MAJOR DEPRESSIVE DISORDER IN YOUTHS WITH IDDM - A CONTROLLED PROSPECTIVE-STUDY OF COURSE AND OUTCOME

OBJECTIVE - To determine whether IDDM affects the course of major depr essive disorder (MDD) in youths. RESEARCH DESIGN AND METHODS - The stu dy samples include 24 youths with IDDM (of a group of 92) who develope d MDD during a longitudinal follow-up of 10 years, on average, since o nset of the medical condition, and 30 depressed psychiatric control su bjects, matched on relevant variables. Both groups were repeatedly ass essed by semistructured interviews and diagnosed by operational criter ia.RESULTS - In diabetic subjects, median time to recovery from the fi rst episode of MDD was 6.4 months; by 12 months from onset, 69% of the youths will have recovered. Within 2 years of recovery, 32% were at r isk for a new episode; by 6.5 years, altogether 47% are estimated to h ave a recurrence. Only 37.5% of diabetic subjects received treatment f or the first episode of depression, and 50% received treatment for the second episode. Overall rates of recovery and recurrence were indisti nguishable in the diabetic and psychiatric control groups. However, yo ung women with diabetes were at nine times greater risk for recurrent depression than their male counterparts, and diabetic subjects eventua lly spent more time being depressed than the control subjects. CONCLUS IONS - The course characteristics of MDD in young diabetic subjects an d psychiatric control subjects appear to be similar in several regards . However, the eventual propensity of diabetic youths for more protrac ted depressions and the higher risk of recurrence among young diabetic women suggest that the mental health of patients with IDDM should be closely monitored. The findings confirm that depression is undertreate d among patients in the primary health care sector.