Diabetes and co-morbid depression among racially diverse, low-income adults

Ann Behav Med. 2011 Jun;41(3):300-9. doi: 10.1007/s12160-010-9241-1.


Background: Research suggests individuals with diabetes are twice as likely as those without diabetes to be clinically depressed. Still unknown is the relationship between diabetes and depression in socioeconomically disadvantaged populations.

Purpose: We examined the relationship between diabetes and depressive symptoms in a large, racially diverse, low-income cohort in the southeastern USA.

Methods: A total of 69,068 adults were recruited from community health centers in 12 southeastern states. A fully adjusted polytomous logistic regression model tested the relationship between demographics, lifestyle behaviors, antidepressant use, body mass index, diabetes diagnosis, diabetes duration, diabetes medication compliance, and depressive symptoms using the Centers for Epidemiological Studies Depression scale.

Results: Diabetes was present in 21.7% of sample. While a diabetes diagnosis was associated with having severe depressive symptoms (AOR, 1.24; 95% CI, 1.14-1.34), demographics, lifestyle behaviors, body mass index and antidepressant use were more strongly associated with severe depressive symptoms than a diabetes diagnosis.

Conclusions: Having diabetes was associated with the presence and severity of depressive symptoms in a large, low-income sample of racially diverse adults. However, the relationship between diabetes and depressive symptoms was weaker than in other studies with higher socioeconomic groups.

MeSH terms

  • Aged
  • Antidepressive Agents / therapeutic use
  • Body Mass Index
  • Cohort Studies
  • Depression / complications
  • Depression / diagnosis
  • Depression / drug therapy
  • Depression / psychology*
  • Diabetes Complications / psychology*
  • Diabetes Mellitus / diagnosis
  • Diabetes Mellitus / drug therapy
  • Diabetes Mellitus / psychology*
  • Female
  • Humans
  • Life Style
  • Male
  • Medication Adherence / psychology
  • Middle Aged
  • Poverty / psychology*
  • Psychiatric Status Rating Scales
  • Racial Groups / psychology*
  • Severity of Illness Index


  • Antidepressive Agents