{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T21:33:38Z","timestamp":1792445618393,"version":"4.5.0"},"reference-count":34,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"unspecified","delay-in-days":158,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100024334","name":"State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100024334","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0033291726104759_sec1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>People with diabetes have increased risk of depression that further worsens clinical outcome. However, occurrence of depression among patients with diabetes exposed to antidiabetes agents is under-studied. We investigated whether antidiabetes agents would decrease the risk of depression in people with diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291726104759_sec2\" sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This population-based cohort study identified 686,522 patients with incident type-2 diabetes between 2002-2021 in Hong-Kong who were exposed to any antidiabetes agents, using territory-wide medical-record database of public-healthcare services. Associations of exposure to antidiabetes agents and risk of first-diagnosed depression were examined by Cox proportional-hazards models for each individual agent. An array of covariates, including age, sex, calendar-year period, catchment-area, pre-existing physical\/psychiatric-comorbidities, average HbA1c-level, diabetic-complications, cardiovascular\/lipid-lowering medications, and presence of other antidiabetes agents under investigation was adjusted. Three sets of sensitivity-analyses were conducted by (a) restricting to patients with cumulative drug-exposure \u226590 days and \u2265180 days, (b) monotherapy, and (c) incorporating commonly-used non-antidiabetic medications as exposure variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291726104759_sec3\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Lower risk of new-onset depression was associated with exposure to any antidiabetes agents (HR 0.42, 95%CI 0.39-0.45) compared with no exposure in patients with incident type-2 diabetes. Lower depression risk was associated with exposure to metformin (0.61[0.57-0.66]) compared with no antidiabetes agents, and to pioglitazone (0.25[0.10-0.63]), linagliptin (0.26[0.13-0.52]), and insulin (0.63[0.55-0.72]). Sensitivity-analyses affirmed that lower depression risk was associated with metformin and insulin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291726104759_sec4\" sec-type=\"conclusions\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients with type-2 diabetes with exposure to several antidiabetes agents is at decreased risk of new-onset depression. Further research is warranted to clarify the depression-reducing mechanisms of antidiabetes agents in this vulnerable population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s0033291726104759","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T10:11:20Z","timestamp":1780913480000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Antidiabetes agents and risk of incident depression in 686,522 people with type 2 diabetes mellitus: A 20-year population-based cohort study"],"prefix":"10.1017","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5834-7416","authenticated-orcid":false,"given":"Matthew Tsz Ho","family":"Ho","sequence":"first","affiliation":[{"name":"University of Hong Kong"},{"name":"United Christian Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joe Kwun 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Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco Tsz Tsun","family":"Lai","sequence":"additional","affiliation":[{"name":"University of Hong Kong"},{"name":"University of Hong Kong"},{"name":"Advanced Data Analytics for Medical Science (ADAMS) Limited"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3867-6447","authenticated-orcid":false,"given":"Amy Pui Pui","family":"Ng","sequence":"additional","affiliation":[{"name":"University of Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William Chi Wai","family":"Wong","sequence":"additional","affiliation":[{"name":"University of Hong Kong"},{"name":"The University of Hong Kong-Shenzhen Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3581-8895","authenticated-orcid":false,"given":"Wing Chung","family":"Chang","sequence":"additional","affiliation":[{"name":"University of Hong 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