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Diress G, Endalifer ML, Addisu A, Mengist B. Association between social supports and depression among patients with diabetes mellitus in Ethiopia: a systematic review and meta-analysis. BMJ Open 2022; 12:e061801. [PMID: 35545384 PMCID: PMC9096548 DOI: 10.1136/bmjopen-2022-061801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE The adverse effects of poor social support on quality of life and adherence to treatment are established. However, the relationship between social support and depression is not well understood. In this systematic review and meta-analysis, we aim to examine the association between social support and depressive symptoms among type 2 patients with diabetes. DESIGN Systematic review and meta-analysis. DATA SOURCES We searched PubMed, African Journals Online, Web of Science, and the Cochrane Library electronic databases. Some studies were also identified through manual Google search and Google scholar. ELIGIBILITY CRITERIA We systematically searched electronic databases for studies published up to October 2020. Only English-language articles were included. DATA EXTRACTION AND SYNTHESIS Screening, data extraction and quality appraisal were conducted by two independent reviewers. A random-effect model was applied to estimate ORs with 95% CIs. The Higgins I2 test was used to assess the heterogeneity between the studies. The risk of publication bias was estimated using the Egger test. Leave-one-out analysis was done. Data were analysed using Stata V.11. RESULTS Seven studies were included in the meta-analysis. The findings from included studies revealed that poor social support increases the odds of depression among patients with diabetes (adjusted OR=2.14, 95% CI 1.34 to 3.43, p=0.003). There was no risk of publication bias (p=0.064), and heterogeneity was substantial (I2=70.7%). The leave-one-out analysis confirmed the consistency of the findings. CONCLUSIONS Our meta-analysis revealed that patients who had poor social support were significantly associated with an increased level of depression. Additional studies exploring factors that might moderate or mediate this association are needed. Targeted interventions for comorbid depression should be implemented in clinical practice. SYSTEMATIC REVIEW REGISTRATION We have submitted the protocol for registration at the PROSPERO on 9 October 2020. But we have not yet received a registration number.
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Affiliation(s)
- Gedefaw Diress
- Department of Public Health, College of Health Science, Debre Markos University, Debre Markos, Amhara, Ethiopia
| | - Melese Linger Endalifer
- Department of Nutrition, College of Health Science, Debre Markos University, Debre Markos, Amhara, Ethiopia
| | - Amanuel Addisu
- School of Public Health, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Belayneh Mengist
- Department of Public Health, College of Health Science, Debre Markos University, Debre Markos, Amhara, Ethiopia
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Tamrchi S, Davoudi M, Khosrojerdi Z, Hosseinpoor S, Ahmadi SM, Emami Rad R. Clarification the optimal cut-off values for Persian-language versions of depression screening tools in Iranian patients with type 2 diabetes. J Diabetes Metab Disord 2021; 20:1359-1367. [PMID: 34900787 PMCID: PMC8630129 DOI: 10.1007/s40200-021-00866-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 07/24/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Depression is the most common psychiatric disorder in patients with type 2 diabetes. There are many questionnaires to measure depression symptoms. These tools are generally used with the same cut-off points in different medical diseases. The present study investigates the optimal cut-off points of these tools in patients with type 2 diabetes in the Iranian diabetic population. The original version of this tool is prepared in Persian. METHOD Two-hundred and forty four patients with a diagnosis of diabetes were selected to participate in the study. The gold standard for diagnosing depression was the Structured Mini-International Neuropsychiatric Interview. We applied the cut-off points of the Persian versions of the Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI), Depression in Diabetes Self-Rating Scale (DDS-RS), Problematic Areas in Diabetes Survey (PAID), Hamilton Depression Rating Scale (HDRS) and Depression in Diabetes Self-Rating Scale (DDS-RS). RESULTS 23.8% of patients were diagnosed with depression. Depressed patients had higher levels of HbA1c and physical complaints than non-depressed patients. In all tools, the sum of Sensitivity and Specificity of our proposed cut-off points was better than the conventional cut-off points. In HADS, the results showed that this questionnaire performed better and more efficiently than other tools. CONCLUSION In patients with type 2 diabetes, it is better to use the proposed cut-off point's specific to this disorder in the Iranian population. These cut-off points have a higher ability to identify depressed and non-depressed cases.
