Mental disorders among persons with diabetes--results from the World Mental Health Surveys.
OBJECTIVE
To estimate 12-month prevalence rate of mood, anxiety, and alcohol-use disorders among community samples of diabetic persons. We assess whether associations of specific mental disorders with diabetes are consistent across diverse countries after controlling for age and gender.


METHODS
Eighteen surveys of household-residing adults were conducted in two phases across 17 countries in Europe, the Americas, the Middle East, Africa, Asia, and the South Pacific (Part 1, N=85,088). Mental disorders, identified by the World Mental Health-Composite International Diagnostic Interview, included anxiety disorders (generalized anxiety disorder, panic disorder/agoraphobia, posttraumatic stress disorder, and social phobia), mood disorders (dysthymia and major depressive disorder), and alcohol abuse/dependence. Diabetes was ascertained by self-report (Part 2, N=42,697). Association was assessed by age-gender adjusted odds ratios.


RESULTS
Risk of mood and anxiety disorders was slightly higher among persons with diabetes relative to those without: odds ratio of 1.38 for depression (95% CI=1.15-1.66) and 1.20 for anxiety disorders, (95 % CI=1.01-1.42), after adjusting for age and gender. Odds ratio estimates across countries did not differ more than chance expectation. Alcohol-use disorders were uncommon among persons with diabetes in most countries, and not associated with diabetes in pooled survey data.


CONCLUSIONS
Population sample surveys revealed mood and anxiety disorders occurred with somewhat greater frequency among persons with diabetes than those without diabetes. Prevalence of major depression among persons with diabetes was lower in the general population than suggested by prior studies of clinical samples. Strength of association did not differ significantly across disorders or countries.
Lin
Elizabeth H B
EH
Center for Health Studies, Group Health Cooperative, Seattle, WA 98101, USA. lin.e@ghc.org
Von Korff
Michael
M
Alonso
Jordi
J
Angermeyer
Matthias C
MC
Anthony
James
J
Bromet
Evelyn
E
Bruffaerts
Ronny
R
Gasquet
Isabelle
I
de Girolamo
Giovanni
G
Gureje
Oye
O
Haro
Josep Maria
JM
Karam
Elie
E
Lara
Carmen
C
Lee
Sing
S
Levinson
Daphna
D
Ormel
J Hans
JH
Posada-Villa
José
J
Scott
Kate
K
Watanabe
Makoto
M
Williams
David
D
D000328:Adult; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D014943:Global Health; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis / Q000453:epidemiology; D016584:Panic Disorder / Q000175:diagnosis / Q000453:epidemiology; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology