Incident psychopharmacological treatment and psychiatric hospital contact in individuals with newly developed type 2 diabetes

Abstract

AbstractObjectiveTo investigate the association between newly developed type 2 diabetes (T2D) and incident psychopharmacological treatment and psychiatric hospital contact.MethodsWe identified all individuals from the Central- and Northern Denmark Regions with newly developed T2D (defined by the first HbA1c measurement >6.5%) from 2000-2016 and up to five age and sex matched individuals without T2D (controls). Those having received psychopharmacological treatment or having had a psychiatric hospital contact in the five years prior to the onset of T2D were excluded. For this cohort, we first assessed the incidence of psychopharmacological treatment and psychiatric hospital contact among individuals with T2D and controls, respectively. Secondly, we compared the incidence of psychopharmacological/psychiatric hospital contact among individuals with T2D to propensity score matched controls. Finally, we assessed which baseline (T2D onset) characteristics that were associated with subsequent psychopharmacological treatment and psychiatric hospital contact.ResultsWe identified 56,640 individuals with newly developed T2D and 315,694 controls. A total of 8.3% of the individuals with T2D initiated psychopharmacological treatment within the 2 years following onset compared to 4.6% among the age and sex matched controls. Individuals with T2D were at increased risk of initiating psychopharmacological treatment compared to the propensity score matched controls (HR=1.51, 95% CI=1.43-1.59), whereas their risk of psychiatric hospital contact was not increased to the same extent (HR=1.14, 95% CI=0.98-1.32). Older age, somatic comorbidity, and being divorced/widowed was associated with both psychopharmacological treatment and psychiatric hospital contact following T2D.ConclusionIndividuals with T2D are at elevated risk of requiring psychopharmacological treatment.Significant outcomes8.3% of the individuals with T2D initiated psychopharmacological treatment within the 2 years following onset compared to 4.6% among the age and sex matched controlsIndividuals with newly developed T2D were at increased risk of initiating psychopharmacological treatment and of having psychiatric hospital contact compared to propensity score matched controls.Risk factors for psychopharmacological treatment/psychiatric hospital contact following development of T2D include older age, somatic comorbidity and being divorced or widowed.LimitationsIdentification of T2D (a HbA1c level >6.5%) itself might lead to the identification of mental illness and thereby psychopharmacological treatment initiation/psychiatric hospital contact.A proportion of the individuals with T2D will likely have initiated treatment with an antidepressant due to neuropathic pain developed as a complication to T2D