The Prevalence of Comorbid Depression in Adults With Diabetes: a...
The Prevalence of Comorbid Depression in Adults With Diabetes: a...
Objective. To estimate the odds and prevalence of clinically relevant depression in adults with type 1 or type 2 diabetes. Depression is associated with hyperglycemia and an increased risk for diabetic complications; relief of depression is associated with improved glycemic control. A more accurate estimate of depression prevalence than what is currently available is needed to gauge the potential impact of depression management in diabetes.
Research Design and Methods. MEDLINE and PsycINFO databases and published references were used to identify studies that reported the prevalence of depression in diabetes. Prevalence was calculated as an aggregate mean weighted by the combined number of subjects in the included studies. We used
2statistics and odds ratios (ORs) to assess the rate and likelihood of depression as a function of type of diabetes, sex, subject source, depression assessment method, and study design.
Results. A total of 42 eligible studies were identified; 20 (48%) included a nondiabetic comparison group. In the controlled studies, the odds of depression in the diabetic group were twice that of the nondiabetic comparison group (OR = 2.0, 95% CI 1.82.2) and did not differ by sex, type of diabetes, subject source, or assessment method. The prevalence of comorbid depression was significantly higher in diabetic women (28%) than in diabetic men (18%), in uncontrolled (30%) than in controlled studies (21%), in clinical (32%) than in community (20%) samples, and when assessed by self-report questionnaires (31%) than by standardized diagnostic interviews (11%).
Conclusions. The presence of diabetes doubles the odds of comorbid depression. Prevalence estimates are affected by several clinical and methodological variables that do not affect the stability of the ORs.
Recent meta-analyses link depression in diabetes with hyperglycemia [1]and with an increased risk for complications of the metabolic disorder [2]. There is also evidence from three controlled trials to suggest that treatment of depression improves glycemic control [3,4,5]. An accurate estimate of depression prevalence is needed to help gauge the potential impact of depression management in patients with comorbid diabetes. Gavard et al. [6]last reviewed studies of the prevalence of depression in diabetes in 1993. Since then, the literature on this subject has expanded considerably. In the present study, we comprehensively reviewed the scientific literature to determine the odds of clinically significant depression in those with diabetes versus those without diabetes and to estimate the aggregate prevalence. These estimates were also studied in relation to the type of diabetes, sex, source of subjects, study design, and method of depression assessment.
Objective. To estimate the odds and prevalence of clinically relevant depression in adults with type 1 or type 2 diabetes. Depression is associated with hyperglycemia and an increased risk for diabetic complications; relief of depression is associated with improved glycemic control. A more accurate estimate of depression prevalence than what is currently available is needed to gauge the potential impact of depression management in diabetes.
Research Design and Methods. MEDLINE and PsycINFO databases and published references were used to identify studies that reported the prevalence of depression in diabetes. Prevalence was calculated as an aggregate mean weighted by the combined number of subjects in the included studies. We used
2statistics and odds ratios (ORs) to assess the rate and likelihood of depression as a function of type of diabetes, sex, subject source, depression assessment method, and study design.
Results. A total of 42 eligible studies were identified; 20 (48%) included a nondiabetic comparison group. In the controlled studies, the odds of depression in the diabetic group were twice that of the nondiabetic comparison group (OR = 2.0, 95% CI 1.82.2) and did not differ by sex, type of diabetes, subject source, or assessment method. The prevalence of comorbid depression was significantly higher in diabetic women (28%) than in diabetic men (18%), in uncontrolled (30%) than in controlled studies (21%), in clinical (32%) than in community (20%) samples, and when assessed by self-report questionnaires (31%) than by standardized diagnostic interviews (11%).
Conclusions. The presence of diabetes doubles the odds of comorbid depression. Prevalence estimates are affected by several clinical and methodological variables that do not affect the stability of the ORs.
Recent meta-analyses link depression in diabetes with hyperglycemia [1]and with an increased risk for complications of the metabolic disorder [2]. There is also evidence from three controlled trials to suggest that treatment of depression improves glycemic control [3,4,5]. An accurate estimate of depression prevalence is needed to help gauge the potential impact of depression management in patients with comorbid diabetes. Gavard et al. [6]last reviewed studies of the prevalence of depression in diabetes in 1993. Since then, the literature on this subject has expanded considerably. In the present study, we comprehensively reviewed the scientific literature to determine the odds of clinically significant depression in those with diabetes versus those without diabetes and to estimate the aggregate prevalence. These estimates were also studied in relation to the type of diabetes, sex, source of subjects, study design, and method of depression assessment.
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