Depression and incident diabetic retinopathy: a prospective cohort study
Open accessAbstract
Objective This study examined whether depression is associated with a higher incidence of diabetic retinopathy among adults with type 2 diabetes after controlling for sociodemographic factors, health risk behaviors and clinical characteristics.Method This study included 2359 patients enrolled in Pathways Epidemiologic Follow-Up Study, a prospective cohort study investigating the impact of depression in primary care patients with type 2 diabetes. The predictor of interest was baseline severity of depressive symptoms assessed with the Patient Health Questionnaire-9 (PHQ-9). The outcome was incident diabetic retinopathy. Risk of diabetic retinopathy was assessed using logistic regression, and time to incident diabetic retinopathy was examined using Cox proportional hazard models.Results Over a 5-year follow-up period, severity of depression was associated with an increased risk of incident retinopathy [odds ratio =1.026; 95% confidence interval (CI) 1.002-1.051] as well as time to incident retinopathy (hazard ratio=1.025; 95% CI 1.009-1.041). The risk of incident diabetic retinopathy was estimated to increase by up to 15% for every significant increase in depressive symptoms severity (5-point increase on the PHQ-9 score).Conclusion Diabetic patients with comorbid depression have a significantly higher risk of developing diabetic retinopathy. Improving depression treatment in patients with diabetes could contribute to diabetic retinopathy prevention.
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In the Pathways Epidemiological Follow-up study (n=2,359 with diabetes mellitus; 5-year follow-up), depressive symptoms were associated with increased risk of incident retinopathy OR 1.03 (95% CI 1.01-1.05); a 5-point increase on PHQ-9 was associated with 15% increased risk of retinopathy.
“Pathways Epidemiological Follow-up study ( n = 2,359 with diabetes mellitus; 5 year follow- up) | Depressive symptoms assessed by the PHQ-9 | *Increased risk of incident retinopathy OR 1.03 (95% CI 1.01- 1.05). 5 point increase on PHQ-9, 15% increased risk of retinopathy.”
From Type 2 diabetes mellitus and psychological stress — a modifiable risk factor (2017) · cites this paper as Sieu (2011) 114
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Experimental — accuracy not yet measuredAnxiety and depression in DR patients reduce their quality of life.
“It not only threatens the physical and mental health of DR patients, but also reduces the quality of life of patients.[9–12]”
From The effect of psychotherapy on anxiety, depression, and quality of life in patients with diabetic retinopathy: A protocol for systematic review and network meta-analysis (2021) · cites this paper as [29]
The Introduction (page unavailable) says that comorbid depression and diabetes are associated with decreased quality of life. It does not make that quality-of-life claim specifically for patients with diabetic retinopathy or address anxiety; the study instead examines depression and the risk of developing retinopathy. (LLM, conf=0.88)
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- Authors
- Sieu, N., Katon, W., Lin, E. H. B., Russo, J., Ludman, E., & Ciechanowski, P.
- Affiliations
- University of Washington (US)
- Kaiser Permanente Washington Health Research Institute (US)
- Corresponding author
- Sieu, Nida
- Venue
- General Hospital Psychiatry
- Publisher
- Elsevier BV
- Published
- 2011-09
- Volume
- 33
- Issue
- 5
- Pages
- 429-435
- ISSN
- 0163-8343 (ISSN-L)
- PMC
- PMC3175259
- OpenAlex
- W2019695196
- Cited by
- 55
- References
- 48
- Citations by year
- 2026: 5 · 2025: 2 · 2024: 2 · 2023: 5 · 2022: 3 · 2021: 10 · 2019: 4 · 2018: 3 · 2017: 5 · 2016: 7 · 2015: 4 · 2013: 1 · 2012: 4
- FWCI
- 1.50
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- General Hospital Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (2t32mh020021-26)
- National Institute of Mental Health (K08MH069741, K24MH069471, T32 MH 20021-12, T-32MH020021, K24MH069741-07, R01MH073686)
- Topics
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- depression, diabetic retinopathy, type 2 diabetes, depressive symptoms, PHQ-9, comorbidities, retinopathy prevention, primary care patients
- MeSH terms
- Adult, Aged, Aged, 80 and over, Depressive Disorder, Diabetes Mellitus, Type 2, Diabetic Retinopathy, Female, Humans, Male, Middle Aged, Prospective Studies, Surveys and Questionnaires, Registries, Risk Factors, Self-Assessment, Washington, Cohort Studies, Comorbidity, Incidence, Logistic Models
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