J Psychosom Res. 2026 Apr 7;207:112662. doi: 10.1016/j.jpsychores.2026.112662. Online ahead of print.
ABSTRACT
BACKGROUND: Psychologic distress, including depression, is a common problem in patients with type 2 diabetes mellitus (T2DM). However, how depression severity relates to vascular complications in T2DM remains uncertain.
METHODS: This study analyzed 1187 patients with long-duration T2DM (mean diabetes duration: 14.0 ± 8.5 years) and 3289 newly diagnosed T2DM patients from the Taiwan Diabetes Registry. Depression severity was assessed using the self-report Patient Health Questionnaire-9, categorized into minimal (score 0-4), mild (score 5-9), and moderate to severe (score ≥ 10). Diabetes associated vascular complications were evaluated through medical record reviews and physical examinations, and their associations with depression severity were analyzed using logistic regression analysis.
RESULTS: In patients with long-duration T2DM, higher depression severity was associated with an increased prevalence of cardiovascular disease, peripheral arterial occlusive disease (PAOD), and neuropathy (p-values of 0.002, 0.025, and 0.003, respectively). After adjusting for multiple variables, mild and moderate to severe depression were both linked to a heightened risk of cardiovascular disease and PAOD, with adjusted odds ratios (OR) of 2.92 (95% CI: 1.45 to 5.86) and 2.91 (95% CI: 1.24-6.83), respectively. Mild depression was linked to polyneuropathy (OR: 1.89, 95% CI: 1.23-2.88). In newly diagnosed T2DM patients, depression prevalence was lower, and moderate to severe depression was associated with microvascular risks, specifically retinopathy (adjusted OR: 1.78, 95% CI: 1.16-2.76) and nephropathy (adjusted OR: 1.48, 95% CI: 1.04-2.09).
CONCLUSION: In T2DM, depression associates with macrovascular and neuropathic complications in long-duration disease, but microvascular conditions at diagnosis. Psychological screening should be tailored to disease duration.
PMID:41965133 | DOI:10.1016/j.jpsychores.2026.112662