Anxiety-depression comorbidity prevalence in type 2 diabetes mellitus and correlation with insulin resistance

doi:10.5498/wjp.119917

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World Journal of Psychiatry

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2220-3206

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Observational Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Psychiatry. Sep 19, 2026; 16(9): 119917
Published online Sep 19, 2026. doi: 10.5498/wjp.119917

Table 1 Demographic characteristics of all patients

	n = 197	Constituent ratio (%)
Sex
Male	94	47.7
Female	103	52.3
Age (years)	51.08 ± 5.93	-
Body mass index (kg/m²)	22.88 ± 3.18	-
DM course (years)	8.82 ± 4.34	-
Family history of DM
Yes	62	31.5
No	135	68.5
Smoking history
Yes	77	39.1
No	120	60.9
Drinking history
Yes	62	31.5
No	135	68.5
Educational level
Junior high school or below	64	32.5
Senior high school/technical secondary school	89	45.2
University degree or above	44	22.3
Marital status
Single	30	15.2
Married	116	58.9
Divorced/widowed	51	25.9
Employment status
Unemployed	37	18.8
Employed	111	56.3
Retired	49	24.9

DM: Diabetes mellitus.

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Table 2 Anxiety and depression scores

Total HAMD score (n = 197)	Total HAMA score (n = 197)	Groups	HAMD	HAMA
19.17 ± 9.29	13.85 ± 6.50	T2DM group (n = 40)	11.73 ± 3.60	8.53 ± 2.52
		T2DM + anxiety group (n = 58)	9.93 ± 2.64	18.38 ± 3.23
		T2DM + depression group (n = 52)	25.62 ± 3.18	7.00 ± 2.19
		T2DM + anxiety-depression group (n = 47)	29.79 ± 4.36	20.36 ± 3.10

HAMD: Hamilton Rating Scale for Depression; HAMA: Hamilton Anxiety Scale; T2DM: Type 2 diabetes mellitus.

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Table 3 Comparison of demographic characteristics

	T2DM group (n = 40)	T2DM + anxiety group (n = 58)	T2DM + depression group (n = 52)	T2DM + anxiety-depression group (n = 47)	F/χ²	P value
Sex					1.411	0.703
Male	18	28	28	20
Female	22	30	24	27
Age (years)	50.70 ± 5.21	51.29 ± 6.85	51.94 ± 6.21	50.19 ± 4.90	0.796	0.497
Body mass index (kg/m²)	22.24 ± 3.59	22.70 ± 3.01	23.10 ± 3.05	23.40 ± 3.16	1.120	0.342
DM course (years)	6.85 ± 3.28	8.81 ± 4.26^a	9.83 ± 4.00^a	9.36 ± 5.11^a	4.112	0.007
Family history of DM					2.264	0.519
Yes	14	21	16	11
No	26	37	36	36
Smoking history					0.094	0.993
Yes	15	23	20	19
No	25	35	32	28
Drinking history					0.183	0.980
Yes	12	19	17	14
No	28	39	35	33
Educational level					1.495	0.960
Junior high school or below	12	18	20	14
Senior high school/technical secondary school	18	26	22	23
University degree or above	10	14	10	10
Marital status					2.690	0.847
Single	7	10	8	5
Married	20	33	31	31
Divorced/widowed	13	15	13	11
Employment status					3.897	0.691
Unemployed	9	13	8	7
Employed	20	29	34	28
Retired	11	16	10	12

^aP < 0.05 vs type 2 diabetes mellitus group.

T2DM: Type 2 diabetes mellitus; DM: Diabetes mellitus.

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Table 4 Comparison of blood glucose and blood lipid levels

	T2DM group (n = 40)	T2DM + anxiety group (n = 58)	T2DM + depression group (n = 52)	T2DM + anxiety-depression group (n = 47)	F	P value
HbA1c (%)	7.33 ± 1.78	7.48 ± 1.50	7.60 ± 1.51	8.39 ± 1.27^a^,^b^,^c	4.550	0.004
FPG (mmol/L)	9.86 ± 2.53	10.31 ± 2.73	10.51 ± 2.25	11.69 ± 3.22^a^,^b^,^c	3.576	0.015
2hPG (mmol/L)	15.57 ± 2.55	16.11 ± 3.12	16.10 ± 2.91	17.64 ± 1.67^a^,^b^,^c	5.154	0.002
TG (mmol/L)	2.04 ± 0.50	2.52 ± 0.68^a	2.35 ± 0.72^a	2.58 ± 0.80^a	5.354	0.002
TC (mmol/L)	5.36 ± 0.58	4.55 ± 0.60^a	4.55 ± 0.50^a	4.41 ± 0.44^a	27.10	< 0.0001
HDL-C (mmol/L)	1.93 ± 0.53	1.38 ± 0.31^a	1.39 ± 0.35^a	1.29 ± 0.23^a	27.45	< 0.0001
LDL-C (mmol/L)	2.03 ± 0.27	2.48 ± 0.32^a	2.43 ± 0.44^a	2.62 ± 0.62^a	14.94	< 0.0001
hs-CRP (mg/L)	2.41 ± 0.34	2.68 ± 0.33^a	2.71 ± 0.34^a	2.88 ± 0.39^a^,^b^,^c	13.68	< 0.0001

^aP < 0.05 vs type 2 diabetes mellitus group.

