Independent factors associated with major depressive disorder in a national sample of individuals with diabetes.
OBJECTIVE
To determine whether perceived poor physical health, duration of diabetes, and smoking are associated with major depressive disorder in a national sample of individuals with diabetes.


METHODS
Data on 1,810 individuals with diabetes from the 1999 National Health Interview Survey (NHIS) were analyzed. The Composite International Diagnostic Interview (CIDI) Short-Form (CIDI-SF) developed by the World Health Organization was used to identify individuals with major depressive disorder. Multiple logistic regression was used to determine whether perceived poor physical health, duration of diabetes, and smoking were associated with major depressive disorder. The model controlled for age, sex, race/ethnicity, education, income, employment, marital status, and health status. Other control variables included BMI, smoking, duration of diabetes, presence or absence of major complications, and type of treatment for diabetes. SUDAAN software was used for statistical analyses to account for the complex sampling design of NHIS.


RESULTS
Independent factors associated with major depressive disorder were age <64 years, female sex, at least high school education, income <124% of federal poverty level, perceived worsening of health status, and smoking.


CONCLUSIONS
In addition to other psychosocial factors such as younger age, female sex, lower income, at least high school education, and smoking, perceptions about the effect of diabetes on overall health seems to play an important role in the etiology of depression.
Egede
Leonard E
LE
Department of Medicine, Medical University of South Carolina, Charleston, South Carolina 29425, USA. egedel@musc.edu
Zheng
Deyi
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D003865:Major Depressive Disorder / Q000453:epidemiology*; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology* / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011584:Psychology; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D012923:Social Class