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Shi‐Heng W, Hsu L, Lin M, Wu C. Associations between depression and cancer risk among patients with diabetes mellitus: A population-based cohort study. Cancer Med 2023; 12:19968-19977. [PMID: 37706606 PMCID: PMC10587979 DOI: 10.1002/cam4.6539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/28/2023] [Accepted: 09/02/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND The co-occurrence of depression and diabetes mellitus has been linked to an increased risk of developing cancer. This study aimed to investigate whether depression further amplifies the risk of cancer among individuals with diabetes. METHODS This population-based matched cohort study utilized Taiwan's National Health Insurance claims database. A total of 85,489 newly diagnosed diabetic patients with depressive disorders were selected, along with 427,445 comparison subjects. The matching process involved age, sex, and the calendar year of diabetes onset. The average follow-up duration for the two cohorts was 6.4 and 6.5 years, respectively. The primary outcome of interest was the occurrence of overall cancer or cancer at specific anatomical sites. RESULTS The adjusted hazard ratios for overall cancer incidence were 1.08 (95% CI, 1.05-1.11). For site-specific cancers, depression exhibited significant associations with oropharyngeal, esophageal, liver, gynecological, prostate, kidney, and hematologic malignancies among patients with diabetes. Notably, a severity-response relationship was observed, indicating that patients with recurrent episodes of major depressive disorders exhibited a higher incidence of cancer compared to those diagnosed with dysthymia or depressive disorder not otherwise specified. Furthermore, the strength of the association between depression and cancer risk was more pronounced among younger patients with diabetes as opposed to older adults. However, no significant relationship was observed between adherence to antidepressant treatment and cancer risk. CONCLUSIONS The findings of this study indicate a significant association between depression and an elevated risk of cancer among individuals diagnosed with diabetes. Future investigations should replicate our findings, explore the effects of pharmacological and non-pharmacological treatments on cancer risk, and identify the underlying mechanisms.
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Affiliation(s)
- Wang Shi‐Heng
- National Center for Geriatrics and Welfare ResearchNational Health Research InstitutesMiaoliTaiwan
- Department of Public Health, College of Public HealthChina Medical UniversityTaichungTaiwan
| | - Le‐Yin Hsu
- Institute of Epidemiology and Preventive Medicine, College of Public HealthNational Taiwan UniversityTaipeiTaiwan
- Graduate Program of Data ScienceNational Taiwan University and Academia SinicaTaipeiTaiwan
| | - Mei‐Chen Lin
- National Center for Geriatrics and Welfare ResearchNational Health Research InstitutesMiaoliTaiwan
- Department of Public Health, College of Public HealthChina Medical UniversityTaichungTaiwan
| | - Chi‐Shin Wu
- National Center for Geriatrics and Welfare ResearchNational Health Research InstitutesMiaoliTaiwan
- Department of PsychiatryNational Taiwan University Hospital, Yunlin BranchDouliuTaiwan
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Robinson DJ, Hanson K, Jain AB, Kichler JC, Mehta G, Melamed OC, Vallis M, Bajaj HS, Barnes T, Gilbert J, Honshorst K, Houlden R, Kim J, Lewis J, MacDonald B, MacKay D, Mansell K, Rabi D, Sherifali D, Senior P. Diabetes and Mental Health. Can J Diabetes 2023; 47:308-344. [PMID: 37321702 DOI: 10.1016/j.jcjd.2023.04.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
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Aschner P, Gagliardino JJ, Ilkova H, Lavalle F, Ramachandran A, Mbanya JC, Shestakova M, Bourhis Y, Chantelot JM, Chan JCN. High Prevalence of Depressive Symptoms in Patients With Type 1 and Type 2 Diabetes in Developing Countries: Results From the International Diabetes Management Practices Study. Diabetes Care 2021; 44:1100-1107. [PMID: 33963019 PMCID: PMC8132319 DOI: 10.2337/dc20-2003] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 02/19/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Depression is common in people with diabetes, but data from developing countries are scarce. We evaluated the prevalence and risk factors for depressive symptoms in patients with diabetes using data from the International Diabetes Management Practices Study (IDMPS). RESEARCH DESIGN AND METHODS IDMPS is an ongoing multinational, cross-sectional study investigating quality of care in patients with diabetes in real-world settings. Data from wave 5 (2011), including 21 