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The association between diabetes and an episode of depressive symptoms in the 2002 World Health Survey: an analysis of 231 797 individuals from 47 countries

The association between diabetes and an episode of depressive symptoms in the 2002 World Health Survey: an analysis of 231 797 individuals from 47 countries
The association between diabetes and an episode of depressive symptoms in the 2002 World Health Survey: an analysis of 231 797 individuals from 47 countries
AIMS: Depression is common in people with diabetes and increases the risk of poor health outcomes, including premature mortality. We explored the association between diabetes and an episode of depressive symptoms in a cross-sectional multinational study, which included a large number of low- and middle-income non-Western countries.

METHODS: Data from 47 countries of the 2002 World Health Organization World Health Survey were used, including 231 797 adults (mean age 41 years, 53% female). Diabetes was assessed by self-report of diagnosis or treatment. The presence of an episode of depressive symptoms was assessed by self-report using an algorithm based on DSM-IV criteria. Odds ratios and 95% confidence intervals were calculated to quantify associations between diabetes and episodes of depressive symptoms in the entire sample and for countries aggregated into four continents: Africa, South America, Asia and Europe. Odds ratios were adjusted for age, sex, education, BMI, smoking and physical activity level.

RESULTS: The prevalence of diabetes (mean 3.6%, range 0.2-13%) and episodes of depressive symptoms (mean 7.9%, range 0.4-38%) differed widely across countries. Globally, individuals with diabetes had increased odds of an episode of depressive symptoms compared with those without diabetes (adjusted odds ratio 2.36, 95% confidence interval 1.91-2.92). Similar associations were found in South America, Asia and Europe (odds ratio > 1.97), but not in Africa (odds ratio 0.86, 95% confidence interval 0.54-1.37).

CONCLUSIONS: Globally, diabetes is associated with a twofold increased prevalence of an episode of depressive symptoms, except in Africa. Given the worldwide rise in diabetes in the coming decades, and the increased risk of poor diabetes outcomes associated with co-morbid depression, studies examining mechanisms and interventions are necessary.
0742-3071
Mommersteeg, P.M.
44ae411d-b4ae-4fb8-8848-f03091a45351
Herr, R.
35c96a35-ff8b-4b7f-a70c-5c64f5f01bcd
Pouwer, F.
1bf90039-859a-487f-9276-3e8c103eeeef
Holt, R.I.G.
d54202e1-fcf6-4a17-a320-9f32d7024393
Loerbroks, A.
6c65a852-8fcf-408e-a7d9-cd34625e4517
Mommersteeg, P.M.
44ae411d-b4ae-4fb8-8848-f03091a45351
Herr, R.
35c96a35-ff8b-4b7f-a70c-5c64f5f01bcd
Pouwer, F.
1bf90039-859a-487f-9276-3e8c103eeeef
Holt, R.I.G.
d54202e1-fcf6-4a17-a320-9f32d7024393
Loerbroks, A.
6c65a852-8fcf-408e-a7d9-cd34625e4517

Mommersteeg, P.M., Herr, R., Pouwer, F., Holt, R.I.G. and Loerbroks, A. (2013) The association between diabetes and an episode of depressive symptoms in the 2002 World Health Survey: an analysis of 231 797 individuals from 47 countries. Diabetic Medicine, 30 (6). (doi:10.1111/dme.12193). (PMID:23614792)

Record type: Article

Abstract

AIMS: Depression is common in people with diabetes and increases the risk of poor health outcomes, including premature mortality. We explored the association between diabetes and an episode of depressive symptoms in a cross-sectional multinational study, which included a large number of low- and middle-income non-Western countries.

METHODS: Data from 47 countries of the 2002 World Health Organization World Health Survey were used, including 231 797 adults (mean age 41 years, 53% female). Diabetes was assessed by self-report of diagnosis or treatment. The presence of an episode of depressive symptoms was assessed by self-report using an algorithm based on DSM-IV criteria. Odds ratios and 95% confidence intervals were calculated to quantify associations between diabetes and episodes of depressive symptoms in the entire sample and for countries aggregated into four continents: Africa, South America, Asia and Europe. Odds ratios were adjusted for age, sex, education, BMI, smoking and physical activity level.

RESULTS: The prevalence of diabetes (mean 3.6%, range 0.2-13%) and episodes of depressive symptoms (mean 7.9%, range 0.4-38%) differed widely across countries. Globally, individuals with diabetes had increased odds of an episode of depressive symptoms compared with those without diabetes (adjusted odds ratio 2.36, 95% confidence interval 1.91-2.92). Similar associations were found in South America, Asia and Europe (odds ratio > 1.97), but not in Africa (odds ratio 0.86, 95% confidence interval 0.54-1.37).

CONCLUSIONS: Globally, diabetes is associated with a twofold increased prevalence of an episode of depressive symptoms, except in Africa. Given the worldwide rise in diabetes in the coming decades, and the increased risk of poor diabetes outcomes associated with co-morbid depression, studies examining mechanisms and interventions are necessary.

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More information

e-pub ahead of print date: 25 April 2013
Published date: 30 June 2013
Organisations: Human Development & Health

Identifiers

Local EPrints ID: 353164
URI: http://eprints.soton.ac.uk/id/eprint/353164
ISSN: 0742-3071
PURE UUID: 489ab577-dcf7-4d80-8d4f-1e564db37468
ORCID for R.I.G. Holt: ORCID iD orcid.org/0000-0001-8911-6744

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Date deposited: 31 May 2013 13:53
Last modified: 27 Jan 2024 02:38

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Contributors

Author: P.M. Mommersteeg
Author: R. Herr
Author: F. Pouwer
Author: R.I.G. Holt ORCID iD
Author: A. Loerbroks

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