Depression and diabetes: factors associated with major depression at five-year follow-up.

Background: In patients with diabetes, comorbid depression has been shown to be associated with increased medical symptom burden, additional functional impairment, poor self-care, increased risk of macrovascular and microvascular complications, higher medical costs, and greater mortality.

Objective: The authors performed a longitudinal observation to assess the pathway between diabetes complications and subsequent depression.

Method: In a prospective study of primary-care patients with diabetes (N=2,759), the authors determined, from automated data and chart review, whether macrovascular or microvascular events or coronary, cerebrovascular, or peripheral vascular procedures during follow-up were associated with meeting criteria for major depression at 5-year follow-up.

Results: After controlling for baseline severity of depression symptoms and history of depression, having one-or-more coronary procedures during follow-up, and baseline severity of diabetes symptoms were strong predictors of having major depression at 5-year follow-up.

Conclusion: The risk of major depression among persons with diabetes is increased by previous depression history, baseline diabetes symptoms, and having had cardiovascular procedures.