Depression and diabetes1 appear to be associated with a significantly increased risk of death from heart disease and risk of death from all causes over a six-year period for women, according to a report in the January issue of Archives of General Psychiatry2, one of the JAMA/Archives journals. Depression affects close to 15 million U.S. adults each year and more than 23.5 million U.S. adults have diabetes, according to background information in the article. Symptoms of depression affect between one-fifth and one-fourth of patients with diabetes, nearly twice as many as individuals without diabetes. Diabetes and its complications are leading causes of death around the world.
An Pan, Ph.D., of the Harvard School of Public Health, Boston, and colleagues studied 78,282 women aged3 54 to 79 in 2000 who were participating in the Nurses' Health Study. The women were classified as having depression if they reported being diagnosed with the condition, were treated with antidepressant medications(药物) or scored high on an index measuring depressive symptoms. Reports of type 2 diabetes were confirmed using a supplementary4 questionnaire.
During six years of follow-up, 4,654 of the women died, including 979 who died from cardiovascular(心血管的) disease. Compared with women who did not have either condition, those with depression had a 44 percent increased risk of death, those with diabetes had a 35 percent increased risk of death and those with both conditions had approximately twice the risk of death.
When considering only deaths from cardiovascular disease, women with diabetes had a 67 percent increased risk, women with depression had a 37 percent increased risk and women with both had a 2.7-fold increased risk.
"The underlying5 mechanisms6 of the increased mortality risk associated with depression in patients with diabetes remains7 to be elucidated8(阐明,说明) ," the authors write. "It is generally suggested that depression is associated with poor glycemic(血糖的) control, an increased risk of diabetes complications, poor adherence9 to diabetes management by patients and isolation10 from the social network." In addition, diabetes and depression are both linked to unhealthy behaviors such as smoking, poor diet and a sedentary(久坐的) lifestyle, and depression could trigger changes in the nervous system that adversely11 affect the heart.
"Considering the size of the population that could be affected12 by these two prevalent disorders13, further consideration is required to design strategies aimed to provide adequate psychological management and support among those with longstanding chronic14 conditions, such as diabetes," the authors conclude.