Elevated Depressive Symptoms, Antidepressant Use, and Diabetes in a Large Multiethnic National Sample of Postmenopausal Women
- Yunsheng Ma, MD, PHD1⇓,
- Raji Balasubramanian, SCD2,
- Sherry L. Pagoto, PHD1,
- Kristin L. Schneider, PHD1,
- Annie L. Culver, BPHARM3,
- Barbara Olendzki, RD, MPH1,
- Lesley Tinker, RD, PHD4,
- Simin Liu, MD, SCD5,
- Monika Safford, MD6,
- Deidre M. Sepavich, MBA1,
- Milagros C. Rosal, PHD1,
- Judith K. Ockene, PHD, MED, MA1,
- Mercedes Carnethon, PHD7,
- Martha Zorn, MS2 and
- James R. Hébert, MSPH, SCD8
- 1Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
- 2Division of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, Massachusetts
- 3Rochester Methodist Hospital, Mayo Clinic, Rochester, Minnesota
- 4Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
- 5Department of Epidemiology, University of California, Los Angeles School of Public Health, Los Angeles, California
- 6Division of Preventive Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama
- 7Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- 8Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- Corresponding author: Yunsheng Ma, yunsheng.ma{at}umassmed.edu.
Abstract
OBJECTIVE To examine elevated depressive symptoms and antidepressant use in relation to diabetes incidence in the Women’s Health Initiative.
RESEARCH DESIGN AND METHODS A total of 161,808 postmenopausal women were followed for over an average of 7.6 years. Hazard ratios (HRs) estimating the effects of elevated depressive symptoms and antidepressant use on newly diagnosed incident diabetes were obtained using Cox proportional hazards models adjusted for known diabetes risk factors.
RESULTS Multivariable-adjusted HRs indicated an increased risk of incident diabetes with elevated baseline depressive symptoms (HR 1.13 [95% CI 1.07–1.20]) and antidepressant use (1.18 [1.10–1.28]). These associations persisted through year 3 data, in which respective adjusted HRs were 1.23 (1.09–1.39) and 1.31 (1.14–1.50).
CONCLUSIONS Postmenopausal women with elevated depressive symptoms who also use antidepressants have a greater risk of developing incident diabetes. In addition, longstanding elevated depressive symptoms and recent antidepressant medication use increase the risk of incident diabetes.
Footnotes
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This article contains Supplementary Data online at http://care.diabetesjournals.org/lookup/suppl/doi:10.2337/dc11-1223/-/DC1.
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The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the National Institute of Diabetes and Digestive and Kidney Diseases.
- Received June 28, 2011.
- Accepted August 8, 2011.
- © 2011 by the American Diabetes Association.
Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
