The joint association of loneliness, social isolation, and satisfaction with major depressive disorder incidence in individuals with diabetes.
To investigate the joint associations of life satisfaction, loneliness and social isolation in relation to the risk of incident major depressive disorder (MDD) in diabetes patients.
A total of 7712 participants with diagnosed diabetes at baseline from the UK Biobank were included. Cox proportional hazards models and interaction analyses were used to examine associations of loneliness, social isolation, and life satisfaction with MDD.
During a median follow-up time of 11.1 years, 442 participants developed MDD (incidence rate: 5.73%). Participants with high loneliness, high social isolation, and low life satisfaction were associated with 176%, 82%, and 493% higher risks of MDD compared to those with low loneliness, low social isolation, and high life satisfaction, respectively (all P < 0.001). Several statistically significant interactions between loneliness and different aspects of life satisfaction were identified in relation to incident MDD. Participants with both low life satisfaction and high loneliness were at 8.06 times the risk of MDD than those with high life satisfaction and low loneliness.
In individuals with diabetes, higher loneliness and social isolation are associated with increased MDD risk, whereas higher life satisfaction was associated with a lower risk. The joint associations varied across levels and domains of life satisfaction, although interaction patterns were not consistent across all measures or statistical scales. These findings may help identify individuals at elevated risk of MDD but should be interpreted cautiously given the observational design, potential residual confounding, and measurement limitations.
A total of 7712 participants with diagnosed diabetes at baseline from the UK Biobank were included. Cox proportional hazards models and interaction analyses were used to examine associations of loneliness, social isolation, and life satisfaction with MDD.
During a median follow-up time of 11.1 years, 442 participants developed MDD (incidence rate: 5.73%). Participants with high loneliness, high social isolation, and low life satisfaction were associated with 176%, 82%, and 493% higher risks of MDD compared to those with low loneliness, low social isolation, and high life satisfaction, respectively (all P < 0.001). Several statistically significant interactions between loneliness and different aspects of life satisfaction were identified in relation to incident MDD. Participants with both low life satisfaction and high loneliness were at 8.06 times the risk of MDD than those with high life satisfaction and low loneliness.
In individuals with diabetes, higher loneliness and social isolation are associated with increased MDD risk, whereas higher life satisfaction was associated with a lower risk. The joint associations varied across levels and domains of life satisfaction, although interaction patterns were not consistent across all measures or statistical scales. These findings may help identify individuals at elevated risk of MDD but should be interpreted cautiously given the observational design, potential residual confounding, and measurement limitations.
Authors
Tan Tan, Wang Wang, Peng Peng, Guo Guo, Zheng Zheng, Zhang Zhang, Li Li, Zhang Zhang, Wu Wu, Huang Huang, Wang Wang, Qi Qi
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