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Outcomes/Effectiveness Research

Individuals who suffer from both major depression and diabetes function worse than those with either illness alone

Individuals who suffer from both major depression and diabetes are less able to carry out routine daily living and social activities than patients with either problem alone, according to a study supported by the Agency for Healthcare Research and Quality (K08 HS11418). This is significant, especially given that about 10 percent of people with diabetes suffer from major depression.

Treatment for depression decreases functional disability. Thus, strategies to improve diagnosis and treatment of depression in diabetes patients are needed to decrease disability in this group, notes Leonard E. Egede, M.D., M.S., of the Medical University of South Carolina. Dr. Egede analyzed data from the 1999 National Health Interview Survey on 30,022 adults to compare the ability of four groups to perform 12 routine tasks without special equipment: those with no diabetes and no major depression, major depression alone, diabetes alone, and diabetes and major depression. Activities ranged from walking a quarter of a mile and standing for 2 hours to carrying a 10-pound bag of groceries and visiting friends.

After controlling for other factors affecting functioning, such as age, 25 percent of those with no diabetes or major depression were functionally disabled, compared with 51 percent of those with major depression, 58 percent of those with diabetes, and 78 percent of those with both diabetes and major depression. Individuals suffering from major depression were three times as likely to be functionally disabled as those without depression or diabetes. Those with diabetes were 2.5 times as likely, and those with diabetes and major depression were 6.15 times as likely to be functionally disabled as those without depression or diabetes. Additional studies are needed to establish a causal relationship.

See "Diabetes, major depression, and functional disability among U.S. adults," by Dr. Egede, in the February 2004 Diabetes Care 27(2), pp. 421-428.

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