The association between diabetes mellitus and incidence of depressive episodes is different based on sex: insights from ELSA-Brasil

Elizabeth Leite Barbosa; Arlinda B Moreno; Eelco Van Duinkerken; Paulo Lotufo; Sandhi Maria Barreto; Luana Giatti; Maria Angélica Nunes; Maria Carmen Viana; Roberta Figueiredo; Dóra Chor; Rosane Harter Griep

doi:10.1177/20420188221093212

The association between diabetes mellitus and incidence of depressive episodes is different based on sex: insights from ELSA-Brasil

Ther Adv Endocrinol Metab. 2022 Apr 17:13:20420188221093212. doi: 10.1177/20420188221093212. eCollection 2022.

Affiliations

¹ National School of Public Health Sérgio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
² Paulo Niemeyer State Brain Institute, Rio de Janeiro, Brazil.
³ University of São Paulo, Cidade Universitária, São Paulo, Brazil.
⁴ Medical School & Clinical Hospital, Federal University of Minas Gerais, Belo Horizonte, Brazil.
⁵ Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
⁶ Federal University of Espírito Santo, Vitória, Brazil.
⁷ Federal University of São João Del-Rei, São João Del-Rei, Brazil.
⁸ Laboratory of Health and Environment Education, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Av. Brasil, 4365, Campus Fiocruz - Manguinhos, Rio de Janeiro 21040-360, Brazil.

Abstract

Objective: To investigate the association between diabetes mellitus (DM) and incidence of depressive episodes among men and women.

Methods: Data were used from 12,730 participants (5866 men and 6864 women) at baseline (2008-2010) and follow-up 1 (2012-2014) of the Longitudinal Study of Adult Health (ELSA-Brasil), a multicenter cohort of Brazilian civil servants. Participants were classified for diabetes using self-reported and clinical information, and evaluated for presence of depressive episodes by the Clinical Interview Schedule-Revised (CIS-R). Associations were estimated by means of logistic regression models (crude and adjusted for socio-demographic variables).

Results: Women classified as with DM prior to the baseline were at 48% greater risk (95% confidence interval (CI) = 1.03-2.07) of depressive episodes in the crude model and 54% greater risk (95% CI = 1.06-2.19) in the final adjusted model compared to women classified as non-DM. No significant associations were observed for men. The regression models for duration of DM and incidence of depressive episodes (n = 2143 participants; 1160 men and 983 women) returned no significant associations.

Conclusion: In women classified as with prior DM, the greater risk of depressive episodes suggests that more frequent screening for depression may be beneficial as part of a multi-factorial approach to care for DM.

Keywords: cohort studies; depression; diabetes mellitus.