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Diabetes associated with decreased severe depression at time of depression diagnosis

Kurt B Angstman, Allen L Pimienta, Meghan G Theofiles


Background: The combined impact of diabetes mellitus and major depressive disorder (MDD) is well defined with significant evidence for a bi-directional relationship.  Prior studies at our institution have demonstrated that the diagnoses of diabetes or the baseline control of diabetes did not independently predict clinical outcomes of depression at 6 months.  Our hypothesis for this study was that the diagnosis of diabetes in depressed primary care patients would have no effect on incidence of severe depression at the time of diagnosis of depression.

Methods: This study was a retrospective chart review analysis of patients who were diagnosed with either MDD or Dysthymia and had a score of ≥ 10 on PHQ-9 at the time of clinical diagnosis.  From 1 January 2008 through 30 September 2012, a cohort of 4,311 patients who authorized research of their medical records and had complete data sets available was then developed. 

Results: With logistic regression modeling, the diagnosis of diabetes was inversely related with the odds of diagnosis of severe depression (PHQ-9 ≥ 20) at index with an odds ratio of 0.649 (95% CI 0.486-0.868, p=0.004).  Obesity was not associated independently with the initial diagnosis of severe depression (p=0.471).

Conclusions: The diagnosis of diabetes was associated with decreased risk for severe depression at the time of diagnosis in our patient population.  Further studies would be beneficial to explore potential reasons for this, with implications for the development of person-centered approaches to care.


Clinical outcomes, collaborative care model, depression, diabetes mellitus, diagnosis, healthcare costs, lifestyle modification, obesity, person-centered healthcare, primary care providers, self-care, severity of depression

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