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On the Association Between Diabetes and Mental Disorders in a Community Sample

Results from the German National Health Interview and Examination Survey

¹ Department of Psychotherapeutic Medicine, Heinrich-Heine University, Duesseldorf, Germany
² Robert Koch-Institut, Berlin, Germany

OBJECTIVE—To determine the relationship between mental disorders and diabetes in a representative community sample.

RESEARCH DESIGN AND METHODS—This was a cross-sectional study. Data on diabetes and HbA_1c values were obtained by structured questionnaires and by laboratory assessments. Current psychiatric disorders were diagnosed by a modified version of the Composite International Diagnostic Interview (CIDI).

RESULTS—People with diabetes (PWD) were not more likely to meet Diagnostic and Statistical Manual of Psychiatric Disorders, 4th edition (DSM-IV) criteria for at least one mental disorder than were individuals without diabetes. However, a different diagnostic pattern occurred compared with the general population: odds ratios (ORs) for anxiety disorders in PWD were higher (OR 1.93, 95% CI 1.19–3.14). Although PWD had higher prevalence rates of affective disorders, the relationship between diabetes and affective disorders was not statistically significant after controlling for age, sex, marital status, and socioeconomic status. In contrast, the relationship between diabetes and anxiety disorders remained significant after controlling for these variables. In contrast to individuals without mental disorders, PWD with affective or anxiety disorders more frequently had adequate glycemic control.

CONCLUSIONS—Diabetes was associated with an increased likelihood of anxiety disorders. The association between mental disorders, diabetes, and glycemic control should be evaluated carefully in terms of potentially confounding sociodemographic variables, sample characteristics, and definitions of the disorders.

Abbreviations: CIDI, Composite International Diagnostic Interview • DSM-IV, Diagnostic and Statistical Manual of Psychiatric Disorders, 4th edition • GNHIES, German National Health Interview and Examination Survey • OR, odds ratio • PWD, people with diabetes

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