Depression and Death in Diabetes; 10-Year Follow-Up of All-Cause and Cause-Specific Mortality in a Diabetic Cohort
Depression and Death in Diabetes; 10-Year Follow-Up of All-Cause and Cause-Specific Mortality in a Diabetic Cohort
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DOI：
10.1016/j.psym.2013.02.015
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发表时间：
2013-09-01
期刊：
影响因子：
3.4
通讯作者：
Von Korff, Michael
中科院分区：
文献类型：
--
作者：
Coleman, Shane M.;Katon, Wayne;Von Korff, Michael
背景：当抑郁症与 2 型糖尿病同时发生时，不良的双向相互作用会增加这两种疾病的负担。除了影响患者的健康、功能和生活质量之外，与单独患有抑郁症或糖尿病的患者相比，这种关系还导致死亡率增加。目的：本研究的目的是通过扩展我们 5 年死亡率研究的结果，探讨抑郁症与 2 型糖尿病患者全因和特定原因死亡率之间的关系。具体来说，我们重新检查了抑郁症和全因、心血管、癌症以及非心血管、非癌症相关死亡的风险。方法：我们使用ICD-10算法结合死亡证明数据对参加Pathways流行病学研究的2型糖尿病患者的死亡类型进行分类。 Cox 比例风险模型用于检查 10 年期间抑郁状态与死亡率之间的关系。结果：我们在该样本中发现抑郁症与全因死亡率以及非心血管、非癌症死亡率之间存在显着的正相关关系 (n = 4128)。在完全调整的模型中，心血管死亡率未能达到显着水平，并且与 5 年数据相比，在抑郁状态和癌症相关死亡之间没有观察到趋势或显着关系。结论：我们的研究证实 2 型糖尿病患者的抑郁症与死亡率之间存在显着的正相关关系。重度抑郁症比轻症抑郁症表现出更强的关系，并且在特定原因组中，非心血管、非癌症死亡类型与抑郁症状态的关联程度最大。
Background: When depression co-occurs with type 2 diabetes, adverse bidirectional interactions increase the burden of both illnesses. In addition to affecting patient's health, functioning, and quality of life, this relationship also results in increased mortality compared with those with depression or diabetes alone. Objective: The purpose of this study was to examine the relationship between depression and all-cause as well as cause-specific mortality in patients with type 2 diabetes by extending findings from our 5-year mortality study. Specifically, we re-examined the risk of depression and all-cause, cardiovascular, cancer, and non-cardiovascular, non-cancer related deaths. Method: We used an ICD-10 algorithm combined with death certificate data to classify mortality types among type 2 diabetic patients who participated in the Pathways Epidemiologic Study. Cox proportional hazard modeling was used to examine the relationships between depression status and mortality over a 10-year period. Results: We found a significant positive relationship between depression and all-cause as well as non-cardiovascular, non-cancer mortality in this sample (n = 4128). Cardiovascular mortality failed to reach significance in fully adjusted models and, in contrast to the 5-year data, no trend or significant relationship was observed between depression status and cancer related deaths. Conclusions: Our study confirmed a significant positive relationship between depression and mortality in patients with type 2 diabetes. Major depression demonstrated a stronger relationship than did minor depression, and among cause-specific groups, non-cardiovascular, non-cancer death types demonstrated the largest magnitude of association with depression status.