Associations of diabetes severity and risk of depression: a population -based cohort study

被引:12
作者
Kao, Kai-Liang [1 ]
Sung, Fung-Chang [2 ,3 ]
Tzang, Ruu-Feng [4 ,5 ,6 ]
Huang, Hui-Chun [6 ,7 ]
Lin, Cheng-Li [3 ,8 ]
Fang, Chun-Kai [5 ]
Wu, Shu-I [4 ,5 ]
Stewart, Robert [9 ]
机构
[1] Far Eastern Mem Hosp, Dept Pediat, Taipei, Taiwan
[2] China Med Univ, Coll Publ Hlth, Dept Hlth Serv Adm, Taichung, Taiwan
[3] China Med Univ Hosp, Management Off Hlth Data, Taichung, Taiwan
[4] Mackay Med Coll, Dept Med, New Taipei, Taiwan
[5] Mackay Mem Hosp, Sect Psychiat, Taipei, Taiwan
[6] Mackay Jr Coll Med Nursing & Management, Taipei, Taiwan
[7] Mackay Mem Hosp, Dept Med Res, Taipei, Taiwan
[8] China Med Univ, Coll Med, Taichung, Taiwan
[9] Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Psychol Med, London, England
基金
英国工程与自然科学研究理事会; 英国医学研究理事会;
关键词
QUALITY-OF-LIFE; MAJOR DEPRESSION; SYMPTOMS; COMPLICATIONS; ADULTS; PREDICTORS; INDEX;
D O I
10.1016/j.jad.2020.04.066
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
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. © 2020 Elsevier B.V.
引用
收藏
页码:476 / 481
页数:6
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