title: RISK OF NEW ONSET TYPE II DM IN MDD PATIENTS RECEIVING SECOND-GENERATION ANTIPSYCHOTICS TREATMENT: A NATIONWIDE COHORT STUDY.
abstract: Second-generation antipsychotics (SGA) augmentation treatment has showed better efficacy in patients with major depressive disorder (MDD). However, the association between SGA and diabetes mellitus (DM) in MDD patients deserves further investigation. The study aimed to examine the risk of new onset type II DM in MDD patients receiving SGA treatment.
  
  
  
  From the Psychiatric Inpatient Medical Claim Dataset, MDD patients treated with SGA continuously for more than 8 weeks were analyzed in a 1:1 propensity score matched pair sample to 1,049 patients that had never been treated with SGA. Patients were followed up to 5 years based on ICD-9 CM codes indicating incident type II DM. Cumulative incidences of type II DM were calculated and the Cox proportional hazards model with competing risk was applied to determine the risk factors for type II DM onset.
  
  
  
  Cumulative incidences of new-onset type II DM between the two groups were similar. Use of SGA showed no significant increase in risk for new-onset type II DM (hazard ratio [HR] = 0.898; 95% confidence interval [CI], 0.605-1.334; P-value = 0.596). Increased risk for type II DM was shown to be associated with aging (per year) (HR = 1.039; 95% CI, 1.026-1.053; P-value < 0.001) and history of hyperlipidemia (HR = 2.323; 95% CI, 1.469-3.675; P-value < 0.001).
  
  
  
  This study indicated that there is no significant difference in the risk of developing type II DM between MDD patients with and without SGA exposure. More studies focused on the benefit-risk assessment of SGA treatment in patients with MDD are warranted.
authors.affiliation: School of Medicine, Chung Shan Medical University, Taichung, Taiwan.|Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan.|National Changhua University of Education, Changhua, Taiwan.
authors.forename: Chun-Yuan
authors.initials: CY
authors.lastname: Lin
authors.affiliation: National Changhua University of Education, Changhua, Taiwan.|Feng Yuan Hospital, Ministry of Health and Welfare, Taichung, Taiwan.
authors.forename: Yu-Hsin
authors.initials: YH
authors.lastname: Wu
authors.affiliation: Department of psychiatry, Changhua Hospital, Ministry of Health and Welfare, Chanhua, Taiwan.
authors.forename: Hong-Song
authors.initials: HS
authors.lastname: Wang
authors.affiliation: Department of Neurology, Lin-Shin Hospital, Taichung, Taiwan.|School of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Ping-Kun
authors.initials: PK
authors.lastname: Chen
authors.affiliation: College of Management, National Taiwan University, Taipei, Taiwan.
authors.forename: Yuan-Fu
authors.initials: YF
authors.lastname: Lin
authors.affiliation: Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan.|Department of Public Health and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
authors.forename: I-Chia
authors.initials: IC
authors.lastname: Chien
mesh_terms: D000328:Adult; D000367:Age Factors; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
chemical_list: D014150:Antipsychotic Agents
keywords: depression; diabetes mellitus (DM); major depressive disorder (MDD); pharmacoepidemiology; pharmacotherapy; second-generation antipsychotic (SGA); treatment; treatment resistance