The impact of diabetes on depression treatment outcomes

Charlene Bryan, Thomas Songer, Maria Mori Brooks, A. John Rush, Michael E. Thase, Bradley Gaynes, G. K. Balasubramani, Madhukar H. Trivedi, Maurizio Fava, Stephen R. Wisniewski

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background: Individuals with diabetes mellitus (DM) are two to four times more likely to be diagnosed with major depressive disorder (MDD). However, few controlled studies have examined the impact of DM on the treatment of MDD. Understanding the effect of DM on depressed patients could provide valuable clinical information toward adjusting current treatment modalities to produce a more effective treatment for depressed patients with DM. Methods: This study was conducted using an evaluable sample of 2876 outpatient participants enrolled in the Sequenced Treatment Alternatives to Relieve Depression study. Sociodemographic and clinical characteristics and treatment characteristics with the selective serotonin reuptake inhibitor (SSRI) citalopram, as well as remission rates for MDD and time to remission, were compared between participants with DM and participants without DM. Results: The odds of remission were lower in participants with DM than in those without DM prior to adjustment [odds ratio (OR)=0.68; 95% confidence interval (95% CI)=(0.49, 0.94); P=.0184]. These differences were no longer present after adjustment [OR=0.92; 95% CI=(0.64, 1.32); P=.6399]. Participants with DM reported fewer side effects than participants without DM despite similar dosing. Conclusions: Depressed patients with DM and depressed patients without DM appear to have similar rates of MDD remission, indicating that a diagnosis of DM per se has no impact on MDD remission. The findings of fewer side effects and psychiatric serious adverse events in participants with DM imply that depressed patients with DM may be excellent candidates for more aggressive SSRI dosing. This lower prevalence of side effects reported by depressed participants with DM warrants further exploration.

Original languageEnglish (US)
Pages (from-to)33-41
Number of pages9
JournalGeneral Hospital Psychiatry
Volume32
Issue number1
DOIs
StatePublished - Jan 2010

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Diabetes Mellitus
Depression
Major Depressive Disorder
Social Adjustment
Serotonin Uptake Inhibitors
Odds Ratio
Confidence Intervals
Therapeutics
Citalopram
Psychiatry
Outpatients

Keywords

  • Depression
  • Diabetes
  • Remission

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Bryan, C., Songer, T., Brooks, M. M., Rush, A. J., Thase, M. E., Gaynes, B., ... Wisniewski, S. R. (2010). The impact of diabetes on depression treatment outcomes. General Hospital Psychiatry, 32(1), 33-41. https://doi.org/10.1016/j.genhosppsych.2009.07.009

The impact of diabetes on depression treatment outcomes. / Bryan, Charlene; Songer, Thomas; Brooks, Maria Mori; Rush, A. John; Thase, Michael E.; Gaynes, Bradley; Balasubramani, G. K.; Trivedi, Madhukar H.; Fava, Maurizio; Wisniewski, Stephen R.

In: General Hospital Psychiatry, Vol. 32, No. 1, 01.2010, p. 33-41.

Research output: Contribution to journalArticle

Bryan, C, Songer, T, Brooks, MM, Rush, AJ, Thase, ME, Gaynes, B, Balasubramani, GK, Trivedi, MH, Fava, M & Wisniewski, SR 2010, 'The impact of diabetes on depression treatment outcomes', General Hospital Psychiatry, vol. 32, no. 1, pp. 33-41. https://doi.org/10.1016/j.genhosppsych.2009.07.009
Bryan C, Songer T, Brooks MM, Rush AJ, Thase ME, Gaynes B et al. The impact of diabetes on depression treatment outcomes. General Hospital Psychiatry. 2010 Jan;32(1):33-41. https://doi.org/10.1016/j.genhosppsych.2009.07.009
Bryan, Charlene ; Songer, Thomas ; Brooks, Maria Mori ; Rush, A. John ; Thase, Michael E. ; Gaynes, Bradley ; Balasubramani, G. K. ; Trivedi, Madhukar H. ; Fava, Maurizio ; Wisniewski, Stephen R. / The impact of diabetes on depression treatment outcomes. In: General Hospital Psychiatry. 2010 ; Vol. 32, No. 1. pp. 33-41.
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AU - Rush, A. John

AU - Thase, Michael E.

AU - Gaynes, Bradley

AU - Balasubramani, G. K.

AU - Trivedi, Madhukar H.

AU - Fava, Maurizio

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N2 - Background: Individuals with diabetes mellitus (DM) are two to four times more likely to be diagnosed with major depressive disorder (MDD). However, few controlled studies have examined the impact of DM on the treatment of MDD. Understanding the effect of DM on depressed patients could provide valuable clinical information toward adjusting current treatment modalities to produce a more effective treatment for depressed patients with DM. Methods: This study was conducted using an evaluable sample of 2876 outpatient participants enrolled in the Sequenced Treatment Alternatives to Relieve Depression study. Sociodemographic and clinical characteristics and treatment characteristics with the selective serotonin reuptake inhibitor (SSRI) citalopram, as well as remission rates for MDD and time to remission, were compared between participants with DM and participants without DM. Results: The odds of remission were lower in participants with DM than in those without DM prior to adjustment [odds ratio (OR)=0.68; 95% confidence interval (95% CI)=(0.49, 0.94); P=.0184]. These differences were no longer present after adjustment [OR=0.92; 95% CI=(0.64, 1.32); P=.6399]. Participants with DM reported fewer side effects than participants without DM despite similar dosing. Conclusions: Depressed patients with DM and depressed patients without DM appear to have similar rates of MDD remission, indicating that a diagnosis of DM per se has no impact on MDD remission. The findings of fewer side effects and psychiatric serious adverse events in participants with DM imply that depressed patients with DM may be excellent candidates for more aggressive SSRI dosing. This lower prevalence of side effects reported by depressed participants with DM warrants further exploration.

AB - Background: Individuals with diabetes mellitus (DM) are two to four times more likely to be diagnosed with major depressive disorder (MDD). However, few controlled studies have examined the impact of DM on the treatment of MDD. Understanding the effect of DM on depressed patients could provide valuable clinical information toward adjusting current treatment modalities to produce a more effective treatment for depressed patients with DM. Methods: This study was conducted using an evaluable sample of 2876 outpatient participants enrolled in the Sequenced Treatment Alternatives to Relieve Depression study. Sociodemographic and clinical characteristics and treatment characteristics with the selective serotonin reuptake inhibitor (SSRI) citalopram, as well as remission rates for MDD and time to remission, were compared between participants with DM and participants without DM. Results: The odds of remission were lower in participants with DM than in those without DM prior to adjustment [odds ratio (OR)=0.68; 95% confidence interval (95% CI)=(0.49, 0.94); P=.0184]. These differences were no longer present after adjustment [OR=0.92; 95% CI=(0.64, 1.32); P=.6399]. Participants with DM reported fewer side effects than participants without DM despite similar dosing. Conclusions: Depressed patients with DM and depressed patients without DM appear to have similar rates of MDD remission, indicating that a diagnosis of DM per se has no impact on MDD remission. The findings of fewer side effects and psychiatric serious adverse events in participants with DM imply that depressed patients with DM may be excellent candidates for more aggressive SSRI dosing. This lower prevalence of side effects reported by depressed participants with DM warrants further exploration.

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