title: Association between number of comorbid medical conditions and depression among individuals with diabetes; race and ethnic variations.
abstract: BACKGROUND
  Medical and psychiatric comorbidities are commonly comorbid with diabetes. Race and ethnicity may, however, modify the link between medical and psychiatric comorbidities in individuals with diabetes. In this study we compared Non-Hispanic Whites, African Americans, and Caribbean Blacks with diabetes for the association between number of comorbid medical conditions and lifetime and 12-month major depressive disorder (MDD) in individuals with diabetes.
  
  
  METHODS
  Data came from the National Survey of American Life (NSAL), 2001-2003. We included 603 patients with diabetes (75 non-Hispanic Whites, 396 African Americans, and 131 Caribbean Blacks). Number of comorbid medical conditions was the independent variable, lifetime and 12-month MDD were dependent variables, and age, gender, education, marital status, employment, and body mass index were covariates. Race- and ethnic- specific logistic regressions were used to determine race and ethnic differences in the associations between number of chronic medical conditions and lifetime and 12-month MDD, while the effect of all covariates were controlled.
  
  
  RESULTS
  Number of chronic medical conditions was positively associated with lifetime MDD among non-Hispanic Whites (OR = 1.719, 95 % CI = 1.018 - 2.902) and African Americans (OR = 1.235, 95 % CI = 1.056- 1.445) but not Caribbean Blacks (P > .05). Number of chronic medical conditions was also associated with 12-month MDD among non-Hispanic Whites (OR = 1.757, 95 % CI = 1.119 - 2.759) and African Americans (OR = 1.381, 95 % CI = 1.175 - 1.623) but not Caribbean Blacks (P > .05).
  
  
  CONCLUSIONS
  This study shows race- and ethnic- differences in the association between number of medical comorbidities and MDD among patients with diabetes. These findings invite researchers to study the mechanisms behind race- and ethnic- differences in vulnerability and resilience to the mental health effects of chronic medical conditions.
authors.affiliation: Department of Psychiatry, School of Medicine, University of Michigan, 4250 Plymouth Rd., Ann Arbor, MI 48109-2700 USA ; Center for Research on Ethnicity, Culture, and Health (CRECH), School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109-2029 USA.
authors.forename: Maryam Moghani
authors.initials: MM
authors.lastname: Lankarani
authors.affiliation: Department of Psychiatry, School of Medicine, University of Michigan, 4250 Plymouth Rd., Ann Arbor, MI 48109-2700 USA ; Center for Research on Ethnicity, Culture, and Health (CRECH), School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109-2029 USA.
authors.forename: Shervin
authors.initials: S
authors.lastname: Assari