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Researchers at McGill University in Montreal, Canada and colleagues have found that depression may add to the risk of developing Type 2 diabetes in those with early symptoms of metabolic disease.

Together with teams at l’Université de Montréal, l’Institut de Recherches Cliniques de Montréal and the University of Calgary, the McGill researchers investigated 2,525 participants in Quebec aged 40-69, in a four-and-a-half year study.

The study cohort was separated into four groups, including those with both depression and three or more metabolic risk factors – as well as two other groups, each with one of the conditions but not the other, together with a reference group with neither condition.

The researchers found that, unlike previous study findings, participants with depression alone were not at significantly greater risk of developing diabetes, compared with those in the reference group.

However, there was a four-fold increased risk of developing diabetes among patients with metabolic symptoms, but not depression – whereas patients with both depression and metabolic risk factors were found to be more than six times more likely to develop diabetes.

The researchers say the findings of the study have clarified that the risk factors involved in the combined effects of depression and metabolic symptoms are greater than the individual effects of either condition.

The team has also warned that diabetes and depression may be involved in a “vicious cycle” – with depression, metabolic symptoms and the risk of developing diabetes interacting in a number of ways, including the possibility of a cycle of symptoms emerging.

The underlying reasons may be that people with depression may not adhere as well to medical advice to tackle metabolic symptoms, including not taking medication, or not giving up smoking, taking more exercise or eating healthily.

The researchers say that, without effective management, metabolic symptoms may worsen and in turn make the symptoms of depression worse.

Dr Norbert Schmitz of McGill University’s Department of Psychiatry said:

“The aim of our study was to evaluate characteristics of individuals with both depressive symptoms and metabolic risk factors.

“Emerging evidence suggests that not depression per se, but depression in combination with behavioural and metabolic risk factors, increases the risk of developing Type 2 diabetes and cardiovascular conditions.”

“Focusing on depression alone might not change lifestyle/metabolic factors –
so people are still at an increased risk of developing poor health outcomes, which in turn increases the risk of developing recurrent depression,” Schmitz added.

The research was supported by the Canadian Institutes of Health Research (CIHR) and the Fonds de Recherche du Québec.

The findings of the study are published in the journal Molecular Psychiatry.

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