Prevalence, awareness, treatment, and control of diabetes mellitus by depressive symptom severity: a cross-sectional analysis of NHANES 2011–2016

Introduction Despite extensive studies on the relationship between diabetes mellitus (DM) and depression, the associations of depressive symptom severity with prevalence, awareness, treatment, and control of diabetes remain unclear. We aimed to investigate changes in these outcomes of diabetes as de...

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Main Authors: Yun Hwan Oh, Sang Min Park, Joung Sik Son, Jaewon Lee, Kyae Hyung Kim, Joseph C Ahn, Jihoon Andrew Kim, Gyeongsil Lee, Soo Jung Choi
Format: Article
Language:English
Published: BMJ Publishing Group 2021-03-01
Series:BMJ Open Diabetes Research & Care
Online Access:https://drc.bmj.com/content/9/1/e002268.full
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author Yun Hwan Oh
Sang Min Park
Joung Sik Son
Jaewon Lee
Kyae Hyung Kim
Joseph C Ahn
Jihoon Andrew Kim
Gyeongsil Lee
Soo Jung Choi
author_facet Yun Hwan Oh
Sang Min Park
Joung Sik Son
Jaewon Lee
Kyae Hyung Kim
Joseph C Ahn
Jihoon Andrew Kim
Gyeongsil Lee
Soo Jung Choi
author_sort Yun Hwan Oh
collection DOAJ
description Introduction Despite extensive studies on the relationship between diabetes mellitus (DM) and depression, the associations of depressive symptom severity with prevalence, awareness, treatment, and control of diabetes remain unclear. We aimed to investigate changes in these outcomes of diabetes as depressive symptoms aggravate.Research design and methods We conducted a cross-sectional analysis of 14 328 participants in the 2011–2016 National Health and Nutrition Examination Survey. Participants were classified into depressive symptom groups of none, mild, moderate, moderately severe, and severe depending on their Patient Health Questionnaire-9 scores. Multivariate logistic regression analyses were conducted in three models adjusted for expanding confounders to evaluate the associations between severity of depressive symptoms and prevalence, awareness, treatment, and control of DM.Results As depressive symptom severity worsened, both prevalence and awareness of DM increased regardless of models (p value for trend <0.01 in all models for prevalence and awareness; adjusted OR (aOR) 2.14, 95% CI 1.29 to 3.56 for prevalence in the severe group, model 1; aOR 2.43, 95% CI 1.27 to 4.64 for awareness in the moderately severe group, model 1). Notwithstanding higher awareness of diabetes in the moderately severe and severe groups (84.5% and 86.2%, respectively, vs 71.3% in the none group), these groups were treated less (aOR 0.25, 95% CI 0.11 to 0.55 in the severe group, model 3) or inadequately controlled (aOR 0.51, 95% CI 0.27 to 0.98 in the moderately severe group, model 3).Conclusions The gap between patients’ higher awareness and lower treatment rate or control of diabetes among individuals with severe depressive symptoms highlights the unmet needs for postdiagnostic multidisciplinary care for patients with comorbid depression and DM.
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spelling doaj-art-2d7b5555aba64ac3b6ef134e4b5a0eda2025-08-20T02:34:33ZengBMJ Publishing GroupBMJ Open Diabetes Research & Care2052-48972021-03-019110.1136/bmjdrc-2021-002268Prevalence, awareness, treatment, and control of diabetes mellitus by depressive symptom severity: a cross-sectional analysis of NHANES 2011–2016Yun Hwan Oh0Sang Min Park1Joung Sik Son2Jaewon Lee3Kyae Hyung Kim4Joseph C Ahn5Jihoon Andrew Kim6Gyeongsil Lee7Soo Jung Choi8Department of Family Medicine, School of Medicine, Jeju National University, Jeju, Republic of KoreaDepartment of Family Medicine, Seoul National University Hospital, Jongno-gu, Korea (the Republic of)Department of Family Medicine, Korea University Guro Hospital, Seoul, Korea (the Republic of)Department of Biomedical Sciences, Seoul National University Hospital, Seoul, Korea (the Republic of)Department of Family Medicine, Seoul National University Hospital, Seoul, Korea (the Republic of)Division of Gastroenterology and Hepatology, Mayo Clinic in Rochester, Rochester, Minnesota, USADepartment of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USADepartment of Family Medicine, Seoul National University Hospital, Seoul, Korea (the Republic of)Department of Family Medicine, Gachon University Gil Medical Center, Incheon, Korea (the Republic of)Introduction Despite extensive studies on the relationship between diabetes mellitus (DM) and depression, the associations of depressive symptom severity with prevalence, awareness, treatment, and control of diabetes remain unclear. We aimed to investigate changes in these outcomes of diabetes as depressive symptoms aggravate.Research design and methods We conducted a cross-sectional analysis of 14 328 participants in the 2011–2016 National Health and Nutrition Examination Survey. Participants were classified into depressive symptom groups of none, mild, moderate, moderately severe, and severe depending on their Patient Health Questionnaire-9 scores. Multivariate logistic regression analyses were conducted in three models adjusted for expanding confounders to evaluate the associations between severity of depressive symptoms and prevalence, awareness, treatment, and control of DM.Results As depressive symptom severity worsened, both prevalence and awareness of DM increased regardless of models (p value for trend <0.01 in all models for prevalence and awareness; adjusted OR (aOR) 2.14, 95% CI 1.29 to 3.56 for prevalence in the severe group, model 1; aOR 2.43, 95% CI 1.27 to 4.64 for awareness in the moderately severe group, model 1). Notwithstanding higher awareness of diabetes in the moderately severe and severe groups (84.5% and 86.2%, respectively, vs 71.3% in the none group), these groups were treated less (aOR 0.25, 95% CI 0.11 to 0.55 in the severe group, model 3) or inadequately controlled (aOR 0.51, 95% CI 0.27 to 0.98 in the moderately severe group, model 3).Conclusions The gap between patients’ higher awareness and lower treatment rate or control of diabetes among individuals with severe depressive symptoms highlights the unmet needs for postdiagnostic multidisciplinary care for patients with comorbid depression and DM.https://drc.bmj.com/content/9/1/e002268.full
spellingShingle Yun Hwan Oh
Sang Min Park
Joung Sik Son
Jaewon Lee
Kyae Hyung Kim
Joseph C Ahn
Jihoon Andrew Kim
Gyeongsil Lee
Soo Jung Choi
Prevalence, awareness, treatment, and control of diabetes mellitus by depressive symptom severity: a cross-sectional analysis of NHANES 2011–2016
BMJ Open Diabetes Research & Care
title Prevalence, awareness, treatment, and control of diabetes mellitus by depressive symptom severity: a cross-sectional analysis of NHANES 2011–2016
title_full Prevalence, awareness, treatment, and control of diabetes mellitus by depressive symptom severity: a cross-sectional analysis of NHANES 2011–2016
title_fullStr Prevalence, awareness, treatment, and control of diabetes mellitus by depressive symptom severity: a cross-sectional analysis of NHANES 2011–2016
title_full_unstemmed Prevalence, awareness, treatment, and control of diabetes mellitus by depressive symptom severity: a cross-sectional analysis of NHANES 2011–2016
title_short Prevalence, awareness, treatment, and control of diabetes mellitus by depressive symptom severity: a cross-sectional analysis of NHANES 2011–2016
title_sort prevalence awareness treatment and control of diabetes mellitus by depressive symptom severity a cross sectional analysis of nhanes 2011 2016
url https://drc.bmj.com/content/9/1/e002268.full
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