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  • Prevalence of depression in patients with type 2 diabetes mellitus in Spain (the DIADEMA Study) : results from the MADIABETES cohort

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Diabetes and endocrinology
Research
Prevalence of depression in patients with type 2 diabetes mellitus in Spain (the DIADEMA Study) : results from the MADIABETES cohort
  1. Miguel Angel Salinero-Fort1,2,
  2. P Gómez-Campelo3,4,
  3. F Javier San Andrés-Rebollo5,
  4. Juan Cárdenas-Valladolid6,
  5. Juan C Abánades-Herranz7,
  6. Enrique Carrillo de Santa Pau8,
  7. Rosa M Chico-Moraleja9,
  8. Domingo Beamud-Victoria10,
  9. Jose M de Miguel-Yanes11,
  10. Rodrigo Jimenez-Garcia12,
  11. Ana López-de-Andres12,
  12. Yolanda Ramallo-Fariña2,
  13. Carmen De Burgos-Lunar2,13
  14. The MADIABETES Research Group
    1. 1 Subdirección General de Investigación Sanitaria, Consejería de Sanidad, Madrid, Spain
    2. 2 Nodo Madrid, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain
    3. 3 Grupo Respuesta Inmune Innata. Hospital La Paz Institute for Health Research (IdiPAZ), La Paz University Hospital, Madrid, Spain
    4. 4 Centro de Ciencias de la Salud San Rafael, Universidad Antonio de Nebrija, Madrid, Spain
    5. 5 Centro de Salud Las Calesas, Servicio Madrileño de Salud, Madrid, Spain
    6. 6 Gerencia Adjunta de Planificación y Calidad, Gerencia de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain
    7. 7 Centro de Salud Monóvar, Sevicio Madrileño de Salud, Madrid, Spain
    8. 8 Grupo de Biología Computacional, Instituto Madrileño de Estudios Avanzados-IMDEA, Madrid, Spain
    9. 9 Servicio de Ortopedia y Traumatología, Hospital Central de la Defensa, Madrid, Spain
    10. 10 Centro de Salud Felipe II, Madrid, Spain
    11. 11 Servicio de Medicina Interna, Hospital Gregorio Marañón, Madrid, Spain
    12. 12 Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
    13. 13 Servicio de Medicina Preventiva, Hospital Clínico San Carlos, Madrid, Spain
    1. Correspondence to Dr P Gómez-Campelo; pgomezc{at}salud.madrid.org

    Abstract

    Objective To estimate the prevalence of depression in patients diagnosed with type 2 diabetes mellitus (T2DM), and to identify sociodemographic, clinical and psychological factors associated with depression in this population. Additionally, we examine the annual incidence rate of depression among patients with T2DM.

    Methods We performed a large prospective cohort study of patients with T2DM from the Madrid Diabetes Study. The first recruitment drive included 3443 patients. The second recruitment drive included 727 new patients. Data have been collected since 2007 (baseline visit) and annually during the follow-up period (since 2008).

    Results Depression was prevalent in 20.03% of patients (n=592; 95% CI 18.6% to 21.5%) and was associated with previous personal history of depression (OR 6.482; 95% CI 5.138 to 8.178), mental health status below mean (OR 1.423; 95% CI 1.452 to 2.577), neuropathy (OR 1.951; 95% CI 1.423 to 2.674), fair or poor self-reported health status (OR 1.509; 95% CI 1.209 to 1.882), treatment with oral antidiabetic agents plus insulin (OR 1.802; 95% CI 1.364 to 2.380), female gender (OR 1.333; 95% CI 1.009 to 1.761) and blood cholesterol level (OR 1.005; 95% CI 1.002 to 1.009). The variables inversely associated with depression were: being in employment (OR 0.595; 95% CI 0.397 to 0.894), low physical activity (OR 0.552; 95% CI 0.408 to 0.746), systolic blood pressure (OR 0.982; 95% CI 0.971 to 0.992) and social support (OR 0.978; 95% CI 0.963 to 0.993). In patients without depression at baseline, the incidence of depression after 1 year of follow-up was 1.20% (95% CI 1.11% to 2.81%).

