Objective:

To compare the prevalence of depressive and generalized anxiety symptoms among US adults with type 1 diabetes, type 2 diabetes, or no diabetes.

Approach:

• Study design and participants: Investigators analyzed 2019 and 2022 National Health Interview Survey data from 58,106 adults, including 326 with type 1 diabetes and 5,802 with type 2 diabetes.
• Measures: Depressive symptoms were assessed with the 8-item Patient Health Questionnaire and anxiety symptoms with the GAD-7. Scores of 10–14 indicated moderate symptoms and scores of 15 or higher indicated severe symptoms.

Key Findings:

• Moderate or severe depressive symptoms were reported by 17% of adults with type 1 diabetes, 12% with type 2 diabetes, and 7% without diabetes.
• Moderate or severe anxiety symptoms were reported by 16%, 9%, and 6%, respectively; differences between groups were statistically significant.
• Severe depressive symptoms were reported by 10% of adults with type 1 diabetes, compared with 5% with type 2 diabetes and 3% without diabetes. Severe anxiety symptoms were reported by 8%, 4%, and 3%, respectively.
• Among participants with type 1 diabetes, moderate or severe anxiety symptoms were most prevalent among those aged 18–44 years (22%); depressive symptoms were most prevalent among those aged 45–64 years (20%).
• Among participants with type 1 diabetes and less than a high school education, 24% reported moderate or severe depressive symptoms and 32% reported moderate or severe anxiety symptoms. Among those with a college education or higher, the corresponding estimates…

Interpretation:

The authors reported that depressive and anxiety symptoms were more prevalent among adults with type 1 diabetes than among adults with type 2 diabetes or no diabetes. They noted that depression and anxiety in people with diabetes have been associated with poorer glycemic control and increased risk of complications.

Limitations:

• Diabetes subtype was based on self-report, allowing possible misclassification.
• The relatively small type 1 diabetes sample limited the precision of subgroup estimates.
• The survey did not assess diabetes-specific psychosocial burdens, which may overlap with depressive and anxiety symptoms.
• Symptoms were assessed over the preceding 2 weeks and were not confirmed by clinical interviews.

Conclusion:

The authors cited the American Diabetes Association’s 2026 recommendation for annual depression and anxiety screening using validated instruments and called for better mental health screening, especially in high-risk populations.

Sources:

• Annals of Internal Medicine