Depression Increases Mortality Risk in Diabetics

The results of a new study confirm that individuals with diabetes are prone to depression and show that over a 10-year period depressive symptoms significantly increase the risk of death among persons with diabetes but not among persons without diabetes. Dr. Xuanping Zhang from the US Centers for Disease Control and Prevention in Atlanta, stated that, "Our analysis indicates that the relationship between depression and mortality is different in people with and without diabetes mellitus." "Depression should be considered a target for diabetes management interventions," the researcher added.

Dr. Zhang and colleagues examined the relation between depressive symptoms and mortality among 558 diabetic and 7063 nondiabetic participants in the NHANES I Epidemiologic Follow-up Study (1982-1992). A total of 276 diabetics and 1499 nondiabetics died during the study.

The prevalence of Centers for Epidemiologic Studies Depression (CES-D) scores greater than or equal to 16, an indicator of depression, was higher in the diabetic than in the nondiabetic cohort (26.3% vs 15.8%).

In analyses controlling for sociodemographic, lifestyle, and health-status variables, diabetics with CES-D scores of 16 or higher had a 54% greater mortality than those with CES-D scores under 16, the team reports in the April 1st issue of the American Journal of Epidemiology.

There was no significant association between depression and mortality in the nondiabetic population.

This study, Dr. Zhang said, "helps to clarify the contradictory findings on the association between depression and mortality among general populations by demonstrating the importance of observing subgroups, rather than aggregated populations, when examining the effect of depression on mortality."
Am J Epidemiol 2005;161:652-660.

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