Prevalence and correlates of depression in individuals with and without type 1 diabetes.
OBJECTIVE
Depression is associated with poor glycemic control and complications in people with type 1 diabetes. We assessed the prevalence of depression and antidepressant medication use among adults with and without type 1 diabetes and the association between depression and diabetes complications.


METHODS
In 2006-2008, the Coronary Artery Calcification in Type 1 Diabetes Study applied the Beck Depression Inventory II (BDI-II) to 458 participants with type 1 diabetes (47% male, aged 44 +/- 9 years, type 1 diabetes duration 29 +/- 9 years) and 546 participants without diabetes (nondiabetic group) (51% male, aged 47 +/- 9 years). Use of antidepressant medication was self-reported. Depression was defined as a BDI-II score >14 and/or use of antidepressant medication. Occurrence of diabetes complications (retinopathy, blindness, neuropathy, diabetes-related amputation, and kidney or pancreas transplantation) was self-reported.


RESULTS
Mean BDI-II score, adjusted for age and sex, was significantly higher in participants with type 1 diabetes than in nondiabetic participants (least-squares mean +/- SE: 7.4 +/- 0.3 vs. 5.0 +/- 0.3; P < 0.0001). Type 1 diabetic participants reported using more antidepressant medications (20.7 vs. 12.1%, P = 0.0003). More type 1 diabetic than nondiabetic participants were classified as depressed by BDI-II cut score (17.5 vs. 5.7%, P < 0.0001) or by either BDI-II cut score or antidepressant use (32.1 vs. 16.0%, P < 0.0001). Participants reporting diabetes complications (n = 209) had higher mean BDI-II scores than those without complications (10.7 +/- 9.3 vs. 6.4 +/- 6.3, P < 0.0001).


CONCLUSIONS
Compared with nondiabetic participants, adults with type 1 diabetes report more symptoms of depression and more antidepressant medication usage. Depression is highly prevalent in type 1 diabetes and requires further study on assessment and treatment.
Gendelman
Nicole
N
Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, Aurora, Colorado, USA.
Snell-Bergeon
Janet K
JK
McFann
Kim
K
Kinney
Gregory
G
Paul Wadwa
R
R
Bishop
Franziska
F
Rewers
Marian
M
Maahs
David M
DM
D000328:Adult; D000671:Amputation, Surgical / Q000523:psychology; D000928:Antidepressive Agents / Q000627:therapeutic use*; D002114:Calcinosis / Q000523:psychology; D003324:Coronary Artery Disease / Q000523:psychology; D003863:Depression / Q000188:drug therapy / Q000453:epidemiology*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000523:psychology*; D003925:Diabetic Angiopathies / Q000523:psychology; D003929:Diabetic Neuropathies / Q000523:psychology; D003930:Diabetic Retinopathy / Q000523:psychology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory; D015995:Prevalence; D012648:Self Care
D000928:Antidepressive Agents; D006442:Glycated Hemoglobin