title: Stages of hyperglycemia and common mental disorders in adults - The Brazilian Study of Adult Health (ELSA-Brasil).
abstract: Diabetes mellitus and depressive disorders frequently coexist. However, this relationship has been little evaluated across stages of hyperglycemia and for a broad range of common mental disorders (CMDs). The objective here was to investigate the association between CMDs and stages of glycemia.
  Cross-sectional study conducted among civil servants aged 35-74 years participating in the ELSA-Brasil cohort.
  CMDs were classified using the Clinical Interview Schedule - Revised (CIS-R). Glycemia was classified in stages as normal, intermediate hyperglycemia, newly classified diabetes or previously known diabetes, based on oral glucose tolerance testing, glycated hemoglobin (HbA1c), self-reported diabetes and medication use. Blood glucose control was assessed according to HbA1c.
  CMDs were most prevalent in individuals with previously known diabetes. After adjustments, associations weakened considerably and remained significant only for those with a CIS-R score ≥ 12 (prevalence ratio, PR: 1.15; 95% confidence interval, CI: 1.03-1.29). Intermediate hyperglycemia did not show any association with CMDs. For individuals with previously known diabetes and newly classified diabetes, for every 1% increase in HbA1c, the prevalence of depressive disorders became, respectively, 12% and 23% greater (PR: 1.12; 95% CI: 1.00-1.26; and PR: 1.23; 95% CI: 1.04-1.44).
  Individuals with previously known diabetes had higher CIS-R scores. Among all individuals with diabetes, worse blood glucose control was correlated with depressive disorder. No relationship between intermediate hyperglycemia and CMDs was observed, thus suggesting that causal processes relating to CMDs, if present, must act more proximally to diabetes onset.
authors.affiliation: MSc. Postgraduate Program on Epidemiology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
authors.forename: Marina
authors.initials: M
authors.lastname: Bessel
authors.affiliation: PhD. Associate Professor, Department of Statistics and Postgraduate Program on Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
authors.forename: Álvaro
authors.initials: Á
authors.lastname: Vigo
authors.affiliation: MD, PhD. Postdoctoral Fellow, Postgraduate Program on Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
authors.forename: Andréa
authors.initials: A
authors.lastname: Poyastro
authors.affiliation: MD, PhD. Professor in the Postgraduate Program on Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
authors.forename: Maria Angélica
authors.initials: MA
authors.lastname: Nunes
authors.affiliation: MD, PhD. Professor, Department of Social Medicine and Postgraduate Program on Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
authors.forename: Bruce Bartholow
authors.initials: BB
authors.lastname: Duncan
authors.affiliation: MD, PhD. Professor, Department of Social Medicine and Postgraduate Program on Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
authors.forename: Maria Inês
authors.initials: MI
authors.lastname: Schmidt
mesh_terms: D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000097:blood* / Q000209:etiology* / Q000503:physiopathology; D001786:Blood Glucose / Q000032:analysis; D001938:Brazil; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000097:blood* / Q000209:etiology* / Q000503:physiopathology; D048909:Diabetes Complications / Q000503:physiopathology; D005260:Female; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin; D006801:Humans; D006943:Hyperglycemia / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin