Socioeconomic factors, rather than diabetes mellitus per se, contribute to an excessive use of antidepressants among young adults with childhood onset type 1 diabetes mellitus: a register-based study

• Published in: Diabetologia 2012-03, Vol.55 (3), p.617-624
• Main Authors: Lind, T., Waernbaum, I., Berhan, Y., Dahlquist, G.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; antidepressant treatment; Antidepressants; Antidepressive Agents - therapeutic use; Biological and medical sciences; Cohort Studies; Cross-Sectional Studies; Depression - drug therapy; Depression - economics; Depression - epidemiology; Depression - physiopathology; Diabetes; Diabetes Mellitus, Type 1 - psychology; Diabetes. Impaired glucose tolerance; Disabled Persons - psychology; Emotional disorders; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Hospitals; Human Physiology; Humans; Incidence; Internal Medicine; Labor market; Longitudinal Studies; Male; Medical sciences; Medicine; Medicine & Public Health; Mental depression; Metabolic Diseases; Metabolism; Mood disorders; Personal identification numbers; Prevalence; Registries; Risk Factors; Severity of Illness Index; Social Isolation - psychology; Socioeconomic Factors; Sweden - epidemiology; type 1 diabetes mellitus; Young Adult; Young adults
• ISSN: 0012-186X; 1432-0428; 1432-0428
• DOI: 10.1007/s00125-011-2405-0

Aims/hypothesis Mood disorders, including depression, are suggested to be prevalent in persons with type 1 diabetes and may negatively affect self-management and glycaemic control and increase the risk of diabetic complications. The aim of this study was to analyse the prevalence of antidepressant (AD) use in adults with childhood onset type 1 diabetes and to compare risk determinants for AD prescription among diabetic patients and a group of matched controls. Methods Young adults ≥18 years on 1 January 2006 with type 1 diabetes ( n  = 7,411) were retrieved from the population-based Swedish Childhood Diabetes Registry (SCDR) and compared with 30,043 age- and community-matched controls. Individual level data were collected from the Swedish National Drug Register (NDR), the Hospital Discharge Register (HDR) and the Labor Market Research database (LMR). Results ADs were prescribed to 9.5% and 6.8% of the type 1 diabetes and control subjects, respectively. Female sex, having received economic or other social support, or having a disability pension were the factors with the strongest association with AD prescription in both groups. Type 1 diabetes was associated with a 44% (OR 1.44, 95% CI 1.32, 1.58) higher risk of being prescribed ADs in crude analysis. When adjusting for potential confounders including sex, age and various socioeconomic risk factors, this risk increase was statistically non-significant (OR 1.11, 95% CI 0.99, 1.21). Conclusions/interpretation The risk factor patterns for AD use are similar among type 1 diabetic patients and controls, and socioeconomic risk factors, rather than the diabetes per se, contribute to the increased risk of AD use in young adults with type 1 diabetes.