Depressive disorders among cohorts of women veterans with diabetes, heart disease, and hypertension

Objectives: To compare the rates of major and minor depression in cohorts of women veterans with diabetes or heart disease or hypertension and examine variations in these rates by demographic, socioeconomic, and health status among these women. Methods: This was a retrospective cross-sectional analysis of fiscal year 2002 and 2003 data on 13,430 women veterans with diabetes or heart disease or hypertension who were diagnosed with depression and used Veteran Health Administration (VHA) clinics. International Classification of Diseases, 9th ed. Clinical Modification codes from merged VHA and Medicare claims files were used to identify diabetes, heart disease, hypertension, and depression. Chi-square tests and multinomial logistic regressions were used to characterize women veterans with major and minor depression. Results: Of all the women veterans diagnosed with diabetes or heart disease or hypertension and using the VHA clinics, 27% were diagnosed with depression. Of these 13,430 women with any depression, 60% were diagnosed with minor depression and 40% had major depressive disorders (MDD). Compared to major depression, minor depression was significantly more likely among women veterans who were older, without any other psychiatric condition and substance use disorders. Conclusions: Minor depression is highly prevalent among women veterans with complex chronic illness, such as diabetes or heart disease or hypertension (i.e., women at risk or with cardiovascular conditions), suggesting a need to closely monitor these women to reduce the risk of major depression. Some subgroups of women were more likely to have minor depression than major depression; studies that exclusively focus on major depression will selectively miss these subgroups of women veterans.