title: Diabetes and psychiatric illness in the total population of Stockholm.
abstract: OBJECTIVE
  Concomitant psychiatric disorders in people with diabetes affect morbidity and mortality. We aimed to study psychiatric morbidity in people with diabetes and the general population using administrative health care data in Stockholm County.
  
  
  METHODS
  The study population included all living persons who resided in Stockholm County, Sweden, on January 1, 2011 (N=2,058,408). Subjects with a diagnosis of diabetes were identified with data from all consultations in primary health care, specialist outpatient care and inpatient care during the time span 2009-2013. As outcome, information was obtained on all consultations due to any psychiatric diagnosis as well as, specifically, schizophrenia, bipolar disorders, depression, and anxiety disorders, in 2011-2013. Analyses were performed by age group and gender. Age-adjusted odds ratios (ORs) with 95% confidence intervals (95% CI) for women and men with diabetes, using individuals without diabetes as referents, were calculated.
  
  
  RESULTS
  Age-adjusted OR for all psychiatric diagnoses among people with diabetes was 1.296 (95% CI 1.267-1.326) for women and 1.399 (95% CI 1.368-1.432) for men. The greatest excess risk was found for schizophrenia, with OR 3.439 (95% CI 3.057-3.868) in women and 2.787 (95% CI 2.514-3.089) in men, with ORs between 1.276 (95% CI 1.227-1.327) and 1.714 (95% CI 1.540-1.905) for the remaining diagnoses.
  
  
  CONCLUSIONS
  The prevalence of psychiatric disorders is elevated in people with diabetes, which calls for preventive action to be taken to minimize suffering and costs to society.
authors.affiliation: Centre for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden. Electronic address: per.wandell@ki.se.
authors.forename: Per
authors.initials: P
authors.lastname: Wändell
authors.affiliation: Public Healthcare Services Committee Administration, Stockholm County Council, Box 6909, SE-102 39 Stockholm, Sweden; Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Berzelius väg 3, SE-17177 Stockholm, Sweden.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Ljunggren
authors.affiliation: Centre for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Wahlström
authors.affiliation: Centre for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden; Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden.
authors.forename: Axel C
authors.initials: AC
authors.lastname: Carlsson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology; D001008:Anxiety Disorders / Q000453:epidemiology; D001714:Bipolar Disorder / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007297:Inpatients / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000209:etiology; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012559:Schizophrenia / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology
keywords: Administrative databases; Age differences; Anxiety; Depression; Epidemiology; Gender differences; Primary care; Psychosis; Schizophrenia