Depression and incident diabetic retinopathy: a prospective cohort study

作者：Sieu Nida^*; Katon Wayne; Lin Elizabeth H B; Russo Joan; Ludman Evette; Ciechanowski Paul

来源：General Hospital Psychiatry, 2011, 33(5): 429-435.

DOI：10.1016/j.genhosppsych.2011.05.021

• Depression
• Type 2 diabetes
• Diabetic retinopathy
• Microvascular complications
• Epidemiologic study

Objective: This study examined whether depression is associated with a higher incidence of diabetic retinopathy among adults with type 2 diabetes after controlling for sociodemographic factors, health risk behaviors and clinical characteristics.
Method: This study included 2359 patients enrolled in Pathways Epidemiologic Follow-Up Study, a prospective cohort study investigating the impact of depression in primary care patients with type 2 diabetes. The predictor of interest was baseline severity of depressive symptoms assessed with the Patient Health Questionnaire-9 (PHQ-9). The outcome was incident diabetic retinopathy. Risk of diabetic retinopathy was assessed using logistic regression, and time to incident diabetic retinopathy was examined using Cox proportional hazard models.
Results: Over a 5-year follow-up period, severity of depression was associated with an increased risk of incident retinopathy [odds ratio = 1.026; 95% confidence interval (Cl) 1.002-1.051] as well as time to incident retinopathy (hazard ratio=1.025; 95% Cl 1.009-1.041). The risk of incident diabetic retinopathy was estimated to increase by up to 15% for every significant increase in depressive symptoms severity (5-point increase on the PHQ-9 score).
Conclusion: Diabetic patients with comorbid depression have a significantly higher risk of developing diabetic retinopathy. Improving depression treatment in patients with diabetes could contribute to diabetic retinopathy prevention.

• 出版日期2011-10