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Cardiovascular and diabetes
O2-4.6 The bi-directional relationships between diabetes mellitus and depression: evidence from two cohort studies based on the same population
  1. C Y Li1,
  2. Y T Chan1
  1. 1National Cheng Kung University, Tainan, Taiwan
  2. 2National Taipei University of Nursing and Health Sciences, Taipei, Taiwan


Introduction It has been argued that the relationship between depression and diabetes is bi-directional, but this hypothesis has not been explicitly tested. We conducted two separate cohort studies, based on Taiwan's National Health Insurance claims, to determine the bi-directional prospective relationships between depression and type 2 diabetes.

Methods The first cohort analysis identified all 390 011 diabetic patients in 2000 and the same number of randomly selected non-diabetic beneficiaries. The second cohort analysis identified 5847 depressive patients and a random sample of non-depressive beneficiaries of the same number in 2000. The subsequent information on incident depression and diabetes was retrieved from ambulatory cares from 2000 to 2006. We evaluated the age-and sex-specific relative hazards of depression/diabetes in relation to diabetes/depression with Cox proportional hazard regression model adjusted for potential confounders.

Results The first cohort analysis noted a covariate adjusted HR of 1.43 (95% CI 1.38 to 1.48) for incident depression among diabetes. The second cohort analysis noted that the depressive patients experienced significantly elevated HR (2.02, 95% CI 1.80 to 2.27) for incident diabetes.

Conclusion The two cohort studies provided support for the bi-directional prospective relationships between diabetes and depression, with a stronger association noted for the depression predicting onset of diabetes. We also noted that the bi-directional relationships were most obvious in younger (<35 years) patients, regardless of gender.

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