Symptoms of depression as a risk factor for incident diabetes: findings from the National Health and Nutrition Examination Epidemiologic Follow-up Study, 1971-1992
Abstract
Symptoms of depression may predict incident diabetes independently or through established risk factors for diabetes. US men and women aged 25-74 years who were free of diabetes at baseline (n = 6,190) were followed from 1971 to 1992 (mean, 15.6 years; standard deviation, 6) for incident diabetes. Depressive symptoms were measured by using the General Well-Being Depression subscale and were categorized to compare persons with high (9%), intermediate (32%), and low (59%) numbers of symptoms. The incidence of diabetes was highest among participants reporting high numbers of depressive symptoms (7.3 per 1,000 person-years) and did not differ between persons reporting intermediate and low numbers of symptoms (3.4 and 3.6 per 1,000 person-years, respectively) (p < 0.01 for high vs. low). In the subset of participants with less than a high school education (a marker of low socioeconomic status), the risk of developing diabetes was three times higher (95% confidence interval: 2.0, 4.7) for persons reporting high versus low numbers of depressive symptoms. These results persisted following adjustment for established diabetes risk factors. Depressive symptoms had no impact on diabetes incidence among persons with at least a high school education. Results suggest an independent role for depressive symptoms in the development of diabetes in populations with low educational attainment.
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Major depressive disorder is a consistent predictor of the subsequent first onset of coronary artery disease, stroke, diabetes, heart attacks, and certain types of cancer, though evidence about major depressive disorder as a cause of physical disorders is spotty.
“we know from meta-analyses of longitudinal studies that MDD is a consistent predictor of the subsequent first onset of coronary artery disease,97, 98 stroke,99 diabetes,100 heart attacks ,101, 102 and certain types of cancer.103”
From The Costs of Depression (2012) · cites this paper as [99]
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- Authors
- Carnethon, M. R.
- Affiliations
- Stanford Medicine (US)
- Corresponding author
- Carnethon, M. R.
- ORCID
- Carnethon, M. R.
- Venue
- American Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2003-09-01
- Volume
- 158
- Issue
- 5
- Pages
- 416-423
- ISSN
- 0002-9262 (ISSN-L)
- OpenAlex
- W2130239487
- Cited by
- 244
- References
- 46
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 8 · 2023: 2 · 2022: 5 · 2021: 9 · 2020: 6 · 2019: 5 · 2018: 7 · 2017: 9 · 2016: 11 · 2015: 15 · 2014: 11 · 2013: 17 · 2012: 17
- FWCI
- 8.14
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (T32HL007034, 5 T32 HL07034)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- depressive symptoms, depression, new-onset diabetes, diabetes risk factors, socioeconomic status, educational attainment, low educational attainment, diabetes incidence, middle-aged adults
- MeSH terms
- Adolescent, Adult, Aged, Anxiety, Child, Child, Preschool, Cross-Sectional Studies, Depression, Diabetes Mellitus, Female, Follow-Up Studies, Humans, Infant, Male, Middle Aged, Risk Factors, Socioeconomic Factors, United States, Cohort Studies, Comorbidity, Incidence, Multivariate Analysis, Age Distribution, Sex Distribution
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