CMAJ • July 4, 2006; 175 (1). doi:10.1503/cmaj.051429.
© 2006 CMA Media Inc. or its licensors
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.
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Research

Type 2 diabetes does not increase risk of depression

Lauren C. Brown, Sumit R. Majumdar, Stephen C. Newman and Jeffrey A. Johnson

From the Departments of Public Health Sciences (Brown, Majumdar, Newman, Johnson), Medicine (Majumdar) and Psychiatry (Newman), University of Alberta, and the Institute of Health Economics (Brown, Majumdar, Johnson), Edmonton, Alta.

Correspondence to: Dr. Jeffrey A. Johnson, Institute of Health Economics, 10405 Jasper Ave., Rm. 1200, Edmonton AB T5J 3N4; fax 780 448-0018; jeff.johnson{at}ualberta.ca

Background: Although diabetes mellitus has a strong association with the presence of depression, it is unclear whether diabetes itself increases the risk of developing depression. The objective of our study was to evaluate whether people with diabetes have a greater incidence of depression than those without diabetes.

Methods: We conducted a population-based retrospective cohort study using the administrative databases of Saskatchewan Health from 1989 to 2001. People older than 20 years with newly identified type 2 diabetes were identified by means of diagnostic codes and prescription records and compared with a nondiabetic cohort. Depression was ascertained via diagnostic codes and prescriptions for antidepressants. Cox regression analysis was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) after adjusting for age, sex, frequency of visits to physicians and presence of comorbidities.

Results: We identified 31 635 people with diabetes and 57 141 without. Those with diabetes were older (61.4 v. 46.8 yr; p < 0.001), were more likely to be male (55.4% v. 49.8%; p < 0.001) and had more physician visits during the year after their index date (mean 14.5 v. 5.9; p < 0.001). The incidence of new-onset depression was similar in both groups (6.5 v. 6.6 per 1000 person-years among people with and without diabetes, respectively). Similarity of risk persisted after controlling for age, sex, number of physician visits and presence of prespecified comorbidities (adjusted HR 1.04, 95% CI 0.94– 1.15). Other chronic conditions such as arthritis (HR 1.18) and stroke (HR 1.73) were associated with the onset of depression.

Interpretation: Using a large, population-based administrative cohort, we found little evidence that type 2 diabetes increases the risk of depression once comorbid diseases and the burden of diabetes complications were accounted for.


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