Diabetes, Major Depression, and Functional Disability Among U.S. Adults
Abstract
OBJECTIVE—The goal of this study was to determine prevalence and odds of functional disability in individuals with diabetes and comorbid major depression compared with individuals with either diabetes or major depression alone. RESEARCH DESIGN AND METHODS—Data on 30,022 adults aged ≥18 years from the 1999 National Health Interview Survey (NHIS) were analyzed. Four disease categories were created: no diabetes and no major depression, major depression alone, diabetes alone, and diabetes and comorbid major depression. Prevalence of functional disability was calculated for each disease category. Multiple logistic regression was used to determine the odds and correlates of functional disability by disease category controlling for age, sex, race/ethnicity, education, income, census region, and disability-associated comorbidity. STATA was used for all analyses to account for the complex survey design of NHIS. RESULTS—Prevalence of functional disability by disease category was as follows: no diabetes and no major depression (24.5%); major depression (51.3%); diabetes (58.1%); and diabetes and comorbid major depression (77.8%). With no diabetes and no major depression as reference and after adjusting for relevant covariates, the odds of functional disability was 3.00 (95% CI 2.62–3.42) for major depression, 2.42 (2.10–2.79) for diabetes, and 7.15 (4.53–11.28) for diabetes and comorbid major depression. CONCLUSIONS—Individuals with diabetes and comorbid major depression have higher odds of functional disability compared with individuals with either diabetes or major depression alone. Additional studies are needed to establish a causal relationship.
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Comorbid MDD in people with type 2 diabetes is associated with increased hospital admissions and complications.
“Comorbid MDD in people with type 2 diabetes is associated with poorer adherence to diabetes treatment52 and self-care activities (e.g., exercise, healthy eating)53,54, increased health care costs22,54, reduced glycemic control55,56, and increased hospital admissions and complications57-60.”
From Comorbidity between major depressive disorder and physical diseases: a comprehensive review of epidemiology, mechanisms and management (2023) · cites this paper as [58]
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- Authors
- Egede, L. E.
- Affiliations
- Medical University of South Carolina (US)
- Corresponding author
- Egede, Leonard E.
- ORCID
- Egede, Leonard E.
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2004-02-01
- Volume
- 27
- Issue
- 2
- Pages
- 421-428
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W1969684313
- Cited by
- 422
- References
- 46
- Citations by year
- 2026: 7 · 2025: 13 · 2024: 14 · 2023: 11 · 2022: 4 · 2021: 12 · 2020: 17 · 2019: 12 · 2018: 19 · 2017: 20 · 2016: 22 · 2015: 29 · 2014: 15 · 2013: 27 · 2012: 20
- FWCI
- 9.75
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Diabetes Association
- World Health Organization
- Agency for Healthcare Research and Quality (5K08HS11418)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- diabetes mellitus, major depressive disorder, functional disability, comorbidities, prevalence, disability risk factors, physical and mental health
- MeSH terms
- Activities of Daily Living, Adult, Aged, Depressive Disorder, Diabetes Mellitus, Ethnicity, Female, Persons with Disabilities, Disabled Persons, Health Surveys, Humans, Interviews as Topic, Male, Middle Aged, Socioeconomic Factors, United States, Comorbidity, Racial Groups
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