The association of comorbid depression with mortality in patients with type 2 diabetes
The association of comorbid depression with mortality in patients with type 2 diabetes
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DOI：
10.2337/diacare.28.11.2668
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发表时间：
2005-11-01
期刊：
影响因子：
16.2
通讯作者：
Von Korff, M
中科院分区：
文献类型：
--
作者：
Katon, WJ;Rutter, C;Von Korff, M
目的-我们评估是否合并轻度和重度抑郁症和2型糖尿病的患者有更高的死亡率超过3年的时间相比，糖尿病患者单独.研究设计和方法-在一个大型的健康维护组织（HMO），4,154例2型糖尿病患者进行了调查，并随访长达3年。患者最初填写了一份书面问卷，收集了HMO自动诊断、实验室和药房数据以及华盛顿州死亡率数据，以评估糖尿病并发症和死亡。考克斯比例风险回归模型被用来计算调整后的危险比死亡为每组与参考group.RESULTS -有275（8.3%）死亡3,303例无抑郁症相比，48（13.6%）死亡354例轻度抑郁症和59（11.9%）死亡497例重度抑郁症患者。调整年龄、性别、种族和教育程度的比例风险模型发现，与非抑郁组相比，轻度抑郁与死亡率增加1.67倍相关（P = 0.003），重度抑郁与死亡率增加2.30倍相关（P < 0.0001）。在第二个模型中，控制了多种潜在的介质，轻微和严重的抑郁症仍然是显着的预测mortality.CONCLUSIONS -在糖尿病患者中，轻微和严重的抑郁症与死亡率增加密切相关。进一步的研究将是必要的，以解开抑郁症之间的因果关系，行为风险因素（坚持医疗方案），糖尿病并发症，死亡率。
OBJECTIVE - We assessed whether patients with comorbid minor and major depression and type 2 diabetes had a higher mortality rate over a 3-year period compared with patients with diabetes alone.RESEARCH DESIGN AND METHODS - in a large health maintenance organization (HMO), 4,154 patients with type 2 diabetes were surveyed and followed for up to 3 years. Patients initially filled out a written questionnaire, and HMO-automated diagnostic, laboratory, and pharmacy data and Washington State mortality data were collected to assess diabetes complications and deaths. Cox proportional hazards regression models were used to calculate adjusted hazard ratios of death for each group compared with the reference group.RESULTS - There were 275 (8.3%) deaths in 3,303 patients without depression compared with 48 (13.6%) deaths in 354 patients with minor depression and 59 (11.9%) deaths among 497 patients with major depression. A proportional hazards model with adjustment for age, sex, race/ethnicity, and educational attainment found that compared with the nondepressed group, minor depression was associated with a 1.67-fold increase in mortality (P = 0.003), and major depression was associated with a 2.30-fold increase (P < 0.0001). In a second model that controlled for multiple potential mediators, both minor and major depression remained significant predictors of mortality.CONCLUSIONS - Among patients with diabetes, both minor and major depression are strongly associated with increased mortality. Further research will be necessary to disentangle causal relationships among depression, behavioral risk factors (adherence to medical regimens), diabetes complications, and mortality.