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Affiliation(s)
- Sepideh Tamrchi
- Department of Clinical Psychology, Behavioral Science Faculty, Khatam University, Tehran, Iran
| | - Mohammadreza Davoudi
- Department of Clinical Psychology, Behavioral Science Faculty, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Department of Clinical Psychology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Zeinab Khosrojerdi
- Department of Clinical Psychology, Behavioral Science Faculty, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Sara Hosseinpoor
- Department of Clinical Psychology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Seyed Mojtaba Ahmadi
- Department of Clinical Psychology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Rasti Emami Rad
- Department of Clinical Psychology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
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Lian WC, Livneh H, Huang HJ, Lu MC, Guo HR, Tsai TY. Adding Pay-for-Performance Program to Routine Care Was Related to a Lower Risk of Depression Among Type 2 Diabetes Patients in Taiwan. Front Public Health 2021; 9:650452. [PMID: 34722429 PMCID: PMC8548469 DOI: 10.3389/fpubh.2021.650452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 09/13/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Patients with type 2 diabetes (T2DM) often experience depression during treatment, negatively influencing their treatment compliance and clinical outcomes. Recently, the pay-for-performance (P4P) program for chronic diseases, with high-cost and high-risk feature, such as T2DM, has been implemented and has been operational for several years. Nevertheless, its effect on the risk of developing depression among T2DM cases is unknown. This study aims to explore the association of P4P use with the subsequent risk of developing depression among these patients. Methods: This cohort study used a nationwide health insurance database to identify patients 20-70 years of age newly diagnosed with T2DM who enrolled in the P4P program between 2001 and 2010. From this group, we enrolled 17,022 P4P users and then 17,022 non-P4P users who were randomly selected using propensity-score-matching. Enrolled patients were followed until the end of 2012 to record the occurrence of depression. The Cox proportional hazards regression was utilized to obtain the adjusted hazard ratio (aHR) for P4P use. Results: During the study period, a total of 588 P4P users and 1,075 non-P4P users developed depression at incidence rates of 5.89 and 8.41 per 1,000 person-years, respectively. P4P users had a lower depression risk than did non-P4P users (aHR, 0.73; 95% Confidence Interval, 0.65-0.80). This positive effect was particularly prominent in those receiving high-intensity use of the P4P program. Conclusion: Integrating P4P into routine care for patients with T2DM may have beneficial effects on curtailing the subsequent risk of depression.
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Affiliation(s)
- Wei-Cheng Lian
- Division of Metabolism and Endocrinology, Department of Internal Medicine, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Hanoch Livneh
- Rehabilitation Counseling Program, Portland State University, Portland, OR, United States
| | - Hui-Ju Huang
- Department of Nursing, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi, Taiwan
| | - Ming-Chi Lu
- School of Medicine, Tzu Chi University, Hualien, Taiwan.,Division of Allergy, Immunology and Rheumatology, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi, Taiwan
| | - How-Ran Guo
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.,Occupational Safety, Health, and Medicine Research Center, National Cheng Kung University, Tainan, Taiwan
| | - Tzung-Yi Tsai
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Medical Research, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi, Taiwan.,Department of Nursing, Tzu Chi University of Science and Technology, Hualien, Taiwan
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Tran NN, Nguyen VQ, Vo HL, Hoang TPN, Bui VS, Nguyen VT. Depression among patients with type 2 diabetes mellitus: Evidence from the Northeast region of Vietnam. Diabetes Metab Syndr 2021; 15:102293. [PMID: 34598010 DOI: 10.1016/j.dsx.2021.102293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 09/07/2021] [Accepted: 09/15/2021] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND AIMS Herein, we aim to examine the prevalence of depression in type 2 diabetic patients at a provincial general hospital located in the Northeast region of Vietnam and to explore its relationship with some sociodemographic, lifestyle and medical history characteristics. MATERIALS AND METHODS This was a single-centre cross-sectional descriptive study. The patients of both sexes who were at the age of 18 years or above, were treated at our institution and were diagnosed with type 2 diabetes mellitus, previously or during the study period. A total of 220 patients were included in the study. RESULTS Depression prevalence was 32.27% according to ICD-10. The severity of depression was categorized as mild in 77.46% patients, moderate in 19.72% patients and severe in 2.82% patients. The odds of depression was 0.18 (95%CI 0.05-0.69, p = 0.012) less for those known as the upper social class compared with those in lower social class. Those who were not on insulin treatment had significantly higher odds of depression than those on treatment with insulin (OR 2.06, 95%CI: 1.01-4.21). Individuals on treatment without oral diabetes drugs had higher odd of depression compared to those being treated with oral diabetes drugs (OR 2.77, 95%CI: 1.14-6.73). Also, hypertension was an increasing contributor to the depression prevalence (OR 2.32, 95%CI: 1.10-4.90). CONCLUSIONS A high prevalence of depression among type 2 diabetic patients was documented. Only significant factors for depression were lower social class, co-morbid hypertension and none of the insulin treatment or oral diabetes drugs.
