Volume 83, Issue 2 , Pages 268-279, February 2009
Prevalence and correlates of undiagnosed depression among U.S. adults with diabetes: The Behavioral Risk Factor Surveillance System, 2006☆
Abstract
Aims
Many people with depression may be undiagnosed and thus untreated. We sought to assess the prevalence and correlates of undiagnosed depression among adults with diabetes.
Methods
Data of U.S. adults from the Behavioral Risk Factor Surveillance System in 2006 were analyzed. Cox proportional hazard regression analysis was used to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) of correlates for undiagnosed depression.
Results
The unadjusted and age-adjusted prevalences of undiagnosed depression were 8.7% and 9.2%. About 45% of diabetes patients with depression were undiagnosed. After adjustments for all correlates, female gender (PR, 1.4; 95% CI: 1.1–1.8), poor or fair health (PR, 2.8; 95% CI: 2.1–3.6), lack of social and emotional support (PR, 2.5; 95% CI: 1.8–3.3), life dissatisfaction (PR, 3.5; 95% CI: 2.2–5.5), use of special equipment (PR, 1.4; 95% CI: 1.1–1.8), no leisure-time physical activity (PR, 1.5; 95% CI: 1.2–1.9), and comorbid cardiovascular disease (PR, 1.5; 95% CI: 1.2–1.9) were associated with undiagnosed depression.
Conclusions
Undiagnosed depression among people with diabetes was common. Because depression is associated with increased risk of diabetes-related complications, early detection of depression is needed in clinical settings.
Abbreviations: BDI, Beck Depression Inventory, BMI, body mass index, BRFSS, Behavioral Risk Factor Surveillance System, CDC, Centers for Disease Control and Prevention, CES-D, Center for Epidemiological Studies-Depression, CI, confidence interval, CIDI, Composite International Diagnostic Interview, DSM-IV, Diagnostic and Statistical Manual of Mental Disordersfourth edition, ICD-9, International Classification of DiseasesNinth Revision, PHQ-8, the 8-item Patient Health Questionnaire, PR, prevalence ratio, SCI, Structured Clinical Interview, SDS, Zung Self-Rating Depression Scale, WHO, World Health Organization
Keywords: Depression, Diabetes, Prevalence, Correlates, Undiagnosed
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☆ The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
PII: S0168-8227(08)00565-2
doi:10.1016/j.diabres.2008.11.006
Published by Elsevier Inc.
Volume 83, Issue 2 , Pages 268-279, February 2009
