Risk of depression in diabetes is highest for young persons using oral anti-diabetic agents

Abstract

Aims: Previous studies report an increased risk of depression in patients with diabetes, but there is little knowledge about if or how the risk varies according to sex, groups of age and different type of treatments for the diabetes. We therefore aimed to investigate the risk of depression in different types of treatment for diabetes and in subgroups of age and sex.

Methods: Data on the Norwegian population from 20 years of age being prescribed antidepressants (n = 253 668) and anti-diabetic agents (n = 121 392) in 2006 was obtained from the National Register of Prescriptions and analysed in a cross-sectional design.

Results: Individuals using insulin in monotherapy (n = 29 611) had an age- and sex-adjusted odds ratio of 1.47 (95% CI 1.42-1.53) for receiving antidepressants. Corresponding odds ratios for individuals receiving oral anti-diabetic agents in monotherapy (n = 76 387) and for those who received both insulin and oral anti-diabetic agents (n = 15 394) were 1.44 (95% CI 1.41-1.47) and 1.82 (95% CI 1.80-1.97), respectively. No major differences in risk according to age were found for persons receiving insulin in monotherapy, while a marked and inverse association between age and risk of receiving antidepressants was found for those receiving oral anti-diabetic agents. Highest risk of antidepressant treatment [odds ratio 4.15 (95% CI 3.12-5.52)] was found for patients receiving both oral anti-diabetic agents and insulin at 30-39 years. The risk was equally increased among men and women.

Conclusions: The risk of depression among patients with diabetes varies strongly according to age and type of treatment for diabetes.