable increase after 2001. Retrieved articles were published in 641 different journals with Diabetes Care journal being the top productive one with a total of 130 (7.8%) articles. Researchers from 83 different countries participated in retrieved publications. Researchers from the United States of America participated in publishing 685 articles. There was a strong and positive correlation between research output and Gross Domestic Product (r = 0.083; p < 0.001) but not with prevalence or mortality caused by DM. Researchers from 4870 different institutions/organizations participated in publishing retrieved articles. Publications from the University of Washington, Seattle, USA had the highest h-index (38), while "VA medical centers" had the highest number of publications (75; 4.5%). In total, 5715 authors appeared in retrieved articles giving an average of 3.4 authors per article. Top cited articles focused on prevalence, impact of depression on glycemic control, and potential risk of diabetic complications. The total number of publications in depression/suicide in diabetic patients was lesser than that in cardiac (1938) or in cancer (1828) patients. However, publications in diabetes depression/suicide exceeded those in cardiac and cancer in the last 2 years of the study period. CONCLUSION The current study showed a noticeable growth of publications indicative of the importance of this topic. Research focusing on the psychiatric component of diabetes mellitus needs to be strengthened and encouraged. At the practical level, screening for depression/suicide among patients attending primary healthcare clinics is needed to optimize health and quality of life of diabetic patients.
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Affiliation(s)
- Waleed M. Sweileh
- Department of Physiology and Pharmacology/Toxicology, College of Medicine and Health Sciences, Nablus, Palestine
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Abstract
PURPOSE OF REVIEW Mental and addictive disorders commonly co-occur with medical comorbidities, resulting in poor health and functioning, and premature mortality. This review provides an overview of the intertwined causal pathways and shared risk factors that lead to comorbidity. Additionally, this review examines the strategies to prevent the onset of and to effectively manage chronic medical conditions among people with mental and addictive disorders. RECENT FINDINGS Recent research provides further evidence for the shared genetic and biological, behavioral, and environmental risk factors for comorbidity. Additionally, there is evidence of effective approaches for screening, self-management, and treatment of medical conditions among people with mental disorders. There are promising health system models of integrated care, but additional research is needed to fully establish their effectiveness. A combination of public health and clinical approaches are needed to better understand and address comorbidity between mental and addictive disorders and chronic medical conditions.
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Affiliation(s)
- Elizabeth Reisinger Walker
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Ave, Atlanta, GA, 30322, USA.
| | - Benjamin G Druss
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Bruce DG, Davis WA, Starkstein SE, Davis TME. Clinical risk factors for depressive syndrome in Type 2 diabetes: the Fremantle Diabetes Study. Diabet Med 2018; 35:903-910. [PMID: 29608787 DOI: 10.1111/dme.13631] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/26/2018] [Indexed: 12/26/2022]
Abstract
AIMS To identify early clinical predictors of depressive syndrome in people with Type 2 diabetes. METHODS Depressive syndrome was assessed in 325 individuals with Type 2 diabetes 15 years after a baseline assessment, which included information on antidepressant use and depressive symptoms obtained using a quality-of-life scale. Follow-up current and lifetime depressive syndrome were assessed using the nine-item Patient Health Questionnaire and the Brief Lifetime Depression Scale and taking account of antidepressant use. Analyses were conducted inclusive and exclusive of antidepressant use where Patient Health Questionnaire criteria were not met. RESULTS At baseline, the participants were aged 57.2±9.3 years and the median (interquartile range) diabetes duration was 2.2 (0.6-6.0) years. After a mean of 14.7±1.1 years' follow-up, 81 participants (24.9%) had depressive syndrome (14.8% defined by the Patient Health Questionnaire, 10.2% defined by antidepressants) and 31.4% reported lifetime depression, and in 10.2% of participants this preceded diabetes onset. With logistic regression (inclusive of antidepressants), follow-up depressive syndrome was negatively associated with education level [odds ratio 0.39 (95% CI 0.20-0.75)] and antidepressant use [odds ratio 0.11 (95% CI 0.03-0.36)] and was positively associated with depression history before diabetes onset [odds ratio 2.79 (95% CI 1.24-6.27)]. In the model exclusive of antidepressants, depressive syndrome was positively associated with baseline depressive symptoms [odds ratio 2.57 (95% CI 1.32-5.03)] and antidepressant use [odds ratio 3.54 (95% CI 1.20-10.42)] and was negatively associated with education level [odds ratio 0.39 (95% CI 0.19-0.81)]. CONCLUSIONS Risk factors for depressive syndrome can be identified early after the onset of Type 2 diabetes. The early presence of depressive symptoms or its treatment and/or history of depression are likely indicators of vulnerability. Early risk stratification for late depressive syndrome is feasible in people with Type 2 diabetes and could assist with depression treatment or prevention.
