title: Depression and type 2 diabetes among Alaska Native primary care patients.
abstract: OBJECTIVE
  To assess whether type 2 diabetes mellitus (DM2) and DM2 complications are associated with presence and severity of depression among Alaska Native and American Indian people (AN/Als).
  
  
  METHODS
  Retrospective, cross-sectional analysis of medical records.
  
  
  METHODS
  Southcentral Foundation Primary Care Center (SCF-PCC) in Anchorage, Alaska.
  
  
  METHODS
  Total of 23,529 AN/AI adults.
  
  
  METHODS
  Patient Health Questionnaire (PHQ) scores (0-9 negative, 10-14 mild, 15-19 moderate, 20+ severe) and DSM-IV depression diagnosis.
  
  
  RESULTS
  DM2 prevalence was 6% (n=1,526). Of those with DM2, 19% (n = 292) had one or more DM2 complications and average HbAlc was 7.1%. Prevalence of depression diagnosis was similar between AN/Als with and without DM2 (P = .124). Among those screened for depression (n = 12,280), there were similar rates of PHQ severity between those without and with DM2; respectively 4% (n = 452) vs 4% (n = 42) mild, 4% (n = 404) vs 3% (n = 29) moderate, and 4% (n = 354) vs 4% (n = 38) severe. In multivariable logistic regression, DM2 was not associated with PHQ severity (OR 1.02, 95% CI 0.81-1.27) or depression diagnosis (OR 1.27, 95% CI 1.00-1.62). Increased odds of depression and higher depression severity were associated with female sex, younger age, being unmarried, substance abuse/dependence, and increased ambulatory visits. Depression was associated with number of other chronic conditions among AN/Als with DM2 but not with number of complications.
  
  
  CONCLUSIONS
  Presence and severity of depression among AN/Al primary care patients was not significantly associated with DM2 nor DM2 complications, despite a slightly higher rate of depression diagnosis among those with DM2.
authors.affiliation: Research Department, Southcentral Foundation, Anchorage, Alaska 99508, USA. ddillard@scf.cc
authors.forename: Denise A
authors.initials: DA
authors.lastname: Dillard
authors.forename: Renee F
authors.initials: RF
authors.lastname: Robinson
authors.forename: Julia J
authors.initials: JJ
authors.lastname: Smith
authors.forename: Burhan A
authors.initials: BA
authors.lastname: Khan
authors.forename: Edward W
authors.initials: EW
authors.lastname: Dubois
authors.forename: Marjorie K
authors.initials: MK
authors.lastname: Mau
mesh_terms: D000293:Adolescent; D000328:Adult; D000413:Alaska; D003863:Depression / Q000453:epidemiology / Q000208:ethnology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology / Q000208:ethnology*; D005260:Female; D006801:Humans; D007198:Indians, North American; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D055815:Young Adult