countries, were analyzed using the 9-item Patient Health Questionnaire (PHQ-9) to evaluate depressive symptoms. Logistic regression analyses were conducted to identify risk factors of depressive symptoms. RESULTS Of 9,865 patients eligible for analysis, 2,280 had type 1 and 7,585 had type 2 diabetes (treatment: oral glucose-lowering drugs [OGLD] only, n = 4,729; OGLDs plus insulin, n = 1,892; insulin only, n = 964). Depressive symptoms (PHQ-9 score ≥5) were reported in 30.7% of those with type 1 diabetes. In patients with type 2 diabetes, the respective figures were 29.0% for OGLDs-only, 36.6% for OGLDs-plus-insulin, and 46.7% for insulin-only subgroups. Moderate depressive symptoms (PHQ-9 score 10-19) were observed in 8-16% of patients with type 1 or type 2 diabetes. Female sex, complications, and low socioeconomic status were independently associated with depressive symptoms. In type 1 diabetes and in the type 2 diabetes OGLDs-only group, depression was associated with poor glycemic control. CONCLUSIONS Depressive symptoms are common in patients with diabetes from developing countries, calling for routine screening, especially in high-risk groups, to reduce the double burden of diabetes and depression and their negative interaction.
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Affiliation(s)
- Pablo Aschner
- Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Juan José Gagliardino
- El Centro de Endocrinología Experimental y Aplicada (CENEXA) (UNLP-CONICET-CEAS CICPBA), Facultad de Ciencias Médicas, Universidad Nacional de La Plata (UNLP), La Plata, Buenos Aires, Argentina
| | - Hasan Ilkova
- Division of Endocrinology Metabolism and Diabetes, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Fernando Lavalle
- Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Ambady Ramachandran
- India Diabetes Research Foundation, Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India
| | - Jean Claude Mbanya
- Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
| | | | | | | | - Juliana C N Chan
- Department of Medicine and Therapeutics, Hong Kong Institute of Diabetes and Obesity and Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, The Prince of Wales Hospital, Shatin, Hong Kong SAR, China
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Jia Z, Li S. Risk of Cardiovascular Disease Mortality in Relation to Depression and 14 Common Risk Factors. Int J Gen Med 2021; 14:441-449. [PMID: 33603451 PMCID: PMC7887189 DOI: 10.2147/ijgm.s292140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 01/13/2021] [Indexed: 01/08/2023] Open
Abstract
Background Depression has been linked to a worse prognosis of Cardiovascular disease (CVD), and these two diseases share a variety of common risk factors such as unhealthy lifestyles and chronic medical conditions. However, the potential role of these common risk factors in modulating the association between depression and CVD mortality and whether the co-occurrence of depression and a specific common risk factor has a cumulative impact on CVD mortality are still largely unknown. Methods We pooled data from 2005–2014 of Nation health and nutritional examination survey, leading to a study population of 22,177 adults. The Patient Health Questionnaire was employed to assess the depression symptoms, and information on CVD mortality was obtained from the linked mortality file of NHANES. Fourteen common risk factors of depression and CVD were included in this study. Results Based on the interaction analyses, we found overweight was protective for the risk of CVD death in depressive participants, but not in people without depression. Moreover, relative risk-based analyses indicated a mutually promotive effect of depression and baseline CVD or living alone on CVD mortality. Conclusion The novel findings in our study may facilitate risk stratification in the clinical programs targeting CVD mortality and help to shed light on the differential pathophysiological mechanisms in the depression-mediated elevation of CVD mortality.
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Affiliation(s)
- Zhaoqi Jia
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Sen Li
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, People's Republic of China
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Robinson DJ, Coons M, Haensel H, Vallis M, Yale JF. Diabetes and Mental Health. Can J Diabetes 2018; 42 Suppl 1:S130-S141. [PMID: 29650085 DOI: 10.1016/j.jcjd.2017.10.031] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Indexed: 01/28/2023]
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Affiliation(s)
- Tomoyuki Kawada
- Department of Hygiene and Public Health, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo 113-8602, Japan.
