Depression and diabetes: factors associated with major depression at five-year follow-up

Psychosomatics. 2009 Nov-Dec;50(6):570-9. doi: 10.1176/appi.psy.50.6.570.


Background: In patients with diabetes, comorbid depression has been shown to be associated with increased medical symptom burden, additional functional impairment, poor self-care, increased risk of macrovascular and microvascular complications, higher medical costs, and greater mortality.

Objective: The authors performed a longitudinal observation to assess the pathway between diabetes complications and subsequent depression.

Method: In a prospective study of primary-care patients with diabetes (N=2,759), the authors determined, from automated data and chart review, whether macrovascular or microvascular events or coronary, cerebrovascular, or peripheral vascular procedures during follow-up were associated with meeting criteria for major depression at 5-year follow-up.

Results: After controlling for baseline severity of depression symptoms and history of depression, having one-or-more coronary procedures during follow-up, and baseline severity of diabetes symptoms were strong predictors of having major depression at 5-year follow-up.

Conclusion: The risk of major depression among persons with diabetes is increased by previous depression history, baseline diabetes symptoms, and having had cardiovascular procedures.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Cardiovascular Surgical Procedures / psychology
  • Cardiovascular Surgical Procedures / statistics & numerical data
  • Cohort Studies
  • Comorbidity
  • Depressive Disorder, Major / diagnosis
  • Depressive Disorder, Major / epidemiology*
  • Depressive Disorder, Major / psychology
  • Diabetes Complications / epidemiology
  • Diabetes Complications / psychology
  • Diabetes Mellitus / epidemiology*
  • Diabetes Mellitus / psychology
  • Female
  • Follow-Up Studies
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prospective Studies
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Risk Factors
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Washington / epidemiology