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Affiliation(s)
- Nguyen-Ngoc Tran
- Department of Psychiatry, Hanoi Medical University, Hanoi, 100000, Vietnam; National Institute of Mental Health, Bach Mai Hospital, Hanoi, 100000, Vietnam
| | | | - Hoang-Long Vo
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, 100000, Vietnam.
| | | | - Van-San Bui
- Department of Psychiatry, Hanoi Medical University, Hanoi, 100000, Vietnam; National Institute of Mental Health, Bach Mai Hospital, Hanoi, 100000, Vietnam
| | - Van-Tuan Nguyen
- Department of Psychiatry, Hanoi Medical University, Hanoi, 100000, Vietnam; National Institute of Mental Health, Bach Mai Hospital, Hanoi, 100000, Vietnam.
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Aschner P, Gagliardino JJ, Ilkova H, Lavalle F, Ramachandran A, Mbanya JC, Shestakova M, Bourhis Y, Chantelot JM, Chan JCN. High Prevalence of Depressive Symptoms in Patients With Type 1 and Type 2 Diabetes in Developing Countries: Results From the International Diabetes Management Practices Study. Diabetes Care 2021; 44:1100-1107. [PMID: 33963019 PMCID: PMC8132319 DOI: 10.2337/dc20-2003] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 02/19/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Depression is common in people with diabetes, but data from developing countries are scarce. We evaluated the prevalence and risk factors for depressive symptoms in patients with diabetes using data from the International Diabetes Management Practices Study (IDMPS). RESEARCH DESIGN AND METHODS IDMPS is an ongoing multinational, cross-sectional study investigating quality of care in patients with diabetes in real-world settings. Data from wave 5 (2011), including 21 countries, were analyzed using the 9-item Patient Health Questionnaire (PHQ-9) to evaluate depressive symptoms. Logistic regression analyses were conducted to identify risk factors of depressive symptoms. RESULTS Of 9,865 patients eligible for analysis, 2,280 had type 1 and 7,585 had type 2 diabetes (treatment: oral glucose-lowering drugs [OGLD] only, n = 4,729; OGLDs plus insulin, n = 1,892; insulin only, n = 964). Depressive symptoms (PHQ-9 score ≥5) were reported in 30.7% of those with type 1 diabetes. In patients with type 2 diabetes, the respective figures were 29.0% for OGLDs-only, 36.6% for OGLDs-plus-insulin, and 46.7% for insulin-only subgroups. Moderate depressive symptoms (PHQ-9 score 10-19) were observed in 8-16% of patients with type 1 or type 2 diabetes. Female sex, complications, and low socioeconomic status were independently associated with depressive symptoms. In type 1 diabetes and in the type 2 diabetes OGLDs-only group, depression was associated with poor glycemic control. CONCLUSIONS Depressive symptoms are common in patients with diabetes from developing countries, calling for routine screening, especially in high-risk groups, to reduce the double burden of diabetes and depression and their negative interaction.
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Affiliation(s)
- Pablo Aschner
- Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Juan José Gagliardino
- El Centro de Endocrinología Experimental y Aplicada (CENEXA) (UNLP-CONICET-CEAS CICPBA), Facultad de Ciencias Médicas, Universidad Nacional de La Plata (UNLP), La Plata, Buenos Aires, Argentina
| | - Hasan Ilkova
- Division of Endocrinology Metabolism and Diabetes, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Fernando Lavalle
- Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Ambady Ramachandran
- India Diabetes Research Foundation, Dr. A. Ramachandran's Diabetes Hospitals, Chennai, India
| | - Jean Claude Mbanya
- Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
| | | | | | | | - Juliana C N Chan
- Department of Medicine and Therapeutics, Hong Kong Institute of Diabetes and Obesity and Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, The Prince of Wales Hospital, Shatin, Hong Kong SAR, China
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Bąk E, Marcisz-Dyla E, Młynarska A, Sternal D, Kadłubowska M, Marcisz C. Prevalence of Depressive Symptoms in Patients with Type 1 and 2 Diabetes Mellitus. Patient Prefer Adherence 2020; 14:443-454. [PMID: 32184573 PMCID: PMC7060793 DOI: 10.2147/ppa.s237767] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 02/11/2020] [Indexed: 12/03/2022] Open
Abstract
PURPOSE Patients with diabetes are at increased risk of developing depression. The aim of the study was to determine the occurrence of depressive symptoms in patients with type 1 (T1DM) and type 2 diabetes (T2DM), including the association with different independent sociodemographic and clinical variables. PATIENTS AND METHODS The studies were carried out on 618 people, including 115 patients with T1DM and 215 patients with T2DM and 288 people without diabetes constituting two control groups. Subjects were characterized in terms of sociodemographic, clinical and biochemical aspects, and the occurrence of depressive symptoms using Beck Depression Inventory (BDI) was determined. In the logistic regression analysis, the correlations between BDI score and with independent variables such as sex, age, body mass index, duration of diabetes, HbA1c level, diabetic complications and mean arterial pressure were examined. RESULTS The mean BDI score was significantly higher in women and men with T1DM and T2DM compared to controls. In diabetic patients, depressive symptoms occurred more often in women than in men. Among patients with T1DM, the incidence of depressive symptoms was 17.5% of the women and 8.6% of the men and in patients with T2DM, the incidence of depressive symptoms was revealed in 28.9% of the women and in 19.8% of the men. In patients with T1DM and T2DM, the occurrence of depressive symptoms increases with age, HbA1c level and complications, and the risk of depressive symptoms turned out to be almost three times higher in women than in men with T2DM. CONCLUSION The prevalence of depressive symptoms in diabetic patients is higher than in non-diabetics. Depressive symptoms account for 13% of the patients with T1DM and 24.7% of the patients with T2DM. The risk of depressive symptoms in T1DM and T2DM increases with age, HbA1c level and the presence of complications, and it is gender-related in T2DM only.
