title: Depressive symptoms, psychiatric medication use, and risk of type 2 diabetes: results from the Health and Retirement Study.
abstract: OBJECTIVE
  This prospective study investigates the relationships between depressive symptoms, psychiatric medication use, and their interaction on risk of developing type 2 diabetes.
  
  
  METHODS
  Data come from the 1998-2010 waves of the Health and Retirement Study, a US nationally representative cohort of adults aged 51 years and older. Analysis is restricted to participants <65 years old who did not have diabetes in 1998 (N=8704). Depressive symptoms were assessed using the 8-item Center for Epidemiologic Studies-Depression Scale. Risk of diabetes over the 12-year follow-up period was assessed using Cox proportional hazard models with time-varying covariates.
  
  
  RESULTS
  After adjusting for covariates, both depressive symptoms [hazard ratio (HR): 1.06, 95% confidence interval (CI): 1.02-1.09] and psychiatric medication use (HR: 1.57, 95% CI: 1.25-1.96) were associated with development of diabetes. The interaction between depressive symptoms and medication use was significant (beta=-0.240, P=.049), indicating that the association between elevated depressive symptoms and diabetes was higher among respondents not taking medications. The associations between depressive symptoms and medication use were also attenuated by increasing body mass index.
  
  
  CONCLUSIONS
  Findings highlight the complex relationship between depressive symptoms and psychiatric medications on diabetes risk and the need for a nuanced understanding of these factors.
authors.affiliation: Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University School of Medicine, 830 East Main Street, Richmond, VA 23298, USA. Electronic address: smratliff@vcu.edu.
authors.forename: Scott
authors.initials: S
authors.lastname: Ratliff
authors.affiliation: Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University School of Medicine, 830 East Main Street, Richmond, VA 23298, USA; Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, 800 East Leigh Street, Richmond, VA 23219, USA; Research Center for Group Dynamics, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI 48106, USA. Electronic address: bmezuk@vcu.edu.
authors.forename: Briana
authors.initials: B
authors.lastname: Mezuk
mesh_terms: D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015331:Cohort Studies; D003863:Depression / Q000150:complications* / Q000188:drug therapy; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D011795:Surveys and Questionnaires
chemical_list: D000928:Antidepressive Agents
keywords: Antidepressants; Depression; Epidemiology; Longitudinal; Type 2 diabetes