Diabetes and Incident Depression: Is the Association Mediated or Modified by Sociodemographic Factors or Co-morbidities? A Systematic Review

Abstract

Objective:

Diabetic patients suffer more frequently from depression. Aim was to evaluate sociodemographic parameters and co-morbidities and late complications as potential modifying factors in the occurrence of depression in diabetic individuals.

Research Design and Methods:

We performed a systematic review, based on established meta-analyses and additional original publications in 2005–2009 in Medline and PsycINFO. We included articles focusing on longitudinal studies which evaluated the appearance of depression in diabetic and non diabetic individuals and further analyzed interactions or separate additional influences of potential modifying factors.

Results:

8 eligible studies were identified. 6 studies were population based. Only 3 studies analyzed the interaction between the variables of interest and diabetes on the incidence of depression. Remaining used diverse other methods to control for associated factors.

The strongest influence was found for a general measure of co-morbidities but this influence was ambiguous. No significant modifying effect or interaction was found for sociodemographic factors.

Conclusion:

There seems to be a clear need for more research concerning mediating and modifying factors or a more stringent presentation of results in order to identify groups at risk or to identify treatment strategies.

Key words

diabetes - depression - co-morbidities - sociodemographic factors - competence network for diabetes mellitus

• References

• 1 Aarts S, van den Akker M, van Boxtel MP et al. Diabetes mellitus type II as a risk factor for depression: a lower than expected risk in a general practice setting. Eur J Epidemiol 2009; 24 (10) 641-648
• 2 Ali S, Stone MA, Peters JL et al. The prevalence of co-morbid depression in adults with Type 2 diabetes: a systematic review and meta-analysis. Diabet Med 2006; 23 (11) 1165-1173
• 3 American Diabetes Association. All About Diabetes (Diabetes Fact Sheet). Available from http://www.diabetes.org/diabetes-basics/diabetes-statistics/ Accessed 06 July 2010
• 4 Anderson RJ, Freedland KE, Clouse RE et al. The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care 2001; 24 (06) 1069-1078
• 5 Black SA, Markides KS, Ray LA. Depression predicts increased incidence of adverse health outcomes in older Mexican Americans with type 2 diabetes. Diabetes Care 2003; 26 (10) 2822-2828
• 6 Brown LC, Majumdar SR, Newman SC et al. Type 2 diabetes does not increase risk of depression. CMAJ 2006; 175 (01) 42-44
• 7 Bruce DG, Davis WA, Starkstein SE et al. A prospective study of depression and mortality in patients with type 2 diabetes: the Fremantle Diabetes Study. Diabetologia 2005; 48 (12) 2532-2539
• 8 de Groot M, Anderson R, Freedland KE et al. Association of depression and diabetes complications: a meta-analysis. Psychosom Med 2001; 63 (04) 619-630
• 9 de Jonge P, Roy JF, Saz P et al. Prevalent and incident depression in community-dwelling elderly persons with diabetes mellitus: results from the ZARADEMP project. Diabetologia 2006; 49 (11) 2627-2633
• 10 Eaton WW, Armenian H, Gallo J. Depression and risk for onset of type II diabetes. A prospective population-based study. Diabetes Care 1996; 19 (10) 1097-1102
• 13 Egede LE. Diabetes, major depression, and functional disability among U.S. adults. Diabetes Care 2004; a 27 (02) 421-428
• 12 Egede LE, Nietert PJ, Zheng D. Depression and all-cause and coronary heart disease mortality among adults with and without diabetes. Diabetes Care 2005; 28 (06) 1339-1345
• 11 Egede LE. Effects of depression on work loss and disability bed days in individuals with diabetes. Diabetes Care 2004; b 27 (07) 1751-1753
• 14 Egede LE, Osborn CY. Role of motivation in the relationship between depression, self-care, and glycemic control in adults with type 2 diabetes. Diabetes Educ 2010; 36 (02) 276-283
• 15 Engum A. The role of depression and anxiety in onset of diabetes in a large population-based study. J Psychosom Res 2007; 62 (01) 31-38
• 16 Golden SH, Lazo M, Carnethon M et al. Examining a bidirectional association between depressive symptoms and diabetes. JAMA 299 2008; 23: 2751-2759
