Antidepressant Use Before and After the Diagnosis of Type 2 Diabetes: A Longitudinal Modeling Study

  1. Jussi Vahtera, MD, PHD1,9
  1. From the 1Department of Epidemiology and Public Health, University College London, London, UK
  2. the 2Finnish Institute of Occupational Health, Helsinki, Finland
  3. the 3 1st Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Hungary
  4. the 4Medical Research Council Centre for Causal Analyses in Translational Epidemiology, University of Bristol, Bristol, UK
  5. the 5Medical Research Council Social & Public Health Sciences Unit, University of Glasgow, Glasgow and Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh, UK
  6. 6 U1018 INSERM, AP-HP, Paris, France
  7. the 7Department of Psychology, University of Helsinki, Helsinki, Finland
  8. 8Steno Diabetes Center, Gentofte, Denmark
  9. 9University of Turku and Turku University Hospital, Turku, Finland


Objective: To examine antidepressant use before and after the diagnosis of diabetes.

Research Design and Methods: Longitudinal analysis of diabetic and non-diabetic groups selected from a prospective cohort study of 151,618 men and women in Finland (the Finnish Public Sector Study, 1995-2005). We analyzed the use of antidepressants in those 493 individuals who developed type 2 diabetes and their 2450 matched non-diabetic controls for each year during a period covering 4 years before and 4 years after the diagnosis. For comparison, we undertook a corresponding analysis on 748 individuals who developed cancer and their 3730 matched controls.

Results: In multilevel longitudinal models, odds ratio for antidepressant use in those who develop diabetes was 2.00 (95% CI 1.57-2.55) times greater compared to that in non-diabetics. The relative difference in antidepressant use between these groups was similar before and after the diabetes diagnosis except for a temporary peak in antidepressant use at the year of the diagnosis (OR=2.66, 95% CI 1.94-3.65). In incident cancer cases, antidepressant use substantially increased after the cancer diagnosis, demonstrating that our analysis was sensitive in detecting long-term changes in antidepressant trajectories when they existed.

Conclusions: Awareness of the diagnosis of type 2 diabetes may temporarily increase risk of depressive symptoms. Further research is needed to determine whether more prevalent use of antidepressants noted before the diagnosis of diabetes relates to effects of depression, side-effects of antidepressant use or a common causal pathway for depression and diabetes.