Major depression and schizophrenia as risks factors for diabetes in Puerto Rican adults

Studies have found that major depression and diabetes mellitus are strongly associated. People with diabetes have a greater risk of presenting a serious psychological disorder such as depression, anxiety and schizophrenia than individuals without diabetes. However, there is also evidence suggesting that major depression is an independent risk factor for diabetes. Research studies of psychiatric disorders as risk factors for diabetes are scarce, especially in racial and ethnically diverse people. The main goal of this study was to evaluate major depression and schizophrenia as associated and possible risks factors for diabetes mellitus in a large population of Puerto Ricans adults living on the island. A secondary database analysis through a cross-sectional design was used for this study. Participants were selected from the Puerto Rico Commonwealth Health Plan database, beneficiaries of the public health sector, for a total of 1,060,323 adult insured's with at least one claim during 2002. The International Classification of Diseases (ICD-9) was used for disease classifications. The prevalence of diabetes was 14.6% in subjects with major depression and 9.7% for those without major depression (POR 1.59, p<0.001). This increased risk remained after adjusting for obesity and schizophrenia. In conclusion, diabetes prevalence appears to be significantly higher in Puerto Rican adults with major depression compared to those without this psychiatric disorder. Longitudinal prospective studies and randomized controlled trials are needed to shed light on the temporal or causal relationship and to test whether effective prevention and treatment can reduce the risk of developing diabetes.