Department of Nursing, China Medical University Hospital, Taichung 404, Taiwan.
Int J Nurs Stud. 2012 Apr;49(4):437-44. doi: 10.1016/j.ijnurstu.2011.09.019. Epub 2011 Oct 7.
Findings of previous studies on the association between diabetes and the risk of depression are contradictory. Furthermore, much less is known concerning the association among young adults.
To investigate whether diabetes is associated with an increased risk of subsequent development of depression, with emphasis on age-specific variations.
A cohort study.
Claims data of one million subjects randomly selected from 23 million people covered by the Taiwan National Health Insurance program.
From the claims data, we identified 14,048 patients aged ≥ 20 years with newly diagnosed diabetes in 2000-2002 and randomly selected 55,608 non-diabetic subjects for comparison, that were frequency-matched by calendar year, age, and gender. Incidence rates of depression to the end of 2007 were identified, and risks were compared between the two groups.
The incidence of depression was 1.80-times higher in the diabetic group than in nondiabetic subjects over a median follow-up of 6.5 years (adjusted hazard ratio [HR]=1.46, 95% confidence interval [CI]: 1.24-1.71). Age-specific HRs for incidence of depression in relation to diabetes were not statistically different between the patient subgroups aged 20-39, 40-49, 50-59, 60-69 and ≥ 70 years (p value for age-diabetes interaction=0.33). Stratified analyses showed that the association was much stronger for subjects without comorbid cardiovascular disease than for those with this comorbidity. Insulin treatment was associated with a 43% reduced risk of depression in diabetic patients.
In this population-based study, diabetic patients were at a higher risk for subsequent depression. Adequate treatment reduced the risk.
之前关于糖尿病与抑郁风险之间关联的研究结果存在矛盾。此外，对于年轻人之间的关联知之甚少。
研究糖尿病是否与随后发生抑郁的风险增加相关，重点关注年龄特异性变化。
队列研究。
从台湾全民健康保险计划覆盖的 2300 万人中随机抽取的 100 万受试者的索赔数据。
从索赔数据中，我们确定了 2000-2002 年期间 14048 名年龄≥20 岁的新诊断糖尿病患者，并随机选择了 55608 名非糖尿病患者作为对照，按日历年份、年龄和性别进行频数匹配。确定了截至 2007 年底的抑郁发生率，并比较了两组之间的风险。
在中位随访 6.5 年期间，糖尿病组的抑郁发生率比非糖尿病组高 1.80 倍（调整后的风险比[HR]=1.46，95%置信区间[CI]：1.24-1.71）。年龄特异性 HR 显示，在年龄 20-39、40-49、50-59、60-69 和≥70 岁的患者亚组中，糖尿病与抑郁发生率之间的年龄-糖尿病交互作用无统计学差异（p 值为 0.33）。分层分析表明，在无合并心血管疾病的患者中，这种关联比合并这种疾病的患者更强。对于糖尿病患者，胰岛素治疗与抑郁风险降低 43%相关。
在这项基于人群的研究中，糖尿病患者发生后续抑郁的风险较高。充分的治疗降低了这种风险。
