Trends in depression by glycemic status: Serial cross-sectional analyses of the National Health and Nutrition Examination Surveys, 2005–2016 |
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| Institution: | 1. University of Rochester Medical Center, Rochester, NY 14642, USA;2. School of Medicine, Emory University, Atlanta, GA 30307, USA;3. Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA;4. Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA;5. Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, USA;6. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina;1. Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra 411001, India;2. Interdisciplinary School of Health Sciences, Savitribai Phule University, Pune, India;3. Senior Pediatric Endocrinologist, Jehangir Hospital, Pune and Bombay Hospital, India;1. Department of General Practice, The Second Affiliated Hospital of Guangxi Medical University, Nanning 530007, China;2. Department of Emergency Medicine, The Second Affiliated Hospital of Guangxi Medical University, Nanning 530007, China;3. International Medical Services, The People''s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China;1. Department of Family Medicine, Uniformed Services University of the Health Sciences, USA;2. Military Primary Care Research Network, Uniformed Services University of the Health Sciences, USA;3. Family Medicine, Eglin Family Medicine Residency, USA;4. Henry M. Jackson Foundation for the Advancement of Military Medicine, USA;5. Department of Family Medicine, Medical College of Georgia at Augusta University, USA;6. Family Medicine, Mike O’Callaghan Military Medical Center, USA;7. Department of Primary Care, Martin Army Community Hospital, Fort Benning, USA;1. Department of Internal Medicine, East Carolina University, United States;2. Department of Family Medicine, East Carolina University, United States;1. College of Pharmacy, University of Sharjah, University City Road, University City, PO Box 27272, Sharjah, United Arab Emirates;2. Sharjah Institute for Medical Research, University of Sharjah, University City Road - University City, PO Box 27272, Sharjah, United Arab Emirates;3. Rashid Hospital, Dubai Health Authority UAE, Dubai Medical College, United Arab Emirates;4. Pharmacist, Fakeeh University Hospital, Dubai Silicon Oasis, Dubai, United Arab Emirates;5. Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates;6. Clinical and Population Health, Baker Institute, Baker Heart and Diabetes Institute, Level 4, 99 Commercial Road, PO Box 6492, Melbourne, VIC 3004, Australia |
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| Abstract: | AimsWe examined changes in the prevalence of elevated depressive symptoms among US adults with diabetes, prediabetes, and normal glycemic status during 2005–2016.MethodsWe analyzed data from 32,676 adults in the 2005–2016 National Health and Nutrition Examination Surveys. We defined diabetes as self-reporting a physician diagnosis of diabetes or A1C ≥ 6.5% 48 mmol/mol], and prediabetes as A1C 5.7–6.4% 39–46 mmol/mol]. We used the 9-item Patient Health Questionnaire (PHQ-9) score ≥ 10 or antidepressant use to define ‘clinically significant depressive symptoms’ (CSDS) and PHQ-9 score ≥ 12 as ‘Major Depressive Disorder’ (MDD). We calculated prevalence age-standardized to the 2000 US census and used logistic-regression to compute adjusted odds of CSDS and MDD for 2005–2008, 2009–2012, and 2015–2016. We analyzed the prevalence of A1C ≥ 9.0% 75 mmol/mol], systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg, non-HDL cholesterol ≥ 130 mg/dL, and current smoking among adults with diagnosed diabetes by depressive status.ResultsThe prevalence of CSDS increased among individuals with normal glycemic status from 15.0% (13.5–16.2) to 17.3% (16.0–18.7) (p = 0.03) over 2005–2016. The prevalence of CSDS and MDD remained stable among adults with prediabetes (~ 16% and 1%, respectively) and diabetes (~ 26% and ~3%). After controlling for glycemic, sociodemographic, economic, and self-rated health variables, we found 2-fold greater odds of CSDS among unemployed individuals and 3-fold greater odds among those with fair/poor self-rated health across all survey periods. Cardiometabolic care targets for adults with diagnosed diabetes were stable from 2005 to 2016 and similar across depressive status.ConclusionsOne-fourth of adults with diabetes have comorbid CSDS; this prevalence remained stable over 2005–2016 with no change in diabetes care. At the population level, depression does not appear to impact diabetes care, but further research could explore subgroups that may be more vulnerable and could benefit from integrated care that addresses both conditions. |
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| Keywords: | Diabetes Depression Comorbidities Epidemiology |
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