Depression and diabetes: factors associated with major depression at five-year follow-up.
BACKGROUND
In patients with diabetes, comorbid depression has been shown to be associated with increased medical symptom burden, additional functional impairment, poor self-care, increased risk of macrovascular and microvascular complications, higher medical costs, and greater mortality.


OBJECTIVE
The authors performed a longitudinal observation to assess the pathway between diabetes complications and subsequent depression.


METHODS
In a prospective study of primary-care patients with diabetes (N=2,759), the authors determined, from automated data and chart review, whether macrovascular or microvascular events or coronary, cerebrovascular, or peripheral vascular procedures during follow-up were associated with meeting criteria for major depression at 5-year follow-up.


RESULTS
After controlling for baseline severity of depression symptoms and history of depression, having one-or-more coronary procedures during follow-up, and baseline severity of diabetes symptoms were strong predictors of having major depression at 5-year follow-up.


CONCLUSIONS
The risk of major depression among persons with diabetes is increased by previous depression history, baseline diabetes symptoms, and having had cardiovascular procedures.
Katon
Wayne
W
Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98195, USA. wkaton@u.washington.edu
Russo
Joan
J
Lin
Elizabeth H B
EH
Heckbert
Susan R
SR
Ciechanowski
Paul
P
Ludman
Evette J
EJ
Von Korff
Michael
M
D013504:Cardiovascular Surgical Procedures / Q000523:psychology / Q000706:statistics & numerical data; D015331:Cohort Studies; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D048909:Diabetes Complications / Q000453:epidemiology / Q000523:psychology; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014861:Washington / Q000453:epidemiology