Prevalence of Various Psychotic Disorders Among Patients with Type 2 Diabetes: Real-World Evidence from Shanghai, China - 17/04/25

Doi : 10.1016/j.deman.2025.100259

Yunxi Ji ^1,^2,^{^{6
These authors contributed equally}}, Ping He ^3,^{^{6
These authors contributed equally}}, Yingxia Zhou ^1,^2,^{^{6
These authors contributed equally}}, Huayan Yao ⁴, Yanbin Xue ⁴, Renjie Jing ^1,², Tingyu Zhang ^1,², Wen Sun ⁵, Ping Lu ⁵, Bin Cui ^1,^2,^⁎ , Weiqing Wang ^1,^2,^⁎
¹ Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
² Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
³ Link Healthcare Engineering and Information Department, Shanghai Hospital Development Center, Shanghai, China
⁴ Computer Net Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
⁵ Wonders Information Co. Ltd., Shanghai, China

^⁎Correspondence author: Weiqing Wang; Bin Cui, Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, Address: 573 Xujiahui Road, Shanghai, China, 200025.Department of Endocrine and Metabolic DiseasesShanghai Institute of Endocrine and Metabolic DiseasesRuijin HospitalShanghai Jiao Tong University School of Medicine573 Xujiahui RoadShanghai200025China

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Highlights

•	Teaching Points:
•	Most studies predominantly examine depression symptoms, particularly within European and American populations. The prevalence of significant psychotic disorders among diabetes patients seeking medical attention in Shanghai remains uncertain.
•	Data derived from healthcare systems can provide more extensive longitudinal insights. This cross-sectional research assesses the profiles of patients with T2DM in Shanghai and ascertains the prevalence of major psychotic disorders utilizing large health databases.
•	Individuals aged 55-80 account for 68.15% of the total population with T2DM. There is a higher prevalence of males compared to females; however, females exhibit a higher rate of psychotic disorders compared to males. Besides, Anxiety is significantly associated with the complications of T2DM.
•	Clinical Relevance: This research offers novel insights into the health conditions of patients with T2DM in Shanghai. By uncovering the prevalence of major psychotic disorders among them, it helps physicians pay attention to mental health problems during diagnosis and treatment. Medical teams need to consider patients' physical and mental conditions comprehensively.

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Abstract

Aims

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder that significantly impacts psychotic health, leading to increased incidence and mortality. We aim to explore the status of patients with T2DM and the issue of comorbid psychotic disorders.

Methods

Our study estimated the characteristics of 836,120 patients with T2DM from 2019 to 2023 based on electronic health records from the Shanghai Link Database (SHLD). We calculated the prevalence of the four major psychotic disorders in patients with T2DM, including depression, anxiety, dementia, and schizophrenia. The data was also stratified by age, sex, and other factors. Additionally, the association between diabetes complications and various psychotic disorders was investigated.

Results

We observed that the age group of 55-80 counted for about 68.15% of the total population with T2DM. There were more male patients with T2DM than females, but females exhibited a higher overall prevalence of psychotic disorders compared to males. For patients with T2DM, anxiety had the highest prevalence (3.97%), followed by depression (2.33%), dementia (2.04%), and schizophrenia (0.16%). There was a significant relationship between psychotic disorders and various diabetes complications.

Conclusions

The high prevalence of psychotic disorders among patients with T2DM highlights the importance of considering the impact of their comorbid psychotic illnesses when treating T2DM. Developing high-quality diabetes healthcare and implementing targeted treatment and management plans are essential in addressing these issues.

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Keywords : Type 2 diabetes mellitus, Psychotic disorders, Prevalence, Primary care, Gender differences