Association between mental disorders and suicide risk among people with type 2 diabetes

Background: This study aimed to investigate the influence of various mental disorders on the risk of suicide among diabetes patients. Methods: Subjects aged ≥20 years with type 2 diabetes who underwent a health examination in 2009 (n = 875,671) were identified using the Korean National Health Information Database and followed until the end of 2021. The relationship between mental disorders (depression, bipolar disorder, schizophrenia, anxiety, and insomnia) and suicide mortality (defined as death recorded as ICD-10 codes X60-X84) risk was estimated using multivariate Cox proportional hazard analysis. Results: During the median follow-up of 12.56 years, 4755 deaths were by suicide. The presence of a mental disorder was associated with a higher risk of all-cause mortality. Of note, after adjusting for possible confounders, the risk of suicide mortality increased 3.24-fold (95 % CI, 2.35–4.47) in the presence of schizophrenia, 2.47-fold (95 % CI, 1.71–3.56) in the presence of bipolar disorder, 2.08-fold (95 % CI, 1.89–2.29) in the presence of depression, 2.03-fold (95 % CI, 1.85–2.23) in the presence of insomnia, and 1.63-fold (95 % CI, 1.50–1.77) in the presence of anxiety. Conclusions: Comorbid mental disorders were associated with significant risks of suicide mortality among people with type 2 diabetes.