title: Depression among people with type 2 diabetes mellitus, US National Health and Nutrition Examination Survey (NHANES), 2005-2012.
abstract: BACKGROUND
  Depression in people with diabetes can result in increased risk for diabetes-related complications. The prevalence of depression has been estimated to be 17.6 % in people with type 2 diabetes mellitus (T2DM), based on studies published between 1980 and 2005. There is a lack of more recent estimates of depression prevalence among the US general T2DM population.
  
  
  METHODS
  The present study used the US National Health and Nutrition Examination Survey (NHANES) 2005-2012 data to provide an updated, population-based estimate for the prevalence of depression in people with T2DM. NHANES is a cross-sectional survey of a nationally representative sample of the civilian, non-institutionalized US population. Starting from 2005, the Patient Health Questionnaire (PHQ-9) was included to measure signs and symptoms of depression. We defined PHQ-9 total scores ≥ 10 as clinically relevant depression (CRD), and ≥ 15 as clinically significant depression (CSD). Self-reported current antidepressant use was also combined to estimate overall burden of depression. Predictors of CRD and CSD were investigated using survey logistic regression models.
  
  
  RESULTS
  A total of 2182 participants with T2DM were identified. The overall prevalence of CRD and CSD among people with T2DM is 10.6 % (95 % confidence interval (CI) 8.9-12.2 %), and 4.2 % (95 % CI 3.4-5.1 %), respectively. The combined burden of depressive symptoms and antidepressants may be as high as 25.4 % (95 % CI 23.0-27.9 %). Significant predictors of CRD include age (younger than 65), sex (women), income (lower than 130 % of poverty level), education (below college), smoking (current or former smoker), body mass index (≥30 kg/m(2)), sleep problems, hospitalization in the past year, and total cholesterol (≥200 mg/dl). Significant predictors of CSD also include physical activity (below guideline) and cardiovascular diseases.
  
  
  CONCLUSIONS
  The prevalence of CRD and CSD among people with T2DM in the US may be lower than in earlier studies, however, the burden of depression remains high. Further research with longitudinal follow-up for depression in people with T2DM is needed to understand real world effectiveness of depression management.
authors.affiliation: Janssen Research & Development, LLC, 1125 Trenton Harbourton Road, Titusville, NJ, 08560, USA. ywang28@its.jnj.com.
authors.forename: Yiting
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Janssen Scientific Affairs, LLC, Raritan, 1000 US Route 202, Raritan, NJ, 08869, USA.
authors.forename: Janice M S
authors.initials: JM
authors.lastname: Lopez
authors.affiliation: Janssen Scientific Affairs, LLC, Raritan, 1000 US Route 202, Raritan, NJ, 08869, USA.
authors.forename: Susan C
authors.initials: SC
authors.lastname: Bolge
authors.affiliation: Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street Suite 303, Charleston, SC, 29425, USA.
authors.forename: Vivienne J
authors.initials: VJ
authors.lastname: Zhu
authors.affiliation: Janssen Research & Development, LLC, 1125 Trenton Harbourton Road, Titusville, NJ, 08560, USA.
authors.forename: Paul E
authors.initials: PE
authors.lastname: Stang
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006306:Health Surveys / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D014481:United States / Q000453:epidemiology
keywords: Depression; Patient Health Questionnaire (PHQ-9); Type 2 diabetes mellitus (T2DM)