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Affiliation(s)
- Ewelina Bąk
- Faculty of Health Sciences, University of Bielsko-Biala, Bielsko-Biala, Poland
- Correspondence: Ewelina Bąk Faculty of Health Sciences, University of Bielsko-Biala, ul. Willowa 2, Bielsko-Biala43-309, PolandTel +48 33 827 9198 Email
| | - Ewa Marcisz-Dyla
- Department of Anxiety Disorders, Hospital of Ministry of Internal Affairs, Katowice, Poland
| | - Agnieszka Młynarska
- Department of Gerontology and Geriatric Nursing, School of Health Sciences, Medical University of Silesia, Katowice, Poland
| | - Danuta Sternal
- Faculty of Health Sciences, University of Bielsko-Biala, Bielsko-Biala, Poland
| | - Monika Kadłubowska
- Faculty of Health Sciences, University of Bielsko-Biala, Bielsko-Biala, Poland
| | - Czesław Marcisz
- Department of Gerontology and Geriatric Nursing, School of Health Sciences, Medical University of Silesia, Katowice, Poland
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Akimoto H, Tezuka K, Nishida Y, Nakayama T, Takahashi Y, Asai S. Association between use of oral hypoglycemic agents in Japanese patients with type 2 diabetes mellitus and risk of depression: A retrospective cohort study. Pharmacol Res Perspect 2019; 7:e00536. [PMID: 31768258 PMCID: PMC6868652 DOI: 10.1002/prp2.536] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 09/29/2019] [Accepted: 10/10/2019] [Indexed: 12/18/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) is a risk factor for depression. Since brain insulin resistance plays a potential role in depression, the future risk of depression in patients with T2DM may be altered depending on the class of oral hypoglycemic agent (OHA) used for T2DM therapy. The aim of the present study was to determine if specific classes of OHAs are associated with a risk for comorbid depression in T2DM. Japanese adult patients with T2DM (n = 40 214) were divided into a case group (with depression; n = 1979) and control group (without depression; n = 38 235). After adjustment for age [adjusted odds ratio (AOR) for 10 years: 1.03; 95% confidence interval (CI): 0.99-1.07; P = .1211], sex [AOR for female: 1.39; 95% CI: 1.26-1.53; P < .0001], hemoglobin A1c [AOR for 1.0%: 1.18; 95% CI: 1.11-1.26; P < .0001], duration of T2DM [AOR for 1 year: 1.00; 95% CI: 0.99-1.01; P = .4089], and history of seven medical conditions, the odds ratios for the development of depression was significantly lower for dipeptidyl peptidase-4 (DPP-4) inhibitors [AOR: 0.31; 95% CI: 0.24-0.42; P < .0001]. However, there was no significant association for the other classes of OHAs. Therefore, this study finds that there is less risk of depression associated with the use of DPP-4 inhibitors for the treatment of T2DM.
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Affiliation(s)
- Hayato Akimoto
- Department of Biomedical SciencesNihon University School of MedicineTokyoJapan
| | - Kotoe Tezuka
- Clinical Trials Research CenterNihon University School of MedicineTokyoJapan
| | - Yayoi Nishida
- Department of Biomedical SciencesNihon University School of MedicineTokyoJapan
| | - Tomohiro Nakayama
- Department of Pathology and MicrobiologyNihon University School of MedicineTokyoJapan
| | - Yasuo Takahashi
- Clinical Trials Research CenterNihon University School of MedicineTokyoJapan
| | - Satoshi Asai
- Department of Biomedical SciencesNihon University School of MedicineTokyoJapan
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González-Castro TB, Escobar-Chan YM, Fresan A, López-Narváez ML, Tovilla-Zárate CA, Juárez-Rojop IE, Ble-Castillo JL, Genis-Mendoza AD, Arias-Vázquez PI. Higher risk of depression in individuals with type 2 diabetes and obesity: Results of a meta-analysis. J Health Psychol 2019; 26:1404-1419. [PMID: 31532262 DOI: 10.1177/1359105319876326] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The aim of this study was to determine the risk of having significant depressive symptoms in subjects with obesity and type 2 diabetes mellitus through a meta-analysis. Our results showed that individuals with obesity and diabetes have an increased risk of having significant symptoms of depression. In subgroup analyses, we observed that Caucasian populations have an increased risk of having these symptoms. Our meta-analysis suggests that obesity is associated with an increased risk of having significant depressive symptoms in patients with type 2 diabetes, and they could be even higher in Caucasian populations.
