Affective and anxiety disorders in a German sample of diabetic patients: prevalence, comorbidity and risk factors

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Abstract
Aims  The aims of this study were to examine (1) the prevalence of clinical and subclinical anxiety and affective disorders in a sample of diabetic patients attending a secondary care clinic in Germany and (2) risk factors associated with the occurrence of these disorders.Methods  Four hundred and twenty diabetic patients (36.9% Type 1; 24.7% Type 2; 38.4% Type 2 with insulin) participated in a questionnaire‐based screening survey. Those who screened positive received a diagnostic interview.Results  Prevalence of clinical affective disorders was 12.6%, with an additional 18.8% of patients reporting depressive symptoms without fulfilling all criteria for a clinical affective disorder. The prevalence of anxiety disorders was 5.9%, with an additional 19.3% of patients reporting some anxiety symptoms. The comorbidity rate of affective and anxiety disorders was 1.8%, whereas 21.4% of the diabetic patients reported elevated affective as well as anxiety symptomatology. Logistic regression established demographic variables such as age, female gender and living alone as well as diabetes‐specific parameters such as insulin treatment in Type 2 diabetes, hypoglycaemia problems and poor glycaemic control as risk factors for affective disorders. For anxiety symptoms female gender, younger age and Type 2 diabetes were significant independent variables.Conclusion  The prevalence of affective disorders in diabetic patients was twofold higher than in the non‐diabetic population, whereas prevalence for anxiety disorders was not increased. Analysis of risk factors can facilitate the identification of patients who are at a greater risk for these disorders.