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See Latest ArticlesDepression and Increased Mortality in Diabetes: Unexpected Causes of Death
Annals of Family Medicine, 09/15/09
Lin EHB et al. – Patients with diabetes and coexisting depression face substantially elevated mortality risks beyond cardiovascular deaths.
Methods- a prospective cohort study of 4,184 primary care patients with type 2 diabetes at Group Health Cooperative in Washington state.
- the Patient Health Questionnaire (PHQ–9) was used to assess depression at baseline and reviewed medical records supplemented by the Washington state mortality registry to ascertain the causes of death.
- 581 patients died during the follow–up period. Deaths occurred among 428 (12.9%) patients with no depression, among 88 (17.8%) patients with major depression, and among 65 (18.2%) patients with minor depression.
- Causes of death were grouped as cardiovascular disease, 42.7%; cancer, 26.9%; and deaths that were not due to cardiovascular disease or cancer, 30.5%.
- Infections, dementia, renal failure, and chronic obstructive pulmonary disease were the most frequent causes in the latter group.
- Adjusting for demographic characteristics, baseline major depression (relative to no depression) was significantly associated with all–cause mortality, with cardiovascular mortality, and with noncardiovascular, noncancer mortality.
- After additional adjustment for baseline clinical characteristics and health habits, major depression was significantly associated only with all–cause mortality and with death not caused by cancer or atherosclerotic cardiovascular disease.
- Minor depression showed similar but nonsignificant associations.
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