PsyDiaKHK research project

General information

Project title: Incidence of mental illness in existing type 2 diabetes mellitus and cardiovascular disease: Health inequalities and identification of vulnerable groups in health insurance data in the time trend between 2005 and 2019

Funding reference EP 157/2-1

Funding body: German Research Foundation

Funding amount: 202,965 €

Project duration: 2023-2026

Project management: PD Dr. Jelena Epping

Project collaborator: Lotte Mond

Brief description

The number of people suffering from type 2 diabetes mellitus (T2D) or cardiovascular disease is steadily increasing. Depending on the severity and subjective perception of the associated stress, these diseases have a negative impact on the patient's quality of life and mental well-being. If a mental disorder develops as a result, the prognosis for the underlying condition worsens. If physicians were better able to identify and treat patients with T2D or cardiovascular disease who are at an increased risk of developing mental illness in good time, the morbidity burden for patients and the cost of care would be reduced.

In the first phase of this research project, anonymized health insurance data (approx. 2 million insured persons per year) will be used to determine the risk of developing a mental disorder in the case of existing T2D or cardiovascular disease between 2005 and 2019. The data is available on the basis of many years of cooperation with the AOK Lower Saxony and can also be used for this research project. Depression, anxiety disorders and stress disorders are used as outcomes. In addition to age and gender, characteristics of social status (income, education, occupation) are also taken into account to differentiate the risk of illness. For insured persons in employment, it is also analyzed whether fixed-term, temporary or part-time work is more frequently associated with mental disorders. Changes in work-related characteristics over time are also taken into account in the analyses in the form of time-variant predictors. To classify the analysis results, a parallelized control sample without T2D or cardiovascular disease is formed according to the aforementioned sociodemographic and work-related characteristics. Risks of the occurrence of depression, anxiety disorders or stress disorders over time are also determined for this group of insured persons.

In the second project phase, the care of patients with T2D or cardiovascular disease and existing depressive disorder will be analyzed. The aim is to identify vulnerable groups in terms of socio-demographic or occupational characteristics who have been diagnosed with depression in the presence of T2D or cardiovascular disease but have not received guideline-based care. The results of these analyses can help to improve the care of such vulnerable patient groups with T2D or cardiovascular disease. In addition, target group-specific psychoeducational programs can be developed to increase the (mental) health literacy of patients with T2D or cardiovascular disease.