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Biopsychosocial factors associated with a current depressive episode in diabetes: the ELSA-Brasil study.

ABSTRACT: AIMS:Depression is more prevalent in people with diabetes, and is associated with worse diabetes outcomes. Depression in diabetes is more treatment resistant, and as underlying mechanisms are unknown, development of more effective treatment strategies is complicated. A biopsychosocial model may improve our understanding of the pathophysiology, and therewith help improving treatment options. METHODS:Diabetes was diagnosed according to American Diabetes Association (ADA) criteria and a current depressive episode according to the International Classification of Diseases (ICD-10), based on the Clinical Interview Schedule Revised (CIS-R). From the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), we included 455 participants without diabetes with a current depressive episode and 10 900 without either diabetes or a current depressive episode. Furthermore, 2183 participants had diabetes alone and 106 had both diabetes and a current depressive episode. Variable selection was based on their relationship with depression and/or diabetes. Multinomial multivariate logistic regression was used to determine how the models differed between participants with and without diabetes. RESULTS:A current depressive episode in diabetes was related to being older and female, having poorer education, financial problems, experiencing discrimination at work, home and school, higher waist circumference, albumin to creatinine ratio and insulin resistance, and the presence of hypertension and cardiovascular disease. In non-diabetes, a current depressive disorder was related to being female, not being black, low income, psychological and social factors, non-current alcohol use, lower HDL cholesterol, higher insulin resistance and the presence of cardiovascular disease. CONCLUSIONS:A current depressive episode in the presence compared with the absence of diabetes was related more to biological than to psychosocial factors.

SUBMITTER: van Duinkerken E

PROVIDER: S-EPMC7540479 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Biopsychosocial factors associated with a current depressive episode in diabetes: the ELSA-Brasil study.

van Duinkerken E E Moreno A B AB Eto F N FN Lotufo P P Barreto S M SM Giatti L L Viana M C MC Nunes M A MA Chor D D Griep R H RH

Diabetic medicine : a journal of the British Diabetic Association 20200714 10

<h4>Aims</h4>Depression is more prevalent in people with diabetes, and is associated with worse diabetes outcomes. Depression in diabetes is more treatment resistant, and as underlying mechanisms are unknown, development of more effective treatment strategies is complicated. A biopsychosocial model may improve our understanding of the pathophysiology, and therewith help improving treatment options.<h4>Methods</h4>Diabetes was diagnosed according to American Diabetes Association (ADA) criteria an ...[more]

PMID: 32580244

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Project description:BackgroundPrevention and reduction of excessive use of alcohol represents damages to society in general. In turn, arterial hypertension is the main attributable risk factor premature life lost years and disability.ObjectiveTo investigate the relationship between alcohol consumption and high blood pressure in participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).MethodologyA baseline data of total of 7,655 participants volunteers between 35 and 74 years of age, of both genders, in six educational and research institutions of three different regions of the country were interviewed between 2008-2010. Socioeconomic, haemodynamic, anthropometric and health data were collected in the research centers of ELSA-Brasil. The presence of high blood pressure was identified when the systolic blood pressure was ≥140 mm Hg and/or the diastolic was ≥90 mm Hg. Alcohol consumption was estimated and categorized regarding consumption and pattern of ingestion. The Student's t-test, chi-squared and logistic regression tests were used for analysis, including potential co-variables of the model, and a 5% significance level was adopted.ResultsA dose-response relation was observed for the consumption of alcohol (g/week) in systolic blood pressure and diastolic blood pressure. Alcohol consumption was associated with high blood pressure in men who reported moderate (OR = 1.69; 95%CI 1.35-2.11) and excessive (OR = 2.70; 95%CI 2.04-3.59) consumption. Women have nearly three times more chance of presenting elevated blood pressure when presenting excessive consumption (OR = 2.86, 95%CI 1.77-4.63), and binge drinkers who drink more than 2 to 3 times a month have approximately 70% more chance of presenting with elevated blood pressure, after adjusting for consumption of drinks with meals.ConclusionThe consumption of alcohol beverages increases the odds of elevated blood pressure, especially among excessive drinkers. Therefore alcohol consumption needs a more robust regulation in view of its impact on population health.

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Biopsychosocial factors associated with a current depressive episode in diabetes: the ELSA-Brasil study.

Publications

Biopsychosocial factors associated with a current depressive episode in diabetes: the ELSA-Brasil study.

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