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A Descriptive and Comparative Study of the Prevalence of Depressive and Anxiety Disorders in Low-Income Adults With Type 2 Diabetes and Other Chronic Illnesses

¹ Mayo Clinic, Nicotine Dependence Center, Rochester, Minnesota
² Louisiana State University Medical Center, Baton Rouge, Louisiana
³ University of Alabama at Birmingham, Birmingham, Alabama
⁴ Louisiana State University, Pennington Biomedical Research Center, Baton Rouge, Louisiana

Address correspondence and reprint requests to Janet Thomas, PhD, Mayo Clinic, Nicotine Dependence Center, 200 First St., SW, Rochester, MN 55905. E-mail: thomas.janet{at}mayo.edu

OBJECTIVE—To determine whether type 2 diabetes contributes to the presence of depressive and anxiety disorder diagnoses in low-income adults with hypertension, asthma, and/or arthritis.

RESEARCH DESIGN AND METHODS—Using a cross-sectional design, this study administered a structured diagnostic interview to low-income primary care patients diagnosed with type 2 diabetes, hypertension, arthritis, and asthma, as well as to those with no chronic illness (n = 326), to determine the 12-month prevalence of depressive and anxiety disorders. A logistic regression (LR) model was used to assess whether a diagnosis of depression and/or anxiety was associated with type 2 diabetes after adjusting for known risk factors.

RESULTS—A high prevalence rate of depressive and/or anxiety disorders was found in the total sample (29%) and in all three illness groups: type 2 diabetes (36%), other chronic illnesses (24%), and no chronic illness (31%). Using LR, a main effect was detected for illness group when age and education were controlled (² = 22.66, df 4, P = 0.000). Specifically, the odds of occurrence of a depressive and/or anxiety disorder in those with comorbid type 2 diabetes were twice that in the nondiabetic, chronically ill comparison group (odds ratio 2.26, 95% CI 1.28–4.01, P = 0.005).

CONCLUSIONS—These results suggest a positive contribution of type 2 diabetes to increased rates of depressive and/or anxiety disorders in patients with hypertension, asthma, and/or arthritis and support prior research that type 2 diabetes may serve as an indicator of depression and anxiety in low-income adults treated in primary care clinics.

Abbreviations: DIS-IV, Diagnostic Interview Schedule for Diagnostic and Statistical Manual of Mental Disorders-IV • DSM-IV, Diagnostic and Statistical Manual of Mental Disorders-IV • LR, logistic regression

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