Associations between diabetes and depressive symptoms across European countries

Article

Gottfried, J., Flynn, G., Gajewska, K., Kenny, R.A., Hernández, B., Lloyd, C., Nouwen, A., Power, S., Rodrigues, R. and Deschênes, S. 2025. Associations between diabetes and depressive symptoms across European countries. European Journal of Public Health. 35 (Supplement_4). https://doi.org/10.1093/eurpub/ckaf161.1229
TypeArticle
TitleAssociations between diabetes and depressive symptoms across European countries
AuthorsGottfried, J., Flynn, G., Gajewska, K., Kenny, R.A., Hernández, B., Lloyd, C., Nouwen, A., Power, S., Rodrigues, R. and Deschênes, S.
Abstract

Background
We examined the potential role of several macro- and micro-sociodemographic factors in moderating the longitudinal bi-directional association between depressive symptom severity and diabetes across European countries. This submission summarizes the results of two empirical studies and workshop-based group discussions with people living with diabetes.

Methods
We analyzed data from three prospective cohort studies - the English Longitudinal Study on Ageing, the Irish Longitudinal study on Ageing, and the Survey on Health, Ageing and Retirement in Europe. We examined possible country-level and individual-level sociodemographic factors of diabetes, including healthcare quality and expenditure, wealth inequalities, and health behaviors, as moderators of the relationship between newly developed diabetes and depressive symptoms. Lived experience of diabetes reports were collected via two public workshops in Ireland.

Results
Depressive symptoms were a risk factor for diabetes (HR = 1.14, 95% CI [1.10;1.18]), and vice versa (HR = 1.48, 95% CI [1.37;1.61]), and the hazard ratios were stable across European geographical regions. All sociodemographic factors significantly (all p's < .01) predicted both the risk of diabetes and the incidence of elevated depressive symptoms but, except for BMI, did not moderate the strength of their association (all p's > .01). Workshop reports demonstrated that some people with diabetes in Ireland experience a significant psychological burden because of their condition, about which they felt their healthcare practitioners should be better informed.

Conclusions
The relationship between depressive symptoms and diabetes was consistent, regardless of most individual- or country-level factors. Because of this, international policies on managing depression-diabetes comorbidity might be applicable across European countries. In Ireland, healthcare practitioners should be better informed about the characteristics of daily living with diabetes.

Key messages
• The relationship between diabetes and depressive symptoms is stable across Europe, suggesting the same robust underlying mechanism of their mutual interaction.

• Healthcare practitioners and public health decision makers in Ireland should be more aware of the challenges to mental health which are associated with diabetes diagnosis.

Sustainable Development Goals3 Good health and well-being
Middlesex University ThemeHealth & Wellbeing
PublisherOxford University Press (OUP)
JournalEuropean Journal of Public Health
ISSN1101-1262
Electronic1464-360X
Publication dates
Online27 Oct 2025
PrintOct 2025
Publication process dates
Accepted2025
Deposited06 Nov 2025
Output statusPublished
Digital Object Identifier (DOI)https://doi.org/10.1093/eurpub/ckaf161.1229
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