title: Associations between diabetes, major depressive disorder and generalized anxiety disorder comorbidity, and disability: findings from the 2012 Canadian Community Health Survey--Mental Health (CCHS-MH).
abstract: OBJECTIVE
  To examine the associations between diabetes, disability, and the likelihood of comorbid major depressive disorder (MDD) and generalized anxiety disorder (GAD).
  
  
  METHODS
  Data were obtained from the 2012 Canadian Community Health Survey - Mental Health (N=17 623). Diabetes assessment consisted of a self-reported diagnosis of diabetes made by a health care professional. Disability was assessed via self-report. 12-Month and lifetime MDD and GAD were assessed with the Composite International Diagnostic Interview 3.0.
  
  
  RESULTS
  In multinomial logistic regression models adjusted for sociodemographic and health-related factors, having diabetes was associated with a greater likelihood of 12-month comorbid MDD and GAD (OR=1.99, 95% CI [1.22, 3.25], p=.006), compared with those with neither MDD nor GAD. No significant associations were found for MDD without GAD or GAD without MDD. This pattern of effects held when lifetime diagnoses of MDD and GAD were considered. For individuals with diabetes (n=1730), adjusted binary logistic regression models demonstrated that with 12-month diagnoses, MDD without GAD (OR=2.79, 95% CI [1.39-5.62], p=.004), GAD without MDD (OR=3.69, 95% CI [1.34-10.11], p=.01), and comorbid MDD and GAD (OR=4.17, 95% CI [1.66-10.51], p=.002) were associated with greater disability than the control group. Only comorbid MDD and GAD were associated with disability when lifetime diagnoses of MDD and GAD were considered.
  
  
  CONCLUSIONS
  Individuals with diabetes may be particularly vulnerable to comorbid MDD and GAD, and MDD-GAD comorbidity may exacerbate disability in persons with diabetes.
authors.affiliation: Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada.
authors.forename: Sonya S
authors.initials: SS
authors.lastname: Deschênes
authors.affiliation: Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada.
authors.forename: Rachel J
authors.initials: RJ
authors.lastname: Burns
authors.affiliation: Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada; Department of Epidemiology and Biostatistics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
authors.forename: Norbert
authors.initials: N
authors.lastname: Schmitz
mesh_terms: D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000150:complications / Q000453:epidemiology* / Q000209:etiology; D002170:Canada / Q000453:epidemiology; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000150:complications / Q000453:epidemiology* / Q000209:etiology; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000523:psychology*; D006233:Persons with Disabilities / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D006306:Health Surveys; D006801:Humans; D057187:Independent Living; D016015:Logistic Models; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D012959:Socioeconomic Factors
keywords: 2012 Canadian Community Health Survey; Comorbidity; Diabetes; Disability; Generalized anxiety disorder; Major depressive disorder