Depressive states among adults with diabetes: Findings from the National Health and Nutrition Examination Survey, 2007-2012.
OBJECTIVE
To determine (1) the prevalence of SubD states among adults with diabetes, and (2) whether evidence exists of an independent association between diabetes status and SubD, controlling for selected confounders.


METHODS
Data from the 2007-2012 National Health and Nutrition Examination Surveys were combined to estimates of depressive states by diabetes status among the noninstitutionalized U.S. adult population, and to assess the association of diabetes status and depressive states using a polytomous logistic regression model.


RESULTS
An estimated 17%, or 3.7 million, of U.S. adults with diabetes (diagnosed and undiagnosed) met criteria for either mD or ssD. The majority of SubD cases with diabetes were found to be ssD (10.1%) compared with mD (6.9%). After controlling for the effects of age, sex, race and ethnicity, education, body mass index, and poverty as covariates, an independent association persists between diagnosed diabetes and each SubD grouping (ssD: OR=1.82, CIs 1.33, 2.47; mD: OR=1.95, CIs 1.39, 2.74) compared with respondents having no diabetes. No association was found between depression and undiagnosed diabetes or prediabetes compared with those having no diabetes.


CONCLUSIONS
Milder forms of depression such as ssD and mD are more extant than major depressive episodes among adults with diabetes. The odds that an adult with diagnosed diabetes meets the criteria for ssD or mD are higher by 80% and 95%, respectively, after controlling for age, sex, race and ethnicity, education, body mass index, and poverty factors when compared against adults with no diabetes.
National Center for Health Statistics, 3311 Toledo Rd., Hyattsville, MD 20782, United States. Electronic address: jna8@cdc.gov.
Juan Rafael
JR
Albertorio-Diaz
National Center for Health Statistics, 3311 Toledo Rd., Hyattsville, MD 20782, United States. Electronic address: wdq7@cdc.gov.
Mark S
MS
Eberhardt
Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 200, Philadelphia, PA 19104-3309, United States. Electronic address: moquendo@mail.med.upenn.edu.
Maria
M
Oquendo
Department of Statistical Science, University of Idaho, 875 Perimeter Drive, MS 1104, Moscow, ID 83844-1104, United States. Electronic address: marco@uidaho.edu.
Marco
M
Mesa-Frias
National Center for Health Statistics, 3311 Toledo Rd., Hyattsville, MD 20782, United States. Electronic address: wdq7@cdc.gov.
Yulei
Y
He
8613 Undermire Ct., Bowie, MD 20720, United States. Electronic address: bjonas8613@gmail.com.
Bruce
B
Jonas
National Center for Health Statistics, 3311 Toledo Rd., Hyattsville, MD 20782, United States. Electronic address: vrr0@cdc.gov.
Kai
K
Kang
D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000209:etiology*; D003920:Diabetes Mellitus / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D014481:United States; D055815:Young Adult
Adults; Diabetes; Minor depression; NHANES; Subsyndromal depression; Subthreshold depression