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Affiliation(s)
| | | | - Ana Fresan
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz, México
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Khaledi M, Haghighatdoost F, Feizi A, Aminorroaya A. The prevalence of comorbid depression in patients with type 2 diabetes: an updated systematic review and meta-analysis on huge number of observational studies. Acta Diabetol 2019; 56:631-650. [PMID: 30903433 DOI: 10.1007/s00592-019-01295-9] [Citation(s) in RCA: 164] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 02/02/2019] [Indexed: 02/06/2023]
Abstract
AIMS Depression is a common co-morbidity in patients with type 2 diabetes mellitus (T2DM). Untreated depression in these patients adversely affects self-care activities and other diabetes complications. The aim of this study is to estimate the prevalence of depression among patients with T2DM by conducting a meta-analysis of observational studies. METHODS MEDLINE, Web of Science, Science Direct, and Google Scholar databases were searched for all observational studies that assessed depression in T2DM. Relevant articles were searched using the combination of Medical Subject Heading (MeSH) terms of "depression", "depressive disorder", and "diabetes mellitus" published between January 2007 and July 2018. Random effects model was used to estimate the weighted prevalence rates and 95% CI using "metaprop program in STATA 11". RESULTS In total, the 248 included studies (with 273 reported prevalence) identified 83,020,812 participants; of them, 23,245,827 (28%; 95% CI 27, 29) suffered from different severity levels of depressive disorders. The prevalence of depression was separately reported in 137,372 males and 134,332 females. Of them, 31,396 males (23%, 95% CI: 20, 26) and 45,673 females (34%, 95% CI: 31, 38) were depressed. Compared with global estimate, depression prevalence was lower in Europe (24%) and Africa (27%), but higher in Australia (29%) and Asia (32%). The prevalence in America was equal to the estimated prevalence in the world (28%). Depression was more common in subjects younger than 65 compared with elderlies (31% vs. 21%). CONCLUSION Our findings demonstrated that almost one in four adults with T2DM experienced depression. Given the high prevalence of depressive disorders in diabetic patients, screening these patients for co-morbid depression and its relevant risk factors is highly recommended.
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Affiliation(s)
- Mohammad Khaledi
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fahimeh Haghighatdoost
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Biostatistics and Epidemiology Department, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ashraf Aminorroaya
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
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Prevalence of Depression among Patients with Type 2 Diabetes Mellitus and its associated Clinical Factors. J ASEAN Fed Endocr Soc 2019; 34:197-203. [PMID: 33442156 PMCID: PMC7784119 DOI: 10.15605/jafes.034.02.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 08/02/2019] [Indexed: 12/05/2022] Open
Abstract
Introduction Type 2 diabetes mellitus has been linked to depression. However, this has been largely unrecognized and untreated. There are no current data available in the Philippine setting of the prevalence of the disease. Objective The objective of the study was to determine the prevalence of depression among adult Filipino patients with type 2 diabetes mellitus and investigate the different clinical factors associated with it. Methodology This is a single-center, analytic cross-sectional study conducted at a tertiary hospital, with 476 patients aged above 18 years old diagnosed with type 2 Diabetes Mellitus included. The Physicians Health Questionnaire 9 (PHQ-9) with a score of >5 was used to make a diagnosis of depression. Results Prevalence of depression among patients with type 2 diabetes mellitus was 19.9%. Factors associated with increased odds of depression were having a post-graduate degree (p-value=0.012), presence of retinopathy (p-value=0.018), and higher MMA Score (lower adherence) (p-value=0.000). Conclusion Depression is prevalent among Filipino patients with type 2 diabetes mellitus. An integrated approach by the attending physicians and psychiatrists is required for the effective management of these patients.
