Does Diabetes Double the Risk of Depression?
Does Diabetes Double the Risk of Depression?
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DOI：
10.1370/afm.964
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发表时间：
2009-07-01
影响因子：
4.4
通讯作者：
Kluznik, John C.
中科院分区：
文献类型：
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作者：
O'Connor, Patrick J.;Crain, A. Lauren;Kluznik, John C.
在这项研究中，我们比较了有和没有糖尿病的成年人的抑郁症诊断率，同时仔细控制了初级保健就诊的次数。（n = 2，932）或流行性糖尿病（n = 14，144）非糖尿病对照患者，基于（1）年龄和性别，或（2）年龄、性别和门诊初级保健访视次数。Logistic回归分析用于评估各糖尿病队列与匹配的非糖尿病对照组患者的抑郁症诊断之间的各种预测因素之间的关联。结果仅在年龄和性别匹配的情况下，患有流行性糖尿病且很少接受初级保健的患者比匹配的对照组患者更可能有新的抑郁症诊断（比值比[OR]= 1.46，95%可信区间[CI]，1.19 - 1.80），但当患者进行超过10次初级保健访视时，这种关系减弱（OR = 0.95，95%CI，0.77 - 1.17）。在增加基层医疗就诊次数匹配的情况下，与对照组相比，糖尿病患病且基层医疗就诊次数较少的患者更有可能出现新的抑郁症诊断（OR = 1.32，95%CI，1.07 - 1.63），但当患者进行4次以上的初级保健就诊时，这种关系减弱并逆转（OR = 0.99，95%CI，0.80-1.23）。类似的结果观察到在事件糖尿病和他们匹配的对照patients.CONCLUSIONS患者的亚组中，糖尿病患者有很少或没有增加的风险，一个新的诊断抑郁症相对于非糖尿病患者时，仔细分析控制的门诊次数。研究表明，这种关联可能没有充分调整合并症或暴露于医疗保健系统。
PURPOSE In this study, we compared the rate of depression diagnoses in adults with and without diabetes mellitus, while carefully controlling for number of primary care visits.METHODS We matched adults with incident diabetes (n = 2,932) or prevalent diabetes (n = 14,144) to nondiabetic control patients based on (1) age and sex, or (2) age, sex, and number of outpatient primary care visits. Logistic regression analysis was used to assess the association between various predictors and a diagnosis of depression in each diabetes cohort relative to matched nondiabetic control patients.RESULTS With matching for age and sex alone, patients with prevalent diabetes having few primary care visits were significantly more likely to have a new depression diagnosis than matched control patients (odds ratio [OR] = 1.46, 95% confidence interval [CI], 1.19-1.80), but this relationship diminished when patients made more than 10 primary care visits (OR = 0.95, 95% CI, 0.77-1.17). With additional matching for number of primary care visits, patients with prevalent diabetes mellitus with few primary care visits were more likely to have a new diagnosis of depression than those in control group (OR = 1.32, 95% CI, 1.07-1.63), but this relationship diminished and reversed when patients made more than 4 primary care visits (OR = 0.99, 95% CI, 0.80-1.23). Similar results were observed in the subset of patients with incident diabetes and their matched control patients.CONCLUSIONS Patients with diabetes have little or no increase in the risk of a new diagnosis of depression relative to nondiabetic patients when analyses carefully control for the number of outpatient visits. Studies showing such an association may have inadequately adjusted for comorbidity or for exposure to the medical care system.