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Affiliation(s)
- D G Bruce
- Medical School, University of Western Australia, Fremantle, WA, Australia
| | - W A Davis
- Medical School, University of Western Australia, Fremantle, WA, Australia
| | - S E Starkstein
- Medical School, University of Western Australia, Fremantle, WA, Australia
| | - T M E Davis
- Medical School, University of Western Australia, Fremantle, WA, Australia
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Wu S, Ell K, Jin H, Vidyanti I, Chou CP, Lee PJ, Gross-Schulman S, Sklaroff LM, Belson D, Nezu AM, Hay J, Wang CJ, Scheib G, Di Capua P, Hawkins C, Liu P, Ramirez M, Wu BW, Richman M, Myers C, Agustines D, Dasher R, Kopelowicz A, Allevato J, Roybal M, Ipp E, Haider U, Graham S, Mahabadi V, Guterman J. Comparative Effectiveness of a Technology-Facilitated Depression Care Management Model in Safety-Net Primary Care Patients With Type 2 Diabetes: 6-Month Outcomes of a Large Clinical Trial. J Med Internet Res 2018; 20:e147. [PMID: 29685872 PMCID: PMC5938593 DOI: 10.2196/jmir.7692] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 12/10/2017] [Accepted: 01/13/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Comorbid depression is a significant challenge for safety-net primary care systems. Team-based collaborative depression care is effective, but complex system factors in safety-net organizations impede adoption and result in persistent disparities in outcomes. Diabetes-Depression Care-management Adoption Trial (DCAT) evaluated whether depression care could be significantly improved by harnessing information and communication technologies to automate routine screening and monitoring of patient symptoms and treatment adherence and allow timely communication with providers. OBJECTIVE The aim of this study was to compare 6-month outcomes of a technology-facilitated care model with a usual care model and a supported care model that involved team-based collaborative depression care for safety-net primary care adult patients with type 2 diabetes. METHODS DCAT is a translational study in collaboration with Los Angeles County Department of Health Services, the second largest safety-net care system in the United States. A comparative effectiveness study with quasi-experimental design was conducted in three groups of adult patients with type 2 diabetes to compare three delivery models: usual care, supported care, and technology-facilitated care. Six-month outcomes included depression and diabetes care measures and patient-reported outcomes. Comparative treatment effects were estimated by linear or logistic regression models that used generalized propensity scores to adjust for sampling bias inherent in the nonrandomized design. RESULTS DCAT enrolled 1406 patients (484 in usual care, 480 in supported care, and 442 in technology-facilitated care), most of whom were Hispanic or Latino and female. Compared with usual care, both the supported care and technology-facilitated care groups were associated with significant reduction in depressive symptoms measured by scores on the 9-item Patient Health Questionnaire (least squares estimate, LSE: usual care=6.35, supported care=5.05, technology-facilitated care=5.16; P value: supported care vs usual care=.02, technology-facilitated care vs usual care=.02); decreased prevalence of major depression (odds ratio, OR: supported care vs usual care=0.45, technology-facilitated care vs usual care=0.33; P value: supported care vs usual care=.02, technology-facilitated care vs usual care=.007); and reduced functional disability as measured by Sheehan Disability Scale scores (LSE: usual care=3.21, supported care=2.61, technology-facilitated care=2.59; P value: supported care vs usual care=.04, technology-facilitated care vs usual care=.03). Technology-facilitated care was significantly associated with depression remission (technology-facilitated care vs usual care: OR=2.98, P=.04); increased satisfaction with care for emotional problems among depressed patients (LSE: usual care=3.20, technology-facilitated care=3.70; P=.05); reduced total cholesterol level (LSE: usual care=176.40, technology-facilitated care=160.46; P=.01); improved satisfaction with diabetes care (LSE: usual care=4.01, technology-facilitated care=4.20; P=.05); and increased odds of taking an glycated hemoglobin test (technology-facilitated care vs usual care: OR=3.40, P<.001). CONCLUSIONS Both the technology-facilitated care and supported care delivery models showed potential to improve 6-month depression and functional disability outcomes. The technology-facilitated care model has a greater likelihood to improve depression remission, patient satisfaction, and diabetes care quality.