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Bai X, Liu Z, Li Z, Yan D. The association between insulin therapy and depression in patients with type 2 diabetes mellitus: a meta-analysis. BMJ Open 2018; 8:e020062. [PMID: 30498035 PMCID: PMC6278799 DOI: 10.1136/bmjopen-2017-020062] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 09/12/2018] [Accepted: 09/25/2018] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Several patients with type 2 diabetes mellitus (T2DM) have depressive disorders. Whether insulin treatment was associated with increased risk of depression remains controversial. We performed a meta-analysis to evaluate the association of insulin therapy and depression. DESIGN A meta-analysis. METHODS We conducted a systematic search of PubMed, PsycINFO, Embase and the Cochrane Library from their inception to April 2016. Epidemiological studies comparing the prevalence of depression between insulin users and non-insulin users were included. A random-effects model was used for meta-analysis. The adjusted and crude data were analysed. RESULTS Twenty-eight studies were included. Of these, 12 studies presented with adjusted ORs. Insulin therapy was significantly associated with increased risk of depression (OR=1.41, 95% CI 1.13 to 1.76, p=0.003). Twenty-four studies provided crude data. Insulin therapy was also associated with an odds for developing depression (OR=1.59, 95% CI 1.41 to 1.80, p<0.001). When comparing insulin therapy with oral antidiabetic drugs, significant association was observed for adjusted (OR=1.42, 95% CI 1.08 to 1.86, p=0.008) and crude (OR=1.61, 95% CI 1.35 to 1.93, p<0.001) data. CONCLUSIONS Our meta-analysis confirmed that patients on insulin therapy were significantly associated with the risk of depressive symptoms.
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Affiliation(s)
- Xiaosu Bai
- Department of Endocrinology, People’s Hospital of Longhua, Shenzhen, China
| | - Zhiming Liu
- Department of Endocrinology, People’s Hospital of Longhua, Shenzhen, China
| | - Zhisen Li
- Department of Endocrinology, People’s Hospital of Longhua, Shenzhen, China
| | - Dewen Yan
- Department of Endocrinology, The Second People’s Hospital of Shenzhen, Shenzhen, China
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Wu H, Ouyang P, Sun W. High -density lipoprotein cholesterol as a predictor for diabetes mellitus. CASPIAN JOURNAL OF INTERNAL MEDICINE 2018; 9:144-150. [PMID: 29732032 PMCID: PMC5912222 DOI: 10.22088/cjim.9.2.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background: Diabetes is a prevalent chronic disease around the world. To evaluate the risk of diabetes comprehensively, we developed a score model for risk prediction with HDL-C as a protective factor. Methods: We extracted physical examination data of 2728 individuals. The data contain 18 demographic and clinical variables. To identify the statistical significant feature variables, the backward stepwise logistic regression was used based on the data of the “exploratory population”. To ascertain the cutoff value of the selected variables, we used the Youden index. Then we assigned each variable level a score according to the estimated regression model coefficients and then calculated the individual’s total score. We gained the cutoff value for the total score through the Youden Index and stratified the total score into four levels. We employed the data of “validation population” to test the performance of the score model based on the area under the ROC curve. Results: Age, LDL-C, HDL-C, BMI, family history of diabetes, diastolic blood pressure and TCHO were selected as statistically significant variables. The diabetes risk score range varied from 0 to 17. The risk level categorized by the total score was low, middle, high and extremely high, with a score range of 0-2, 3-7, 8-12 and 13-17, respectively. Conclusions: The score model based on physical examination data is an efficient and valuable tool to evaluate and monitor the potential diabetes risk for both healthy and unhealthy people at an individual level.
