Depression and Death in Diabetes; 10-Year Follow-Up of All-Cause and Cause-Specific Mortality in a Diabetic Cohort

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 depres...

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Published in:Psychosomatics (Washington, D.C.) D.C.), 2013-09, Vol.54 (5), p.428-436
Main Authors: Coleman, Shane M., M.D, Katon, Wayne, M.D, Lin, Elizabeth, M.D, Von Korff, Michael, Sc.D
Format: Article
Language:English
Subjects:
Adult and adolescent clinical studies
Age Distribution
Aged
Biological and medical sciences
Cardiovascular Diseases - complications
Cardiovascular Diseases - mortality
Cause of Death
Cohort Studies
Depression
Depressive Disorder - complications
Depressive Disorder - mortality
Depressive Disorder, Major - complications
Depressive Disorder, Major - mortality
Diabetes Mellitus, Type 2 - complications
Diabetes Mellitus, Type 2 - mortality
Diabetes. Impaired glucose tolerance
Endocrine pancreas. Apud cells (diseases)
Endocrinopathies
Etiopathogenesis. Screening. Investigations. Target tissue resistance
Female
Humans
Internal Medicine
Male
Medical sciences
Middle Aged
Miscellaneous
Mood disorders
Proportional Hazards Models
Psychiatry
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Sex Distribution
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Summary: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.
ISSN:0033-3182
1545-7206
DOI:10.1016/j.psym.2013.02.015