Evidence mapPaperPMID 41587142Full record

ArticlePsychotherapy and psychosomatics2026

Antidepressants and Risk of Mortality in People with Depressive Disorder and Co-Occurring Type 2 Diabetes Mellitus: A 20-Year Population-Based Cohort Study.

Matthew Tsz Ho Ho, Joe Kwun Nam Chan, Heidi Ka Ying Lo, Catherine Zhiqian Fang, Corine Sau Man Wong, Krystal Chi Kei Lee, Francisco Tsz Tsun Lai, Amy Pui Pui Ng, William Chi Wai Wong, Wing Chung Chang

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Article in Psychotherapy and psychosomatics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Matthew Tsz Ho HoDepartment of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong, China.
Joe Kwun Nam ChanDepartment of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong, China.
Heidi Ka Ying LoDepartment of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong, China.
Catherine Zhiqian FangDepartment of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong, China.
Corine Sau Man WongSchool of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong, China.
Krystal Chi Kei LeeDepartment of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong, China.
Francisco Tsz Tsun LaiCentre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong, China.
Amy Pui Pui NgDepartment of Family Medicine and Primary Care, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong, China.
William Chi Wai WongDepartment of Family Medicine and Primary Care, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong, China.
Wing Chung ChangDepartment of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong, China, changwc@hku.hk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDepression and diabetes often co-occur and worsen clinical outcomes of both conditions. However, mortality risk among depression patients with diabetes exposed to antidepressant is understudied. We investigated whether antidepressant would decrease mortality risk in people with depression and incident diabetes.

methodsThis population-based cohort study identified 11,137 depression patients with incident type 2 diabetes between 2002 and 2021 in Hong Kong who were exposed to antidepressants, using territory-wide electronic medical-record database. Association between antidepressant exposure and mortality risk was analyzed by Cox proportional-hazards models for any antidepressant, specific drug classes, and individual agents, with stratified analysis by HbA1c level. A comprehensive array of covariates, including age, sex, calendar-year period, catchment-area, preexisting physical comorbidities, diabetic complications, substance/alcohol use disorders, cardiovascular/antidiabetes medications, and presence of antidepressants other than the specified drug was adjusted. Three sets of sensitivity analyses were conducted by restricting to patients (a) with cumulative drug exposure ≥90 days and ≥180 days, (b) with medication-possession ratio ≥80%, and (c) monotherapy.

resultsLower risk of all-cause mortality was associated with exposure to any antidepressant (hazard ratio 0.79, 95% confidence interval 0.70-0.90) compared with no antidepressant in depression patients with incident diabetes. Lower mortality risk was associated with exposure to noradrenergic and specific-serotonergic antidepressants (0.77 [0.66-0.90]) compared with no antidepressant, and to mirtazapine (0.76 [0.65-0.88]) and trazodone (0.75 [0.63-0.90]). Sensitivity analyses affirmed that lower mortality risk was associated with mirtazapine.

conclusionDepression patients with comorbid type 2 diabetes with exposure to several antidepressant are at decreased mortality risk. Further research is warranted to confirm our findings and clarify the mortality-reducing mechanisms of antidepressant in this vulnerable population.

Indexed as

AntidepressantsDepressive disorderMortalityPopulation-based cohort studyType 2 diabetes

Identifiers

PMID41587142
PMCPMC12999188

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.