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Affiliation(s)
- Hong Wu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Peng Ouyang
- School of Management, Harbin Institute of Technology, Harbin, China
| | - Wenjun Sun
- School of Management, Harbin Institute of Technology, Harbin, China
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Prinz N, Ebner S, Grünerbel A, Henkelüdecke U, Hermanns N, Hummel M, Schäfer C, Wagner C, Weiland J, Welp R, Holl RW. Female sex, young age, northern German residence, hypoglycemia and disabling diabetes complications are associated with depressed mood in the WHO-5 questionnaire - A multicenter DPV study among 17,563 adult patients with type 2 diabetes. J Affect Disord 2017; 208:384-391. [PMID: 27810722 DOI: 10.1016/j.jad.2016.08.077] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 06/14/2016] [Accepted: 08/28/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND Like other mental illnesses, depression is a culturally sensitive topic. Hence, findings cannot be transferred between countries. We investigated the frequency of depressed mood and its association with diabetes-related factors in a large type 2 diabetes (T2D) cohort from real-life care in Germany. METHODS 17,563 adults (median [IQR]: 64.5[55.9-71.1] years) from the multicenter diabetes follow-up registry, DPV (diabetes prospective follow-up), were investigated. All had completed the WHO-5 questionnaire, a screening tool for depression. Logistic regression was applied to study the association of demographic and diabetes-related factors with depressed mood (SAS 9.4). P<0.05 was considered significant. RESULTS Using a WHO-5 cut-off of <13, 27.4% of patients were at risk for depressed mood. A clinical depression diagnosis was recognized in 8.4%. Female sex (OR: 1.5[95%-CI: 1.4-1.6]), young age (1.2[1.1-1.4]), longer diabetes duration (1.2[1.1-1.3]), and living in Northern Germany (1.3[1.2-1.4]) were each associated with increased odds for depressed mood. After adjusting for these confounders, worse glycemic control (1.4[1.3-1.5]), insulin use (1.3[1.2-1.4]), myocardial infarction (1.3[1.2-1.5]), stroke (1.8[1.5-2.0]), retinopathy (1.4[1.3-1.6]), renal failure (1.4[1.2-1.8]), diabetic foot syndrome (1.3[1.2-1.4]), severe hypoglycemia (1.5[1.2-1.9]), two or more inpatient admissions (2.1[1.8-2.4]), and longer duration of hospital stay (1-<14 days: 1.3[1.2-2.3]; >14 days: 2.1[1.9-2.3]) were related to depressed mood. LIMITATION Due to the cross-sectional design, no causality can be drawn. CONCLUSIONS In T2D, depressed mood is not uncommon. However, in routine care a clinical depression might be missed and regular screening is advisable. Besides the well-known associations with depressed mood, northern German residence and mainly life-compromising diabetes comorbidities were identified as related factors.
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Affiliation(s)
- Nicole Prinz
- Institute of Epidemiology and Medical Biometry, Central Institute for Biomedical Technology, University of Ulm, Ulm, Germany; German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany.
| | - Stefan Ebner
- Medical Campus III, Clinic for Internal Medicine 2 - Nephrology, Endocrinology/Diabetes, Rheumatology and Gastroenterology/Hepatology, Kepler University Hospital, Linz, Austria
| | - Arthur Grünerbel
- Specialized Practice for Diabetes and Nutritional Medicine, Munich, Germany
| | - Uwe Henkelüdecke
- Internal Medicine, Hospital Malteser St. Johannes-Stift, Duisburg, Germany
| | | | | | - Claus Schäfer
- Internal Medicine, Hospital Neumarkt, Neumarkt, Germany
| | | | - Jörg Weiland
- Internal Medicine, Hospital Bad Reichenhall, Bad Reichenhall, Germany
| | - Reinhard Welp
- Internal Medicine, Knappschafts-Krankenhaus, Bottrop, Germany
| | - Reinhard W Holl
- Institute of Epidemiology and Medical Biometry, Central Institute for Biomedical Technology, University of Ulm, Ulm, Germany; German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
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Comorbidity of depression and diabetes: an application of biopsychosocial model. Int J Ment Health Syst 2016; 10:74. [PMID: 27980612 PMCID: PMC5135819 DOI: 10.1186/s13033-016-0106-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 11/25/2016] [Indexed: 02/06/2023] Open
Abstract
Background Type 2 diabetes (T2D) is one of the most psychologically demanding chronic medical illness in adult. Comorbidity between diabetes and depression is quite common, but most studies were based on developed country sample. Limited data exists to document biopsychosocial predictors of depressive symptoms in Ethiopian patients. Therefore, the aim of the study was to describe the association of depressive symptoms and T2D and explore the potential underlying associated biopsychosocial risk factors. Methods Institution based cross-sectional study was conducted on 276 patient with T2D at diabetic clinic, Black Lion General Specialized Hospital in Ethiopia. Patients were selected using systematic random sampling technique. Depressive symptoms score, which constructed from a validated nine-item Patient Health Questionnaire (PHQ-9), was an outcome variable. Finally, significant associated factors were identified using multiple linear regression analysis with backward elimination procedure. Statistical Package for Social Science (SPSS) version 22.0 (IBM SPSS Corp.) was used to perform all analysis. Results Total of 264 patient data was analyzed with 95.7% response rate. Patients mean (SD) current age and age at diagnosis was 55.9 (10.9) and 43.9 (10.9) years, respectively. Patients waist circumference (mean ± SD) was 98.9 ± 11.1 cm. The average PHQ-9 score was 4.9 (SD 4.1) and fasting blood glucose was 166.4 (SD 73.2). Marital status (divorced), occupation (housewife), diabetic complication (nephropathy), negative life event in the last six months, and poor social support significantly associated with increased mean PHQ-9 score after adjustment for covariates. Whereas not fearing diabetic-related complication and death significantly lower mean PHQ-9 score. Conclusion Biopsychosocial variables including marital status, negative life event in the last 6 months, occupation, diabetic complication, and poor social support significantly increase average depressive symptoms score. Evidence-based intervention focusing on these identified biopsychosocial factors are necessary to prevent the development of depressive symptoms. Electronic supplementary material The online version of this article (doi:10.1186/s13033-016-0106-2) contains supplementary material, which is available to authorized users.
