title: Prevalence of depression and its associations with cardio-metabolic control in Aboriginal and Anglo-Celt patients with type 2 diabetes: the Fremantle Diabetes Study Phase II.
abstract: OBJECTIVE
  To determine the prevalence and associates of depression in Aboriginal and Anglo-Celt (AC) Australians with type 2 diabetes.
  
  
  METHODS
  Community-based patients were screened using the Patient Health Questionnaire (PHQ-9) as part of detailed assessment. The prevalence of any current depression, major depression and antidepressant use by racial group was compared after adjustment for age, sex, educational attainment and marital status. Multiple logistic regression was used to determine associates of current depression.
  
  
  RESULTS
  The 107 Aboriginal participants were younger (mean±SD 54.3±11.8 vs. 67.2±10.6 years), less often male (34.6% vs. 50.9%) and married (39.3% vs. 61.7%), and more likely to smoke (44.6% vs. 8.1%) than the 793 AC subjects (P≤0.002). Fifty-two Aboriginal (48.5%) and 772 AC participants (97.4%) completed the PHQ-9; these Aboriginals had similar socio-demographic, anthropometric and diabetes-related characteristics to those without PHQ-9 data. A quarter of the Aboriginals had current depression vs 10.6% of ACs (P=0.16), 15.4% vs. 4.1% had major depression (P=0.029), and 68.8% vs. 29.7% had untreated depression (P=0.032). Compared with non-depressed participants, patients with current depression were younger and more likely to smoke, to be overweight/obese and to have worse glycaemic control (P≤0.024). Significant independent associates of current depression were educational attainment (inversely), smoking status, body mass index and fasting plasma glucose in the AC group and alcohol use in the Aboriginal group.
  
  
  CONCLUSIONS
  Although prevalence of depression was not significantly increased in the Aboriginal patients, it was more likely to be major and untreated. Depression complicating type 2 diabetes is associated with adverse cardiovascular risk.
authors: University of Western Australia, School of Medicine & Pharmacology, Fremantle Hospital, Fremantle, Western Australia, Australia. Electronic address: tim.davis@uwa.edu.au.
authors: Timothy M E
authors: TM
authors: Davis
authors: University of Western Australia, School of Medicine & Pharmacology, Fremantle Hospital, Fremantle, Western Australia, Australia.
authors: Kerry
authors: K
authors: Hunt
authors: University of Western Australia, School of Medicine & Pharmacology, Fremantle Hospital, Fremantle, Western Australia, Australia.
authors: David G
authors: DG
authors: Bruce
authors: University of Western Australia, School of Psychiatry and Clinical Neurosciences, Fremantle Hospital, Fremantle, Western Australia, Australia.
authors: Sergio
authors: S
authors: Starkstein
authors: Charles Darwin University, School of Psychological and Clinical Sciences, Casuarina, Northern Territory, Australia.
authors: Timothy
authors: T
authors: Skinner
authors: Edith Cowan University, Kurongkurl Katitjin Centre for Indigenous Australian Education and Research, Mt Lawley, Western Australia, Australia; Australian National University, Australian Primary Health Care Research Institute, Canberra, Australian Capital Territory, Australia.
authors: Daniel
authors: D
authors: McAullay
authors: University of Western Australia, School of Medicine & Pharmacology, Fremantle Hospital, Fremantle, Western Australia, Australia.
authors: Wendy A
authors: WA
authors: Davis
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D001786:Blood Glucose / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology; D003863:Depression / Q000150:complications / Q000453:epidemiology*; D003865:Major Depressive Disorder / Q000150:complications / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000453:epidemiology* / Q000378:metabolism*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D044465:White People / Q000706:statistics & numerical data
chemical_list: D001786:Blood Glucose
keywords: Aboriginal; Antidepressant treatment; Depression; Metabolic control; Type 2 diabetes