Table 4.
Risk of type 2 diabetes according to severe depressive symptoms (SDS) and antidepressant medication (ADM) use in the Nurses Health Studies (NHS). a
| No SDS | SDS | |||
|---|---|---|---|---|
| No ADM use | ADM use | No ADM use | ADM use | |
| NHS I (1996–2008)
| ||||
| Cases/person-years | 2810/478455 | 376/44980 | 128/18707 | 90/8520 |
| Crude incidence, per 1000 person-years | 5.87 | 8.36 | 6.84 | 10.56 |
| Age-adjusted model | 1.00 | 1.37 (1.23–1.52) | 1.20 (1.01–1.43) | 1.77 (1.43–2.18) |
| Multivariable-adjusted modelb | 1.00 | 1.18 (1.05–1.31) | 1.05 (0.88–1.26) | 1.38 (1.12–1.71) |
| Further adjusted for BMIc | 1.00 | 1.09 (0.97–1.21) | 1.10 (0.92–1.31) | 1.30 (1.05–1.61) |
|
| ||||
| NHS II (1993–2007)
| ||||
| Cases/person-years | 1107/573190 | 342/74137 | 162/61832 | 131/25689 |
| Crude incidence, per 1000 person-years | 1.93 | 4.61 | 2.62 | 5.10 |
| Age-adjusted model | 1.00 | 1.98 (1.75–2.24) | 1.48 (1.25–1.75) | 2.42 (2.02–2.90) |
| Multivariable-adjusted modelb | 1.00 | 1.44 (1.27–1.63) | 1.20 (1.02–1.42) | 1.37 (1.14–1.65) |
| Further adjusted for BMIc | 1.00 | 1.23 (1.08–1.39) | 1.17 (0.99–1.38) | 1.22 (1.01–1.47) |
| Pooled resultsd | ||||
| Final multivariate adjusted model | 1.00 | 1.15 (1.06–1.24) | 1.14 (1.01–1.28) | 1.25 (1.09–1.44) |
Abbreviations: BMI, body-mass index.
Severe depressive symptoms were defined as five-item Mental Health Index score 0–52.
Hazard ratios were adjusted for age (continuous), ethnicity (whites, non-whites), marital status (having spouse or not), living status (alone, with others), smoking status (never smoked, past smoker, current smoker), alcohol intake (0, 0.1–4.9, 5.0–14.9, ≥15.0 g/d in women, 0, 0.1–4.9, 5.0–29.9, ≥30.0 g/d in men), multivitamin and aspirin use (yes, no), physical activity (<3.0, 3.0–8.9, 9.0–17.9, 18.0–26.9, and ≥27.0 metabolic equivalent-hours/week), family history of diabetes, major comorbidities (history of hypertension, hypercholesterolemia, and their treatments), and quintile of dietary score. Among women, we also adjusted for menopausal status and hormone use, and oral contraceptive use (NHS II participants only).
Hazard ratios were further adjusted for BMI (<23.0, 23.0–24.9, 25.0–29.9, 30.0–34.9, and ≥35.0 kg/m2).
Results were pooled by fixed-effect models due to non-significant heterogeneity statistic (p for heterogeneity all >0.10).