    Conclusions Depression is very prevalent among patients with T2DM and is associated with several key diabetes-related outcomes. Our results suggest that previous mental status, self-reported health status, gender and several diabetes-related complications are associated with differences in the degree of depression. These findings should alert practitioners to the importance of detecting depression in patients with T2DM.

    • depression
    • diabetes mellitus, type 2
    • self-care
    • cohort studies

    This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

    https://doi.org/10.1136/bmjopen-2017-020768

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      Footnotes

      • Contributors CDB-L and MAS-F designed the study and obtained funding. JC-V, PG-C, JCA-H, RMC-M and DB-V selected the patient sample by the participating general practitioner, collected data and combined the data collection strategies in a single database. FJSA-R, CDB-L, YR-F, PG-C and MAS-F analysed the data. PG-C, MAS-F and JMdM-Y wrote the initial draft of the paper. RJ-G, AL-A, CDB-L and ECdSP were involved in further drafting of the paper. All authors interpreted the data, revised the paper critically for important intellectual content and gave final approval of the submitted version.

      • Funding This study forms part of research funded by FIS (Fondo de Investigaciones Sanitarias—Health Research Fund, Instituto de Salud Carlos III) grants no.: PI10/02796, PI12/01806 and PI15/00259 and co-financed by the European Union through the Fondo Europeo de Desarrollo Regional (FEDER, “Una manera de hacer Europa”). Also, this article has been supported by the Foundation for Biomedical Research and Innovation of Primary Care FIIBAP through the call for aid for publications 2017.(https://saluda.salud.madrid.org/atencionprimaria/investigacion/Paginas/fiibap.aspx).

      • Competing interests None declared.

      • Patient consent Obtained.

      • Ethics approval Review Board of the Ramón y Cajal Hospital (Madrid).

      • Provenance and peer review Not commissioned; externally peer reviewed.

      • Data sharing statement No additional data are available

      • Collaborators The members of the MADIABETES Group are as follows : AM Sobrado-de Vicente-Tutor; Mar Sanz-Pascual; M Arnalte-Barrera; S Pulido-Fernández; EM Donaire-Jiménez; C Montero-Lizana; M Domínguez-Paniagua; P Serrano-Simarro; R Echegoyen-de Nicolás; P Gil-Díaz; I Cerrada-Somolinos; R Martín-Cano; A Cava-Rosado; T Mesonero-Grandes; E Gómez-Navarro; A Maestro-Martín; A Muñoz-Cildoz; ME Calonge-García; M Martín-Bun; P Carreño-Freire; J Fernández-García; A Morán-Escudero; J Martínez-Irazusta; E Calvo-García; AM Alayeto-Sánchez; C Reyes-Madridejos; MJ Bedoya-Frutos; B López-Sabater; J Innerarity-Martínez; A Rosillo-González; AI Menéndez-Fernández; F Mata-Benjumea; P Vich-Pérez; C Martín-Madrazo; MJ Gomara-Martínez; C Bello-González; A Pinilla-Carrasco; M Camarero-Shelly; A Cano-Espin; J Castro Martin; B de Llama-Arauz; A de Miguel-Ballano; MA García-Alonso; JN García-Pascual; MI González-García; C López-Rodríguez; M Miguel-Garzón; MC Montero-García; S Muñoz-Quiros-Aliaga; S Núñez-Palomo; O Olmos-Carrasco; N Pertierra-Galindo; G Reviriego-Jaén; P Rius-Fortea; G Rodríguez-Castro; JM San Vicente-Rodríguez; ME Serrano-Serrano; MM Zamora-Gómez; and MP Zazo-Lázaro.