• 17 Golden SH, Williams JE, Ford DE et al. Depressive symptoms and the risk of type 2 diabetes: the Atherosclerosis Risk in Communities study. Diabetes Care 2004; 27 (02) 429-435
• 18 Gregg EW, Yaffe K, Cauley JA et al. Is diabetes associated with cognitive impairment and cognitive decline among older women? Study of Osteoporotic Fractures Research Group. Arch Intern Med 2000; 160 (02) 174-180
• 19 Haupt E, Herrmann R, Benecke-Timp A et al. The KID study IV: effects of inpatient rehabilitation on the frequency of glucose self-monitoring, quality of further primary care, on time being unable to work and on everyday psychic strain of type I and type II diabetics – a one-year follow-up. Kissingen Diabetes Intervention Study. Exp Clin Endocrinol Diabetes 1997; 105: 21-31
• 20 Hayashino Y, Suzuki H, Yamazaki K et al. Depressive symptoms, not completing a depression screening questionnaire, and risk of poor compliance with regular primary care visits in patients with type 2 diabetes: The Japan Diabetes Outcome Intervention Trial 2 (J-DOIT2) Study Group. Exp Clin Endocrinol Diabetes 2010; Oct (Epub ahead of print)
• 21 Hennings JM, Ising M., Grautoff S et al. Glucose Tolerance in Depressed Inpatients, under Treatment with Mirtazapine and in Healthy Controls. Exp Clin Endocrinol Diabetes 2010; 118: 98-100
• 22 Icks A, Kruse J, Dragano N et al. Are symptoms of depression more common in diabetes? Results from the Heinz Nixdorf Recall study. Diabet Med 2008; 25 (11) 1330-1336
• 23 Kessler RC, Berglund P, Demler O et al. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005; 62 (06) 593-602
• 24 Kim JM, Stewart R, Kim SW et al. Vascular risk factors and incident late-life depression in a Korean population. Br J Psychiatry 2006; 189: 26-30
• 25 Kruse J, Schmitz N, Thefeld W. On the association between diabetes and mental disorders in a community sample: results from the German National Health Interview and Examination Survey. Diabetes Care 2003; 26 (06) 1841-1846
• 26 Lustman PJ, Anderson RJ, de Groot M et al. Depression and poor glycemic control: a meta-analytic review of the literature. Diabetes Care 2000; 23 (07) 934-942
• 27 Maraldi C, Volpato S, Penninx BW et al. Diabetes mellitus, glycemic control, and incident depressive symptoms among 70- to 79-year-old persons: the health, aging, and body composition study. Arch Intern Med 2007; 167 (11) 1137-1144
• 28 Mezuk B, Eaton WW, Albrecht S et al. Depression and type 2 diabetes over the lifespan: a meta-analysis. Diabetes Care 2008; 31 (12) 2383-2390
• 29 Moher D, Liberati A, Tetzlaff J et al. The PRIMA Group. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA Statement. PLoS Medicine 2009; 6: e1000097
• 30 Nawroth PP, Rudofsky G, Humpert P. Have we understood diabetes? New tasks for diagnosis and therapy. Exp Clin Endocrinol Diabetes 2010; 118: 1-3
• 31 Nouwen A, Winkley K, Twisk J et al. Type 2 diabetes mellitus as a risk factor for the onset of depression: a systematic review and meta-analysis. Diabetologia 2010; 53 (12) 2480-2486
• 32 O’Connor PJ, Crain AL, Rush WA et al. Does diabetes double the risk of depression?. Ann Fam Med 2009; 7 (04) 328-335
• 33 Palinkas LA, Lee PP, Barrett-Connor E. A prospective study of Type 2 diabetes and depressive symptoms in the elderly: the Rancho Bernardo Study. Diabet Med 2004; 21 (11) 1185-1191
• 34 Pan A, Lucas M, Sun Q et al. Bidirectional association between depression and type 2 diabetes mellitus in women. Arch Intern Med 2010; 170 (21) 1884-1891
• 35 Polsky D, Doshi JA, Marcus S et al. Long-term risk for depressive symptoms after a medical diagnosis. Arch Intern Med 2005; 165 (11) 1260-1266
• 36 Pouwer F, Beekman AT, Nijpels G et al. Rates and risks for co-morbid depression in patients with Type 2 diabetes mellitus: results from a community-based study. Diabetologia 2003; 46 (07) 892-898
• 37 Weber B, Schweiger U, Deutschle M et al. Major depression and impaired glucose tolerance. Exp Clin Endocrinol Diabetes 2000; 108: 187-190
• 38 Wild S, Roglic G, Green A et al. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care 2004; 27 (05) 1047-1053
• 39 Zhang X, Norris SL, Gregg EW et al. Depressive symptoms and mortality among persons with and without diabetes. Am J Epidemiol 2005; 161 (07) 652-660