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The association between diabetes and an episode of depressive symptoms in the 2002 World Health Survey: an analysis of 231,797 individuals from 47 countries.
Diabet Med 2013; 30(6):e208-14DM

Abstract

AIMS

Depression is common in people with diabetes and increases the risk of poor health outcomes, including premature mortality. We explored the association between diabetes and an episode of depressive symptoms in a cross-sectional multinational study, which included a large number of low- and middle-income non-Western countries.

METHODS

Data from 47 countries of the 2002 World Health Organization World Health Survey were used, including 231,797 adults (mean age 41 years, 53% female). Diabetes was assessed by self-report of diagnosis or treatment. The presence of an episode of depressive symptoms was assessed by self-report using an algorithm based on DSM-IV criteria. Odds ratios and 95% confidence intervals were calculated to quantify associations between diabetes and episodes of depressive symptoms in the entire sample and for countries aggregated into four continents: Africa, South America, Asia and Europe. Odds ratios were adjusted for age, sex, education, BMI, smoking and physical activity level.

RESULTS

The prevalence of diabetes (mean 3.6%, range 0.2-13%) and episodes of depressive symptoms (mean 7.9%, range 0.4-38%) differed widely across countries. Globally, individuals with diabetes had increased odds of an episode of depressive symptoms compared with those without diabetes (adjusted odds ratio 2.36, 95% confidence interval 1.91-2.92). Similar associations were found in South America, Asia and Europe (odds ratio > 1.97), but not in Africa (odds ratio 0.86, 95% confidence interval 0.54-1.37).

CONCLUSIONS

Globally, diabetes is associated with a twofold increased prevalence of an episode of depressive symptoms, except in Africa. Given the worldwide rise in diabetes in the coming decades, and the increased risk of poor diabetes outcomes associated with co-morbid depression, studies examining mechanisms and interventions are necessary.

Authors+Show Affiliations

CoRPS, Center of Research on Psychology in Somatic diseases, Tilburg University, Tilburg, the Netherlands. P.M.C.Mommersteeg@tilburguniversity.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

23614792

Citation

Mommersteeg, P M C., et al. "The Association Between Diabetes and an Episode of Depressive Symptoms in the 2002 World Health Survey: an Analysis of 231,797 Individuals From 47 Countries." Diabetic Medicine : a Journal of the British Diabetic Association, vol. 30, no. 6, 2013, pp. e208-14.
Mommersteeg PM, Herr R, Pouwer F, et al. The association between diabetes and an episode of depressive symptoms in the 2002 World Health Survey: an analysis of 231,797 individuals from 47 countries. Diabet Med. 2013;30(6):e208-14.
Mommersteeg, P. M., Herr, R., Pouwer, F., Holt, R. I., & Loerbroks, A. (2013). The association between diabetes and an episode of depressive symptoms in the 2002 World Health Survey: an analysis of 231,797 individuals from 47 countries. Diabetic Medicine : a Journal of the British Diabetic Association, 30(6), pp. e208-14. doi:10.1111/dme.12193.
Mommersteeg PM, et al. The Association Between Diabetes and an Episode of Depressive Symptoms in the 2002 World Health Survey: an Analysis of 231,797 Individuals From 47 Countries. Diabet Med. 2013;30(6):e208-14. PubMed PMID: 23614792.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The association between diabetes and an episode of depressive symptoms in the 2002 World Health Survey: an analysis of 231,797 individuals from 47 countries. AU - Mommersteeg,P M C, AU - Herr,R, AU - Pouwer,F, AU - Holt,R I G, AU - Loerbroks,A, Y1 - 2013/04/25/ PY - 2013/03/14/accepted PY - 2013/4/26/entrez PY - 2013/4/26/pubmed PY - 2013/11/5/medline SP - e208 EP - 14 JF - Diabetic medicine : a journal of the British Diabetic Association JO - Diabet. Med. VL - 30 IS - 6 N2 - AIMS: Depression is common in people with diabetes and increases the risk of poor health outcomes, including premature mortality. We explored the association between diabetes and an episode of depressive symptoms in a cross-sectional multinational study, which included a large number of low- and middle-income non-Western countries. METHODS: Data from 47 countries of the 2002 World Health Organization World Health Survey were used, including 231,797 adults (mean age 41 years, 53% female). Diabetes was assessed by self-report of diagnosis or treatment. The presence of an episode of depressive symptoms was assessed by self-report using an algorithm based on DSM-IV criteria. Odds ratios and 95% confidence intervals were calculated to quantify associations between diabetes and episodes of depressive symptoms in the entire sample and for countries aggregated into four continents: Africa, South America, Asia and Europe. Odds ratios were adjusted for age, sex, education, BMI, smoking and physical activity level. RESULTS: The prevalence of diabetes (mean 3.6%, range 0.2-13%) and episodes of depressive symptoms (mean 7.9%, range 0.4-38%) differed widely across countries. Globally, individuals with diabetes had increased odds of an episode of depressive symptoms compared with those without diabetes (adjusted odds ratio 2.36, 95% confidence interval 1.91-2.92). Similar associations were found in South America, Asia and Europe (odds ratio > 1.97), but not in Africa (odds ratio 0.86, 95% confidence interval 0.54-1.37). CONCLUSIONS: Globally, diabetes is associated with a twofold increased prevalence of an episode of depressive symptoms, except in Africa. Given the worldwide rise in diabetes in the coming decades, and the increased risk of poor diabetes outcomes associated with co-morbid depression, studies examining mechanisms and interventions are necessary. SN - 1464-5491 UR - https://www.unboundmedicine.com/medline/citation/23614792/The_association_between_diabetes_and_an_episode_of_depressive_symptoms_in_the_2002_World_Health_Survey:_an_analysis_of_231797_individuals_from_47_countries_ L2 - https://doi.org/10.1111/dme.12193 DB - PRIME DP - Unbound Medicine ER -