The Impact of Antidepressants Use on Mental Healthcare Use

Objective. To determine whether patients with type 2 diabetes on antidepressant treatment were being monitored by a mental health professional (MHP). Background. Depression often occurs co-morbidly with diabetes; however, it is often unrecognized and undertreated in nearly two-thirds of patients with both conditions. Studies that assess mental health treatment are limited. Methods. This retrospective study was a secondary data analysis of the cross-sectional National Health and Nutrition Examination Survey (2005-2014). It included adults with type 2 diabetes and mild to severe depression symptoms. The dichotomous outcome was whether patients had seen a MHP (e.g., psychologist or psychiatrist) in the last 12 months. Sociodemographic, clinical, and behavioral factors were compared among 2 study groups: those on an antidepressant and those on no treatment. Univariate and multivariate logistic regression analyses evaluated the association of antidepressant use and MHP monitoring. Results. 966 subjects met inclusion criteria and 33.2% were on antidepressants. Seventy-seven percent of patients on treatment had not been followed by a specialist. Univariate analysis determined that those using antidepressants were 7.11 times more likely to have seen a MHP (23% v. 8%, p Conclusion.Diabetes patients with depression symptoms are generally not being monitored by a MHP, unless they are receiving medications. However, the majority of those on medications are not regularly followed by a MPH. Monitoring by a MHP should be the standard of care regardless of medication use.