Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Diabetes Care. 2010 May;33(5):1050-4. doi: 10.2337/dc09-1929. Epub 2010 Feb 25.
Individuals with diabetes are at higher risk for depression than the general population. Although depression can be treated with antidepressant medications, patients with diabetes and comorbid depression often go untreated. The goal of this study was to examine racial disparities in the treatment of depression with antidepressant medication in the southeastern U.S.
Cross-sectional data were collected at baseline from 69,068 participants (71% African American, 60% female, and 82% with incomes <$25,000) recruited from community health centers and enrolled in the Southern Cohort Community Study (SCCS). The SCCS is a prospective epidemiological cohort study designed to explore causes of health disparities in adults aged 40-79 years. Binary logistic regression was used to identify factors associated with antidepressant use among those with diabetes (n = 14,279).
Individuals with diagnosed diabetes (14,279) were classified with no depressive symptoms (54.7%), or with mild (24.2%), moderate (12.8%), or severe depressive symptoms (8.3%). After controlling for sex, age, insurance, income, education, BMI, smoking status, alcohol consumption, and level of depression, African Americans with diabetes were much less likely to report taking antidepressant medication than whites (adjusted odds ratio 0.32 [95% CI 0.29-0.35], P < 0.0001).
Antidepressant use is much less common among African Americans than among whites with diabetes. Reasons for racial disparities in treatment of depressive symptoms are unclear but may include a combination of differential diagnosis and treatment by health professionals as well as cultural differences in seeking help for emotional distress.
患有糖尿病的个体患抑郁症的风险高于一般人群。虽然抗抑郁药物可以治疗抑郁症，但患有糖尿病和共病抑郁症的患者往往未得到治疗。本研究的目的是在美国东南部研究抗抑郁药物治疗抑郁症的种族差异。
从社区卫生中心招募的 69068 名参与者（71%为非裔美国人，60%为女性，82%的收入<$25000）的横断面数据在基线时收集，并纳入南方队列社区研究（SCCS）。SCCS 是一项前瞻性的流行病学队列研究，旨在探索导致 40-79 岁成年人健康差异的原因。使用二元逻辑回归确定了糖尿病患者（n=14279）使用抗抑郁药物的相关因素。
诊断为糖尿病的个体（n=14279）分为无抑郁症状（54.7%）、轻度（24.2%）、中度（12.8%）或重度抑郁症状（8.3%）。在控制性别、年龄、保险、收入、教育、BMI、吸烟状况、饮酒和抑郁程度后，与白人相比，患有糖尿病的非裔美国人服用抗抑郁药物的可能性要小得多（调整后的优势比为 0.32[95%CI 0.29-0.35]，P<0.0001）。
与白人相比，患有糖尿病的非裔美国人使用抗抑郁药物的情况要少得多。治疗抑郁症状种族差异的原因尚不清楚，但可能包括卫生专业人员在诊断和治疗方面的差异以及在寻求情感困扰帮助方面的文化差异。
