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Undiagnosed depression constitutes nearly half of all depression cases in patients with diabetes, results indicate

Wednesday, February 25 2009 | Comments

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What's This? Among individuals with diabetes, approximately 45% of depression cases have not been diagnosed, according to an analysis of data for U.S. adults included in the 2006 Behavioral Risk Factor Surveillance System (BRFSS) survey.

As part of the 2006 BRFSS survey, depression and anxiety were assessed with the 8-item Primary Care Evaluation of Mental Disorders Health Questionnaire (PHQ-8). The PHQ-8, the study authors noted, contains questions that address 8 of the 9 DSM-IV criteria for major and minor depression diagnoses such that it can be used to establish a provisional diagnosis and evaluate symptom severity.

Among individuals with diabetes who did not have a depression diagnosis, 3.0% met criteria for major depression, 6.0% met criteria for minor depression, and 8.7% met criteria for any depression in unadjusted analyses. Undiagnosed cases of depression accounted for 28.3% of all major depression cases, 60.9% of all minor depression cases, and 45.0% of all depression cases.

Additional analyses showed that undiagnosed depression was significantly associated with female sex, poor or fair health (vs excellent, good, or very good health), a lack of social and emotional support, life dissatisfaction, use of special equipment, no leisure-time physical activity, and comorbid cardiovascular disease.

Given the large number of people with diabetes and undiagnosed depression, as well as existing evidence linking depression with an increased risk of diabetes-related complications, the study authors advocated early detection of depressive symptoms in this patient population, especially among high-risk groups. (Li C, et al. Diabetes Res Clin Pract 2009;83:268-279.)

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