Key result
Comorbid depression and diabetes linked to ~116% greater all-cause mortality risk versus having neither condition.
Why the study?
The study was conducted to investigate the risks of all-cause and cause-specific mortality among individuals with neither, one, or both diabetes and depression.
Does comorbid depression and diabetes increase the risk of all-cause and cause-specific mortality compared to either condition alone or neither condition in adults?
Cohort (n=499,830)
Yes
Does comorbid depression and diabetes increase the risk of all-cause and cause-specific mortality compared to either condition alone or neither condition in adults?
Comorbid depression and diabetes have a synergistic effect on increasing the risk of all-cause mortality, largely driven by cancer and non-circulatory causes.
Answers are grounded in this paper and cite their sources.
Supports integrated mental health screening in diabetes; extends observational data on synergistic risks but leaves causality open.
AIMS/HYPOTHESIS: The aim of this study was to investigate the risks of all-cause and cause-specific mortality among participants with neither, one or both of diabetes and depression in a large prospective cohort study in the UK. METHODS: Our study population included 499,830 UK Biobank participants without schizophrenia and bipolar disorder at baseline. Type 1 and type 2 diabetes and depression were identified using self-reported diagnoses, prescribed medication and hospital records. Mortality was identified from death records using the primary cause of death to define cause-specific mortality. We performed Cox proportional hazards models to estimate the risk of all-cause mortality and mortality from cancer, circulatory disease and causes of death other than circulatory disease or cancer among participants with either depression (n=41,791) or diabetes (n=22,677) alone and with comorbid diabetes and depression (n=3597) compared with the group with neither condition (n=431,765), adjusting for sociodemographic and lifestyle factors, comorbidities and history of CVD or cancer. We also investigated the interaction between diabetes and depression. RESULTS: During a median of 6.8 (IQR 6.1-7.5) years of follow-up, there were 13,724 deaths (cancer, n=7976; circulatory disease, n=2827; other causes, n=2921). Adjusted HRs of all-cause mortality and mortality from cancer, circulatory disease and other causes were highest among people with comorbid depression and diabetes (HRs 2.16 [95% CI 1.94, 2.42]; 1.62 [95% CI 1.35, 1.93]; 2.22 [95% CI 1.80, 2.73]; and 3.60 [95% CI 2.93, 4.42], respectively). The risks of all-cause, cancer and other mortality among those with comorbid depression and diabetes exceeded the sum of the risks due to diabetes and depression alone. CONCLUSIONS/INTERPRETATION: We confirmed that depression and diabetes individually are associated with an increased mortality risk and also identified that comorbid depression and diabetes have synergistic effects on the risk of all-cause mortality that are largely driven by deaths from cancer and causes other than circulatory disease and cancer.
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Prigge et al. (2022) conducted a cohort in Depression and Diabetes (n=499,830). Comorbid depression and diabetes vs. Neither depression nor diabetes was evaluated on All-cause mortality (HR 2.16, 95% CI 1.94-2.42). Comorbid depression and diabetes synergistically increased the risk of all-cause mortality by 116% compared to having neither condition.
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