^bP < 0.05 vs type 2 diabetes mellitus + anxiety group.

^cP < 0.05 vs type 2 diabetes mellitus + depression group.

T2DM: Type 2 diabetes mellitus; HbA1c: Glycosylated hemoglobin; FPG: Fasting plasma glucose; 2hPG: 2-hour postprandial blood glucose; TG: Triglyceride; TC: Total cholesterol; HDL-C: High-density lipoprotein cholesterol; LDL-C: Low-density lipoprotein cholesterol; hs-CRP: High-sensitivity C-reactive protein.

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Table 5 Comparison of islet function indices

	T2DM group (n = 40)	T2DM + anxiety group (n = 58)	T2DM + depression group (n = 52)	T2DM + anxiety-depression group (n = 47)	F	P value
FINS (mIU/L)	7.48 ± 2.25	8.36 ± 2.34	8.42 ± 2.87	10.36 ± 2.25^a^,^b^,^c	11.00	< 0.0001
FCP (nmol/L)	0.62 ± 0.16	0.94 ± 0.20^a	0.89 ± 0.25^a	0.91 ± 0.30^a	17.19	< 0.0001
HOMA-IR	3.43 ± 1.74	3.96 ± 1.85	4.07 ± 1.91	5.46 ± 2.08^a^,^b^,^c	9.392	< 0.0001
HOMA-β	27.06 ± 13.20	28.29 ± 12.94	25.62 ± 9.91	28.87 ± 12.04	0.726	0.538
HOMA-IS	0.37 ± 0.17	0.31 ± 0.14	0.31 ± 0.16	0.21 ± 0.09^a^,^b^,^c	9.648	< 0.0001

^aP < 0.05 vs type 2 diabetes mellitus group.

^bP < 0.05 vs type 2 diabetes mellitus + anxiety group.

^cP < 0.05 vs type 2 diabetes mellitus + depression group.

T2DM: Type 2 diabetes mellitus; FINS: Fasting insulin; FCP: Fasting C-peptide; HOMA-IR: Homeostasis Model Assessment of insulin resistance; HOMA-IS: Homeostasis Model Assessment of insulin sensitivity.

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Table 6 Comparison of insulin resistance incidence

HOMA-IR	T2DM group (n = 40)		T2DM + anxiety group (n = 58)		T2DM + depression group (n = 52)		T2DM + anxiety-depression group (n = 47)		χ²	P value
HOMA-IR	Frequency	Percentage (%)	Frequency	Percentage (%)	Frequency	Percentage (%)	Frequency	Percentage (%)	χ²	P value
HOMA-IR	17	42.5	30	51.7	28	53.8	41	87.2	21.813	< 0.0001
Non-HOMA-IR	23	57.5	28	48.3	24	46.2	6	12.8	21.813	< 0.0001

T2DM: Type 2 diabetes mellitus; HOMA-IR: Homeostasis Model Assessment of Insulin Resistance.

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Table 7 Logistic regression analysis of insulin resistance

	β	SE	Wald	P value	OR	95%CI
Constant	-0.459	0.413	1.234	0.267	0.632	-
T2DM	-	-	17.533	0.001	-	-
T2DM + anxiety	0.327	0.421	0.605	0.437	1.387	0.608-3.163
T2DM + depression	0.389	0.438	0.787	0.375	1.476	0.625-3.485
T2DM + anxiety-depression	2.172	0.548	15.737	0.000	8.776	3.001-25.667
DM course	0.023	0.038	0.362	0.547	1.023	0.950-1.102

OR: Odds ratio; CI: Confidence interval; T2DM: Type 2 diabetes mellitus; DM: Diabetes mellitus.

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Citation: Wu CC, Sun WH, Yang QQ, Xue L, Zhao WD. Anxiety-depression comorbidity prevalence in type 2 diabetes mellitus and correlation with insulin resistance. World J Psychiatry 2026; 16(9): 119917
URL: https://www.wjgnet.com/2220-3206/full/v16/i9/119917.htm
DOI: https://dx.doi.org/10.5498/wjp.119917

Wu CC, Sun WH, Yang QQ, Xue L, Zhao WD. Anxiety-depression comorbidity prevalence in type 2 diabetes mellitus and correlation with insulin resistance. World J Psychiatry 2026; 16(9): 119917 [DOI: 10.5498/wjp.119917]

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