Depressive Symptoms and Risk of Type 2 Diabetes in Women

  1. Cassandra Arroyo, MS, PHD1,
  2. Frank B. Hu, MD, PHD26,
  3. Louise M. Ryan, PHD13,
  4. Ichiro Kawachi, MD, PHD46,
  5. Graham A. Colditz, MD, DRPH56,
  6. Frank E. Speizer, MD56 and
  7. JoAnn Manson, MD, DRPH56
  1. 1Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts
  2. 2Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts
  3. 3Dana-Farber Cancer Institute, Boston, Massachusetts
  4. 4Department of Health and Social Behavior, Harvard School of Public Health, Boston, Massachusetts
  5. 5Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
  6. 6Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, and Harvard Medical School, Boston, Massachusetts
  1. Address correspondence reprint requests to Cassandra Arroyo, Social Epidemiology Research Division, Morehouse School of Medicine, 720 Westview Dr. SW, NCPC Room 313, Atlanta, GA 30310. E-mail: carroyo{at}msm.edu

Abstract

OBJECTIVE—To explore the relationship between depressive symptoms and incidence of type 2 diabetes in women.

RESEARCH DESIGN AND METHODS—We conducted an analysis of 72,178 female nurses aged 45–72 years who did not have diagnosed diabetes and who answered the Medical Outcomes Study 36-Item Short-Form Health Status Survey (SF-36) at baseline in 1992. We calculated relative risks (RR) of type 2 diabetes for women with presence of depressive symptoms (i.e., Five-Item Mental Health Index [MHI-5] score >52).

RESULTS—During 4 years of follow-up (282,317 person-years), 973 incident cases of type 2 diabetes were documented. Age-adjusted RR of developing type 2 diabetes for women with presence of depressive symptoms was 1.55 (95% CI 1.27–1.90). Additional adjustment for BMI resulted in a RR of developing type 2 diabetes of 1.36 (1.11–1.67). The multivariate RR of developing type 2 diabetes was 1.22 (1.00–1.50). After excluding women diagnosed with diabetes between 1992 and 1994, 472 incident cases of type 2 diabetes were documented for the follow-up period from 1994 to 1996 (148,889 person-years). The multivariate RR of developing type 2 diabetes for women with depressive symptoms was 1.29 (0.96–1.72).

CONCLUSIONS—Our data suggest that depressive symptoms are associated with a modest increase in the risk of type 2 diabetes.

Footnotes

  • A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    • Accepted October 4, 2003.
    • Received June 5, 2003.
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