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Affiliation(s)
- Shinyi Wu
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States.,Roybal Institute on Aging, University of Southern California, Los Angeles, CA, United States.,Daniel J. Epstein Department of Industrial and Systems Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States.,Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, United States
| | - Kathleen Ell
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States
| | - Haomiao Jin
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States.,Roybal Institute on Aging, University of Southern California, Los Angeles, CA, United States.,Daniel J. Epstein Department of Industrial and Systems Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States
| | - Irene Vidyanti
- Daniel J. Epstein Department of Industrial and Systems Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States.,Policy Analysis Unit, Los Angeles County Department of Public Health, Los Angeles, CA, United States
| | - Chih-Ping Chou
- Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Pey-Jiuan Lee
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States
| | | | - Laura Myerchin Sklaroff
- Los Angeles County Department of Health Services, Los Angeles, CA, United States.,College of Social and Behavioral Sciences, California State University, Northridge, Los Angeles, CA, United States
| | - David Belson
- Daniel J. Epstein Department of Industrial and Systems Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States
| | - Arthur M Nezu
- Department of Psychology, Drexel University, Philadelphia, PA, United States
| | - Joel Hay
- Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, United States
| | - Chien-Ju Wang
- Los Angeles County Department of Health Services, Los Angeles, CA, United States
| | - Geoffrey Scheib
- Los Angeles County Department of Health Services, Los Angeles, CA, United States
| | - Paul Di Capua
- Caremore Medical Group, East Haven, CT, United States.,Herbert Wertheim College of Medicine, Florida International University, Miami, FL, United States
| | - Caitlin Hawkins
- Daniel J. Epstein Department of Industrial and Systems Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States
| | - Pai Liu
- Daniel J. Epstein Department of Industrial and Systems Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States
| | - Magaly Ramirez
- Daniel J. Epstein Department of Industrial and Systems Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States.,Department of Health Policy and Management, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, United States
| | - Brian W Wu
- Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Mark Richman
- Department of Emergency Medicine, Northwell Health Long Island Jewish Medical Center, New Hyde Park, NY, United States
| | - Caitlin Myers
- Los Angeles County Department of Health Services, Los Angeles, CA, United States
| | - Davin Agustines
- Los Angeles County Department of Health Services, Los Angeles, CA, United States
| | - Robert Dasher
- Los Angeles County Department of Health Services, Los Angeles, CA, United States
| | - Alex Kopelowicz
- Los Angeles County Department of Health Services, Los Angeles, CA, United States
| | - Joseph Allevato
- Los Angeles County Department of Health Services, Los Angeles, CA, United States
| | - Mike Roybal
- Los Angeles County Department of Health Services, Los Angeles, CA, United States
| | - Eli Ipp
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States.,Harbor-UCLA Medical Center, University of California Los Angeles, Los Angeles, CA, United States.,Los Angeles Biomedical Research Institute, Los Angeles, CA, United States
| | - Uzma Haider