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Rosiek A, Kornatowski T, Frąckowiak-Maciejewska N, Rosiek-Kryszewska A, Wyżgowski P, Leksowski K. Health behaviors of patients diagnosed with type 2 diabetes mellitus and their influence on the patients' satisfaction with life. Ther Clin Risk Manag 2016; 12:1783-1792. [PMID: 27932885 PMCID: PMC5135006 DOI: 10.2147/tcrm.s118014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background The diagnosis of type 2 diabetes mellitus (T2DM) carries with it a number of changes to the patient’s lifestyle. A healthy lifestyle, health and preventive behaviors, as well as healthy nutrition habits play a key role in treating T2DM as well as limiting its complications. Materials and methods The aim of this study was the analysis of the correlation of T2DM patients’ health behaviors and their influence on the patients’ quality of life. The study was performed on a group of 50 patients from the Kuyavian–Pomeranian Voivodeship. In this study, the Health Behavior Inventory and the Satisfaction with Life Scale were used. The results were statistically analyzed. The study was approved by the ethics committee. Results The intensity of severity of health behavior and satisfaction with life of T2DM patients depends on the gender of the patient (P<0.05). The analysis of the patients’ behaviors in four categories, proper eating habits (consuming vegetables, fruit, whole meal bread), health practices (daily physical activity, recreation, sleeping habits), preventive behaviors (including keeping to health recommendations), and positive mental attitude, showed substantial correlation of the Health Behavior Inventory and the Satisfaction with Life Scale (P<0.05). Conclusion The categorization of the prohealth behaviors shown by diabetics allowed us to measure the connection between the individual categories of satisfaction with life. Males with T2DM showed a higher satisfaction with life score than females with the same diagnosis. The analysis showed that patients with a higher intensity of health behaviors also had superior health behaviors. The resulting correlations prove a notable relationship.
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Affiliation(s)
- Anna Rosiek
- Department of Public Health, Faculty of Health Science, Nicolaus Copernicus University in Toruń
| | - Tomasz Kornatowski
- Department of Public Health, Faculty of Health Science, Nicolaus Copernicus University in Toruń
| | | | | | | | - Krzysztof Leksowski
- Department of Public Health, Faculty of Health Science, Nicolaus Copernicus University in Toruń; Department of General Surgery, 10th Military Hospital, Bydgoszcz, Poland
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Cols-Sagarra C, López-Simarro F, Alonso-Fernández M, Mancera-Romero J, Pérez-Unanua MP, Mediavilla-Bravo JJ, Barquilla-García A, Miravet-Jiménez S. Prevalence of depression in patients with type 2 diabetes attended in primary care in Spain. Prim Care Diabetes 2016; 10:369-375. [PMID: 27025441 DOI: 10.1016/j.pcd.2016.02.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 02/01/2016] [Accepted: 02/28/2016] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To estimate the prevalence of known and undiagnosed depression in patients with type 2 diabetes attended in primary care setting in Spain, and to determine the factors associated with the presence of depression. METHODS This was a cross-sectional and multicenter study performed in a random sample of patients with type 2 diabetes attended in 21 primary care centers. Depressive symptoms were measured with the self-administered Patient Health Questionnaire (PHQ-9). RESULTS A total of 411 patients were analyzed (mean age 70.8 (SD 10.3) years; 53.8% women). 29.2% of patients met the diagnostic criteria of depression, of whom 17% had known depression and 12.2% undiagnosed depression (PHQ-9 score ≥10, without a previous diagnosis of depression). Depression was more common in women (43.4%; 95% confidence interval [CI] 34.5-52.3%), widow (33.3%; 95% CI 27.9-38.7%), and hypothyroidism (12.5%; 95% CI 8.7-16.3%). Cardiovascular risk factors, the degree of control, complications related to diabetes, antidiabetic therapy and the number of drugs were not associated with the presence of depression. CONCLUSIONS The prevalence of depression was high in patients with type 2 diabetes. However, in approximately 40% of patients depression was undiagnosed. The complications related to diabetes and antidiabetic therapy were not associated with the presence of depression.
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Gonzalez JS, Shapira A. What can screening measures tell us about risk for depression in patients with diabetes? Rev Clin Esp 2015; 215:169-70. [PMID: 25697495 DOI: 10.1016/j.rce.2015.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 01/11/2015] [Indexed: 10/24/2022]
Affiliation(s)
- J S Gonzalez
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, United States; Diabetes Research Center, Albert Einstein College of Medicine, Bronx, NY, United States.
| | - A Shapira
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, United States
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