A review of the relationship between depression and diabetes in adults: is there a link?

Talbot, France; Nouwen, Arie

doi:10.2337/diacare.23.10.1556

Cited by 351 publications

(252 citation statements)

References 57 publications

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“…Other studies that assessed incidence of depression after diagnosis of diabetes calculated this after a period of at least 2 years [8][9][10] and therefore may have missed the increased incidence shortly after diagnosis. The increased use of antidepressants and benzodiazepines could be a consequence of the burden of diabetes, as was noticed in previous papers [20][21][22]. It is also possible that it reflects selective detection by the physician.…”

Section: Discussionmentioning

confidence: 72%

Antidepressant use before and after initiation of diabetes mellitus treatment

et al. 2009

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Aims/hypothesis Although current literature suggests an association between diabetes and depression, the direction of the association is unclear. We examined the temporal association between diabetes and depression by studying antidepressant and benzodiazepine use around the initiation of diabetes treatment. Methods From a pharmacy registry database we selected 49,593 diabetic patients and a random sample of non-diabetic individuals (n=154,441), all >40 years old. Antidepressant and benzodiazepine use was calculated for the 7 years before and 7 years after the index date. The index date in diabetes patients was defined as the date of initiation of diabetes medication. A random index date was assigned to nondiabetic individuals. Time-specific incidence rate ratios of antidepressant and benzodiazepine use were calculated for intervals of 1 year, 3 months and 1 month. Results Antidepressant and benzodiazepine use was increased 2 months before and 3 months after the initiation of diabetes treatment compared with non-diabetic individuals.The strongest increase in incidence of antidepressant and benzodiazepine use was seen in the month after initiation of diabetes treatment with incidence rate ratios of 2.4 (95% CI 2.0-3.0) and 3.4 (95% CI 3.0-3.8) respectively, after adjustment for age, sex and Chronic Disease Score. Conclusions/interpretation The increased incidence of antidepressant and benzodiazepine use may be a consequence of the burden of disease, of starting with diabetes medication or of being diagnosed with diabetes. Our findings could also reflect earlier detection by their physician.

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Section: Discussionmentioning

confidence: 72%

Antidepressant use before and after initiation of diabetes mellitus treatment

et al. 2009

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“…Depression is often regarded as a comorbid condition that results from the daily burden of having diabetes and/or its complications. Interestingly, there are also indications that depression in turn is an independent risk factor for the development of type 2 diabetes [4,5]. This is an observation that dates back to 1684, when the English physician Thomas Willis noted that emotional factors such as grief or sadness could bring on diabetes [6,7].…”

Section: Introductionmentioning

confidence: 99%

Depression as a risk factor for the onset of type 2 diabetes mellitus. A meta-analysis

et al. 2006

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Aims/hypothesis: Evidence strongly suggests that depression and type 2 diabetes are associated, but the direction of the association is still unclear. Depression may occur as a consequence of having diabetes, but may also be a risk factor for the onset of type 2 diabetes. This study examined the latter association by reviewing the literature and conducting a meta-analysis of longitudinal studies on this topic. Methods: Medline and PsycInfo were searched for articles published up to January 2005. All studies that examined the relationship between depression and the onset of type 2 diabetes were included. Pooled relative risks were calculated using fixed and random effects models. To explore sources of heterogeneity between studies, subgroup analyses and meta-regression analyses were performed. Results: Nine studies met our inclusion criteria for this meta-analysis. The pooled relative risk was 1.26 (1.13-1.39) using the fixed effects model and 1.37(1.14-1.63) using the random effects model. Heterogeneity between studies could not be explained by (1) whether studies controlled for undetected diabetes at baseline; (2) the method of diabetes assessment at followup; (3) the baseline overall risk of diabetes in the study population; and (4) follow-up duration. Conclusions/ interpretation: Depressed adults have a 37% increased risk of developing type 2 diabetes mellitus. The pathophysiological mechanisms underlying this relationship are still unclear and warrant further research. A randomised controlled study is needed to test whether effective prevention or treatment of depression can reduce the incidence of type 2 diabetes and its health consequences.

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“…The reasons for the high comorbidity of depression and diabetes are not fully understood [13]. Besides general demographic and psychosocial characteristics, certain diabetes-related stressors are associated with elevated depression rates in diabetes; these stressors include the presence of complications, poor glycaemic control, and treatment with insulin [5,12,14,15].…”

Section: Introductionmentioning

confidence: 99%

How to screen for depression and emotional problems in patients with diabetes: comparison of screening characteristics of depression questionnaires, measurement of diabetes-specific emotional problems and standard clinical assessment

et al. 2006

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Aims/hypothesis: We compared the screening performance of different measures of depression: the standard clinical assessment (SCA); the Beck Depression Inventory (BDI); the Center of Epidemiological StudiesDepression Scale (CES-D); and the Problem Areas in Diabetes (PAID) questionnaire, which assesses diabetesspecific distress. We also studied the ability of these measures to detect diabetes-related distress. Materials and methods: A total of 376 diabetic patients (37.2% type 1; 23.9% type 2 without insulin treatment, 38.8% type 2 with insulin) completed the BDI and CES-D; patients who screened positive participated in a diagnostic interview, the Composite International Diagnostic Interview (CIDI). Also, all patients completed the PAID questionnaire. Results of the SCA that related to depression diagnosis were reviewed to correct for false negative screening results. Results: The prevalence of clinical depression was 14.1%, with an additional 18.9% of patients receiving a diagnosis of subclinical depression. Sensitivity for clinical depression in SCA (56%) was moderate, whereas BDI, CES-D and the PAID questionnaire showed satisfactory sensitivity (87, 79 and 81%, respectively). For subclinical depression, the sensitivity of the PAID questionnaire (79%) was sufficient, whereas that of SCA (25%) was poor. All methods showed low sensitivity for the detection of diabetes-specific emotional problems (SCA 19%, CIDI 34%, BDI 60%, CES-D 49%). Conclusions/interpretation: The screening performance of SCA for clinical and subclinical depression was modest. Additional screening for depression using the PAID or another depression questionnaire seems reasonable. The ability of depression screening measures to identify diabetes-related distress is modest, suggesting that the PAID questionnaire could be useful when screening diabetic patients for both depression and emotional problems.

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A review of the relationship between depression and diabetes in adults: is there a link?

Cited by 351 publications

References 57 publications

Antidepressant use before and after initiation of diabetes mellitus treatment

Antidepressant use before and after initiation of diabetes mellitus treatment

Depression as a risk factor for the onset of type 2 diabetes mellitus. A meta-analysis

How to screen for depression and emotional problems in patients with diabetes: comparison of screening characteristics of depression questionnaires, measurement of diabetes-specific emotional problems and standard clinical assessment

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