- Harbor-UCLA Medical Center, University of California Los Angeles, Los Angeles, CA, United States
| | - Sharon Graham
- Los Angeles County Department of Health Services, Los Angeles, CA, United States
| | - Vahid Mahabadi
- Los Angeles County Department of Health Services, Los Angeles, CA, United States
| | - Jeffrey Guterman
- Los Angeles County Department of Health Services, Los Angeles, CA, United States.,David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
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The association of depression and diabetes across methods, measures, and study contexts. Clin Diabetes Endocrinol 2018; 4:1. [PMID: 29318033 PMCID: PMC5755050 DOI: 10.1186/s40842-017-0052-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 12/14/2017] [Indexed: 01/09/2023] Open
Abstract
Background Empirical research has revealed a positive relationship between type 2 diabetes mellitus and depression, but questions remain regarding timing of depression measurement, types of instruments used to measure depression, and whether “depression” is defined as clinical depression or depressive symptoms. The present study sought to establish the robustness of the depression-diabetes relationship across depression definition, severity of depressive symptoms, recent depression, and lifetime depression in a nationally representative dataset and a large rural dataset. Methods The present examination, conducted between 2014 and 2015, used two large secondary datasets: the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2008 (n = 3072) and the Arthritis, Coping, and Emotion Study (ACES) from 2002 to 2006 (n = 2300). Depressive symptoms in NHANES were measured using the Patient Health Questionnaire 9-item survey (PHQ-9). ACES used the Center for Epidemiologic Studies—Depression Scale (CES-D) to measure depressive symptoms and the Composite International Diagnostic Interview (CIDI) to measure diagnosable depression. Diabetes was modelled as the dichotomous outcome variable (presence vs. absence of diabetes). Logistic regression was used for all analyses, most of which were cross-sectional. Analyses controlled for age, ethnicity, sex, education, and body mass index, and NHANES analyses used sample weights to account for the complex survey design. Additional analyses using NHANES data focused on the addition of health behavior variables and inflammation to the model. Results NHANES. Every one-point increase in depressive symptoms was associated with a 5% increase in odds of having diabetes [OR: 1.05 (CI: 1.03, 1.07)]. These findings persisted after controlling for health behaviors and inflammation. ACES. For every one-point increase in depressive symptom score, odds of having diabetes increased by 2% [OR: 1.02 (CI: 1.01, 1.03)]. Recent (past 12 months) depression [OR: 1.49, (CI: 1.03, 2.13)] and lifetime depression [OR: 1.40 (CI: 1.09, 1.81)] were also significantly associated with having diabetes. Conclusions This study provides evidence for the robustness of the relationship between depression or depressive symptoms and diabetes and demonstrates that depression occurring over the lifetime can be associated with diabetes just as robustly as that which occurs more proximal to the time of study measurement.
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Rosedale MT, Strauss SM, Kaur N, Danoff A, Malaspina D. Identification of diabetes risk in dental settings: Implications for physical and mental health. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2018; 47:64-73. [DOI: 10.1080/00207411.2017.1377803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Mary T. Rosedale
- Rory Meyers College of Nursing, New York University, New York, NY, USA
- New York University Langone Medical Center, New York, NY, USA
| | - Shiela M. Strauss
- Rory Meyers College of Nursing, New York University, New York, NY, USA
- New York University Langone Medical Center, New York, NY, USA
| | - Navjot Kaur
- New York University Langone Medical Center, New York, NY, USA
| | - Ann Danoff
- New York University Langone Medical Center, New York, NY, USA
| | - Dolores Malaspina
- Department of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai Medical Center, New York, NY, USA
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