Co-occurrence of diabetes and depression in the U.S

PLoS One. 2020 Jun 25;15(6):e0234718. doi: 10.1371/journal.pone.0234718. eCollection 2020.

Abstract

Evidence exists that depression interacts with physical illness to amplify the impact of chronic conditions like diabetes. The co-occurrence of these two conditions leads to worse health outcomes and higher healthcare costs. This study seeks to understand what demographic and socio-economic indicators can be used to predict co-occurrence at both the state and the individual level. Diabetes and depression are modeled as a bivariate normal distribution using data from the Behavioral Risk Factor Surveillance System 2016-2017 cohorts. The tetrachoric (latent) correlation between diabetes and depression is 17.2% and statistically significant, however the likelihood of any person being diagnosed with both conditions is small-as high as 4.3% (Arizona) and as low as 2.3% (Utah). We find that demographic characteristics (sex, age, and race) operate in opposite directions in predicting diabetes and depression diagnosis. Behavioral indicators (BMI≥30, smoking, and exercise); and life outcomes, (schooling attainment, marital and veteran status) work in the same direction to produce co-occurrence and as such are more powerful predictors of co-occurrence than demographic characteristics. It is important to have a rapid and efficient instrument to diagnoses co-occurrence. Simple questions about lifestyle choices, educational attainment and family life could help bridge the gap between primary care and psychological services with beneficial spillovers for patient-doctor communication.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Depression / epidemiology*
  • Diabetes Mellitus / epidemiology*
  • Diabetes Mellitus / psychology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Policy
  • United States / epidemiology
  • Young Adult