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Barnacle M, Strand MA, Werremeyer A, Maack B, Petry N. Depression Screening in Diabetes Care to Improve Outcomes. DIABETES EDUCATOR 2016; 42:646-51. [DOI: 10.1177/0145721716662917] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Purpose Evidence-based guidelines recommend regular depression screening among individuals with type 2 diabetes mellitus (T2DM). The purpose of this study is to examine depression screening patterns among a primary care population with T2DM, through use of the Patient Health Questionnaire-9 (PHQ-9). Methods In total, 1817 patients with T2DM were analyzed through a retrospective observational study at 2 sites, a regional health center and a federally qualified health center (FQHC). The T2DM sample was divided into those with and without a major depressive disorder (MDD) diagnosis. Depression screening rates and depression severity were assessed through the PHQ-9. Results Both sites had higher rates of PHQ-9 screening among individuals with a history of MDD (64.82%) vs those without MDD (11.39%). Individuals from the FQHC without a history of depression had a higher mean PHQ-9 score (10.11) than those with a previous MDD diagnosis at both RHS and FQHC (7.16 and 9.85, respectively). Conclusions Depression screening rates among individuals with diabetes and no history of MDD were remarkably low. Patients with diabetes but no MDD diagnosis who sought health care at a FQHC clinic had more depressive symptoms than those with a history of MDD at both sites. Individuals with diabetes and who have a MDD diagnosis are much more likely to receive regular depression screening than those without MDD, which leaves a substantial proportion of patients with undetected depression. Depression screening must be enhanced for all individuals with diabetes, particularly for low-income individuals and those without a previous diagnosis of MDD.
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Affiliation(s)
- Mykell Barnacle
- School of Nursing, North Dakota State University, Fargo, North Dakota, USA (Dr Barnacle)
- Department of Pharmacy Practice and Masters in Public Health Program, North Dakota State University, Fargo, North Dakota, USA (Dr Strand)
- Department of Pharmacy Practice, North Dakota State University, Fargo, North Dakota, USA (Dr Werremeyer, Dr Maack, Dr Petry)
| | - Mark A. Strand
- School of Nursing, North Dakota State University, Fargo, North Dakota, USA (Dr Barnacle)
- Department of Pharmacy Practice and Masters in Public Health Program, North Dakota State University, Fargo, North Dakota, USA (Dr Strand)
- Department of Pharmacy Practice, North Dakota State University, Fargo, North Dakota, USA (Dr Werremeyer, Dr Maack, Dr Petry)
| | - Amy Werremeyer
- School of Nursing, North Dakota State University, Fargo, North Dakota, USA (Dr Barnacle)
- Department of Pharmacy Practice and Masters in Public Health Program, North Dakota State University, Fargo, North Dakota, USA (Dr Strand)
- Department of Pharmacy Practice, North Dakota State University, Fargo, North Dakota, USA (Dr Werremeyer, Dr Maack, Dr Petry)
| | - Brody Maack
- School of Nursing, North Dakota State University, Fargo, North Dakota, USA (Dr Barnacle)
- Department of Pharmacy Practice and Masters in Public Health Program, North Dakota State University, Fargo, North Dakota, USA (Dr Strand)
- Department of Pharmacy Practice, North Dakota State University, Fargo, North Dakota, USA (Dr Werremeyer, Dr Maack, Dr Petry)
| | - Natasha Petry
- School of Nursing, North Dakota State University, Fargo, North Dakota, USA (Dr Barnacle)
- Department of Pharmacy Practice and Masters in Public Health Program, North Dakota State University, Fargo, North Dakota, USA (Dr Strand)
- Department of Pharmacy Practice, North Dakota State University, Fargo, North Dakota, USA (Dr Werremeyer, Dr Maack, Dr Petry)
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Depression, anxiety, and daytime sleepiness among type 2 diabetic patients and their correlation with the diabetes control: A case-control study. J Taibah Univ Med Sci 2016. [DOI: 10.1016/j.jtumed.2016.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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