What is the clinical evidence from this study?

Study design: Cohort. Population: Type 2 diabetes (n=338). Intervention: Prior major depressive disorder vs. No prior major depressive disorder. Primary outcome: Diagnosis of major depressive disorder (MDD) at 9 or 18 months (OR 4.19, 95% CI 1.79-9.79, p=0.001).

March 1, 2011The Annals of Family MedicineOpen Access

Patients With Type 2 Diabetes at Risk for Major Depressive Disorder Over Time

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Key result

Prior major depressive disorder (OR 4.19) and higher baseline negative affect (OR 1.09) significantly and independently predicted the development of major depressive disorder over 18 months in patients with type 2 diabetes.

Why the study?

What are the risk factors associated with the development of major depressive disorder (MDD) among patients with type 2 diabetes over time?

Population

338 adult patients with type 2 diabetes for at least 12 months, aged 21 to 75 years, with no major…

Design

Cohort

Follow-up

18 months

Authors

DNDiana NaranjoOregon Medical Research Center LFLawrence FisherRutgers, The State University of New Jersey PAP. A. AreanUniversity of California, San Francisco

Discussion

Member takes

Implication

May inform MDD screening in type 2 diabetes; hypothesis-generating and requires validation before practice change.

Study Design

Type

Cohort (n=338)

Multicenter

Yes

Structured PICO

What are the risk factors associated with the development of major depressive disorder (MDD) among patients with type 2 diabetes over time?

Population

338 adults aged 21 to 75 years with type 2 diabetes and no major depressive disorder at baseline, followed for 18 months to identify predictors of developing MDD.

Exposure

Noninterventional assessment of personal, behavioral, biologic, and psychosocial variables as predictors of MDD.

Outcome

Development of major depressive disorder (MDD) at 9 or 18 months, measured by the Composite International Diagnostic Interview (CIDI).

Main Result

Odds Ratio: 4.19 (95% CI 1.79–9.79)

p-value: p=0.001

In patients with type 2 diabetes, baseline negative affect and prior MDD strongly predict future MDD, while negative life events and poor glycemic control also contribute in stratified subgroups.

Limitations

Modest sample size limiting power to detect associations between some variables and developing MDD
18-month follow-up period may not have been long enough to capture a sufficiently large group of patients that developed MDD
Modest effect sizes
Little power to detect differential predictors of MDD at 9 and 18 months in subgroups due to small sample size
Sample of modest size for the relatively large number of predictors explored
Little power to detect differential predictors of MDD at 9 and 18 months after baseline in subgroups due to small sample size

Cite This Study

Naranjo et al. (2011) conducted a cohort in Type 2 diabetes (n=338). Prior major depressive disorder vs. No prior major depressive disorder was evaluated on Diagnosis of major depressive disorder (MDD) at 9 or 18 months (OR 4.19, 95% CI 1.79-9.79, p=0.001). Prior major depressive disorder (OR 4.19) and higher baseline negative affect (OR 1.09) significantly and independently predicted the development of major depressive disorder over 18 months in patients with type 2 diabetes.

synapsesocial.com/papers/6ab86ee419c093df746fa601 https://doi.org/10.1370/afm.1212

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Patients With Type 2 Diabetes at Risk for Major Depressive Disorder Over Time

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Patients With Type 2 Diabetes at Risk for Major Depressive Disorder Over Time

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider