Does awareness of diabetic status increase risk of depressive or anxious symptoms? Findings from the China Multi-Ethnic cohort (CMEC) study

• Published in: Journal of affective disorders 2023-01, Vol.320, p.218-229
• Main Authors: Liu, Yuanyuan, Chen, Liling, Zhou, Hanwen, Guan, Han, Feng, Yuemei, Yangji, Baima, Liu, Qiaolan, Liu, Xiang, Xia, Jinjie, Li, Jingzhong, Zhao, Xing
• Format: Article
• Language: English
• Subjects: Adult; Anxiety; Anxious symptoms; China - epidemiology; Cohort Studies; Depression; Depressive symptoms; Diabetes Mellitus - epidemiology; Humans; Prevalence; Type 2 diabetes
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2022.09.135

People with diabetes mellitus (DM) have increased risk of depressive symptoms (DS) or anxious symptoms (AS). This study explores whether awareness of DM will contribute to prevalence of DS or AS. The baseline data including 81,717 adults from Southwest China was analyzed. DS and AS were assessed using PHQ-2 and GAD-2. Exposures were defined as 1) having self-reported physician diagnosis of diabetes (self-reported DM), 2) no prior diagnosis of diabetes but meeting diagnostic criteria (newly diagnosed DM), 3) having self-reported physician diagnosis or meeting criteria of non-diabetic diseases (non-diabetic patients), 4) healthy participants. Generalized linear mixed models were used to assess impact of presence and awareness of DM on DS or AS, adjusting for regional and individual related factors. The prevalence of DS in self-reported DM, newly diagnosed DM, non-diabetic patient and healthy participants was 7.08 %, 4.30 %, 5.37 % and 3.17 %. The prevalence of AS was 7.80 %, 5.77 %, 6.37 % and 3.91 %. After adjusting for related factors, compared with healthy participants, self-reported DM and non-diabetic patients were associated with DS [AORDS, self-reported = 1.443(1.218,1.710), AORDS, nondiabetic patients = 1.265(1.143,1.400)], while the association between newly diagnosed DM and DS was not statistically significant. The associations between self-reported DM, newly diagnosed DM, non-diabetic patients and AS were all statistically significant. DS and AS were assessed through self-report and may suffer recall or information bias. The association between awareness of diabetes and DS/AS suggests to pay attention to distinguish between self-reported and newly diagnosed DM and screening for DS and AS in diabetic population. •Based on data of the whole population from a multi-ethnic cohort including nearly 100,000 participants in southwest China, we provided empirical evidence to complement Talbot's hypothesis of the association between diabetes and DS. We also explored the evidence of the association between diabetes and AS.•Based on previous studies, we further divided the study population by separating out those who were aware of their diseases except diabetes. We divided the study population into four groups, namely self-reported DM, newly diagnosed DM, non-diabetic patients and healthy participants. Using healthy participants as control group provided a better understanding of the effect of awareness of diabetes on symptoms of depression or anxiety.•In add