Predicting Depression in Canadians with or at Risk of Diabetes: A Cross-Sectional Machine Learning Analysis

Depression often goes unrecognized in individuals at risk or living with diabetes, presenting considerable challenges for primary care clinicians. Although large language models and other foundation model approaches are drawing significant attention, we systematically compared six established machine learning algorithms-Logistic Regression, Random Forest, AdaBoost, XGBoost, Naive Bayes, and Artificial Neural Networks-chosen for their reliability, interpretability, and feasibility in everyday clinical settings. By benchmarking their performance under real-world constraints, we identified key factors linked to depression risk in diabetes care, including patient sex, age, osteoarthritis, hemoglobin A1c, and body mass index. Although incomplete demographic information and potential label bias limited predictive power, our results demonstrate that a diverse set of clinical features can still help pinpoint high-risk patients. They also indicate a need for longitudinal follow-up and richer clinical data to enhance model accuracy. As a practical benchmark for both clinicians and data scientists, this work suggests that machine learning–based risk stratification can improve early detection of depression and inform targeted interventions in diabetic populations.