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Depression and type 2 diabetes among Alaska Native primary care patients

TitleDepression and type 2 diabetes among Alaska Native primary care patients
Publication TypeJournal Article
Year of Publication2013
AuthorsDillard, DA, Robinson, RF, Smith, JJ, Khan, BA, Dubois, EW, Mau, MK
JournalEthn DisEthn Dis
Date PublishedWinter
ISBN Number1049-510X (Print)<br/>1049-510X (Linking)
Accession Number23495623
KeywordsAdolescent, Adult, Alaska, Depression/epidemiology/ ethnology, Diabetes Mellitus, Type 2/ complications/epidemiology/ ethnology, Female, Humans, Indians, North American, Logistic Models, Male, Middle Aged, Primary Health Care, Young Adult
AbstractOBJECTIVES: To assess whether type 2 diabetes mellitus (DM2) and DM2 complications are associated with presence and severity of depression among Alaska Native and American Indian people (AN/Als). DESIGN: Retrospective, cross-sectional analysis of medical records. SETTING: Southcentral Foundation Primary Care Center (SCF-PCC) in Anchorage, Alaska. PARTICIPANTS: Total of 23,529 AN/AI adults. PRIMARY OUTCOME MEASURES: Patient Health Questionnaire (PHQ) scores (0-9 negative, 10-14 mild, 15-19 moderate, 20+ severe) and DSM-IV depression diagnosis. RESULTS: DM2 prevalence was 6% (n=1,526). Of those with DM2, 19% (n = 292) had one or more DM2 complications and average HbAlc was 7.1%. Prevalence of depression diagnosis was similar between AN/Als with and without DM2 (P = .124). Among those screened for depression (n = 12,280), there were similar rates of PHQ severity between those without and with DM2; respectively 4% (n = 452) vs 4% (n = 42) mild, 4% (n = 404) vs 3% (n = 29) moderate, and 4% (n = 354) vs 4% (n = 38) severe. In multivariable logistic regression, DM2 was not associated with PHQ severity (OR 1.02, 95% CI 0.81-1.27) or depression diagnosis (OR 1.27, 95% CI 1.00-1.62). Increased odds of depression and higher depression severity were associated with female sex, younger age, being unmarried, substance abuse/dependence, and increased ambulatory visits. Depression was associated with number of other chronic conditions among AN/Als with DM2 but not with number of complications. CONCLUSIONS: Presence and severity of depression among AN/Al primary care patients was not significantly associated with DM2 nor DM2 complications, despite a slightly higher rate of depression diagnosis among those with DM2.
Ethno Med: