"We found a steady increase in the probability of PGC with advancing categories of depression severity," according to Raz Gross, MD, MPH assistant professor of Epidemiology and Psychiatry at Columbia University's Mailman School of Public Health and College of Physicians and Surgeons and principal author of the study. "This held especially true among patients with moderate-severe depression, where likelihood for PGC was more than three-fold higher compared to patients without depression." No association was found between depression and PGC among the non-Hispanic diabetes patients.
According to Dr. Gross, there is ample evidence that among the population, in general, depressive disorders are more prevalent among adults with diabetes. However, the relationship between depression and glycemic control in patients with diabetes is less obvious. Hispanics have high rates of diabetes and are more likely to have poor glycemic control. Diabetes ranks fifth among the leading causes of death in people of Hispanic origin. Earlier research has indicated that Hispanic patients are usually less likely to have regular sources of medical care, to undergo screening, to use preventive services, to be referred to a specialist, or to receive appropriate treatment.
Says Dr. Gross, "There are important clinical and public health implications to our finding. As rates of diabetes, especially among Hispanics, continue to increase, it is important for clinicians caring for patients with diabetes to be aware of the association between depression and PGC. Our findings suggest that identification and adequate treatment of depression in this understudied, high-risk population of Hispanic primary care patients might have favorable effects on diabetic outcomes."
In addition to the Mailman School of Public Health, the study was conducted within the Division of Clinical and Genetic Epidemiology at the Department of Psychiatry and New York State Psychiatric Institute, headed by Myrna Weissman, PhD, professor of Psychiatry and Epidemiology at Columbia University Medical Center, and senior author on the study. The data for the research derive from a general medicine practice-based study conducted at the Associates in Internal Medicine (AIM), of which Dr. Raphael Lantiqua is medical director; and the faculty and resident group practice of the Division of General Medicine at the College of Physicians & Surgeons of Columbia University, headed by Steven Shea, MD, Hamilton Southworth Professor of Medicine and Professor of Epidemiology. The practice serves approximately 70,000 patient visits each year.
The findings are published in the May issue of the Journal of General Internal Medicine.
About the Mailman School of Public Health
The only accredited school of public health in New York City, and among the first in the nation, Columbia University's Mailman School of Public Health provides instruction and research opportunities to more than 850 graduate students in pursuit of masters and doctoral degrees. Its students and over 250 multi-disciplinary faculty engage in research and service in the city, nation, and around the world, concentrating on biostatistics, environmental health sciences, epidemiology, health policy and management, population and family health, and sociomedical sciences. (www.mailman.hs.columbia.edu)
Columbia University Medical Center provides international leadership in basic, pre-clinical and clinical research, medical education, and health care. The medical center trains future leaders in health care and includes the dedicated work of many physicians, scientists, nurses, dentists, and other health professionals at the College of Physicians & Surgeons, the School of Dental & Oral Surgery, the School of Nursing, the Mailman School of Public Health, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. With a strong history of some of the most important advances and discoveries in health care, its researchers are leading the development of novel therapies and advances to address a wide range of health conditions.
NY State Psychiatric Institute
Founded in 1896, the New York State Psychiatric Institute (PI) continues to contribute importantly to knowledge about understanding and treating psychiatric disorder and is ranked among the best psychiatric research facilities in the world today. Noted for its research on depression and suicide, schizophrenia, anxiety and child psychiatric disorders, PI is also at the forefront of research dedicated to unraveling the brain's mysteries. Its scientists constitute the core of the Department of Psychiatry at Columbia University. In 2000, Dr. Eric Kandel was awarded the Nobel Prize in Physiology or Medicine for research in his labs at PI on the cellular basis of memory. (www.nyspi.org)
Journal
Journal of General Internal Medicine