title: Diabetes and co-morbid depression among racially diverse, low-income adults.
abstract: BACKGROUND
  Research suggests individuals with diabetes are twice as likely as those without diabetes to be clinically depressed. Still unknown is the relationship between diabetes and depression in socioeconomically disadvantaged populations.
  
  
  OBJECTIVE
  We examined the relationship between diabetes and depressive symptoms in a large, racially diverse, low-income cohort in the southeastern USA.
  
  
  METHODS
  A total of 69,068 adults were recruited from community health centers in 12 southeastern states. A fully adjusted polytomous logistic regression model tested the relationship between demographics, lifestyle behaviors, antidepressant use, body mass index, diabetes diagnosis, diabetes duration, diabetes medication compliance, and depressive symptoms using the Centers for Epidemiological Studies Depression scale.
  
  
  RESULTS
  Diabetes was present in 21.7% of sample. While a diabetes diagnosis was associated with having severe depressive symptoms (AOR, 1.24; 95% CI, 1.14-1.34), demographics, lifestyle behaviors, body mass index and antidepressant use were more strongly associated with severe depressive symptoms than a diabetes diagnosis.
  
  
  CONCLUSIONS
  Having diabetes was associated with the presence and severity of depressive symptoms in a large, low-income sample of racially diverse adults. However, the relationship between diabetes and depressive symptoms was weaker than in other studies with higher socioeconomic groups.
authors.affiliation: Department of Medicine, Division of General Internal Medicine, Center for Health Services Research, Vanderbilt University Medical Center, Nashville, TN 37232-8300, USA. chandra.osborn@vanderbilt.edu
authors.forename: Chandra Y
authors.initials: CY
authors.lastname: Osborn
authors.forename: Kushal A
authors.initials: KA
authors.lastname: Patel
authors.forename: Jianguo
authors.initials: J
authors.lastname: Liu
authors.forename: Hollister W
authors.initials: HW
authors.lastname: Trott
authors.forename: Maciej S
authors.initials: MS
authors.lastname: Buchowski
authors.forename: Margaret K
authors.initials: MK
authors.lastname: Hargreaves
authors.forename: William J
authors.initials: WJ
authors.lastname: Blot
authors.forename: Sarah S
authors.initials: SS
authors.lastname: Cohen
authors.forename: David G
authors.initials: DG
authors.lastname: Schlundt
mesh_terms: D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D015992:Body Mass Index; D015331:Cohort Studies; D003863:Depression / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology*; D048909:Diabetes Complications / Q000523:psychology*; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology*; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D011203:Poverty / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D044469:Racial Groups / Q000523:psychology*; D012720:Severity of Illness Index
chemical_list: D000928:Antidepressive Agents