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Yu Y, Wan W. Association between prediabetes and depression: A meta-analysis. PLoS One 2024; 19:e0307428. [PMID: 39172897 PMCID: PMC11340969 DOI: 10.1371/journal.pone.0307428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 07/04/2024] [Indexed: 08/24/2024] Open
Abstract
BACKGROUND Previous studies evaluating the association between prediabetes and depression have shown inconsistent results. Consequently, the aim of the systematic review and meta-analysis was to investigate whether prediabetes is associated with depression in the general population. METHODS Relevant observational studies were obtained by searching the Medline, Web of Science, and Embase databases. A random-effects model was utilized to pool the results by incorporating the influence of heterogeneity. Multiple subgroup analysis was performed to evaluate the influence of the study characteristics on the outcome. RESULTS Sixteen large-scale cross-sectional studies involving 322,863 participants were included. Among the total participants, 82,154 (25.4%) had prediabetes. The pooled results showed that prediabetes was associated with a higher prevalence of depression in this population (odds ratio [OR]: 1.16, 95% confidence interval [CI]: 1.05 to 1.28, p = 0.003; I2 = 58%). Subgroup analysis showed a stronger association between prediabetes and depression in younger subjects (<50 years old, OR: 1.25, 95% CI: 1.04 to 1.50) than that in older subjects (≥50 years old, OR: 1.05, 95% CI: 1.10 to 1.10; p for subgroup difference = 0.03). Other study characteristics, such as the study country, sex of the participants, definition of prediabetes, methods for the detection of depression, and study quality score, did not seem to significantly affect the results (p for subgroup difference all > 0.05). CONCLUSIONS Prediabetes may be associated with a slightly higher prevalence of depression in the general population, particularly in subjects aged <50 years old.
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Affiliation(s)
- Yi Yu
- Department of Psychiatry, Wuchang Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei, China
| | - Weitao Wan
- Department of Psychiatry, Tianyou Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei, China
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2
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Denche-Zamorano A, Perez-Gomez J, Barrios-Fernandez S, Oliveira R, Adsuar JC, Brito JP. Relationships between Physical Activity Frequency and Self-Perceived Health, Self-Reported Depression, and Depressive Symptoms in Spanish Older Adults with Diabetes: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2857. [PMID: 36833555 PMCID: PMC9958756 DOI: 10.3390/ijerph20042857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
Diabetes is one of the most prevalent noncommunicable diseases in the world. This disease can affect both physical and mental health in the population. This study analyzed the prevalence of Self-Perceived Health (SPH), self-reported depression, and depressive symptoms in comparison with the Physical Activity Frequency (PAF) reported by Spanish older adults with diabetes. A cross-sectional study was carried out with data from 2799 self-reported diabetic participants, all of whom were residents of Spain, aged 50-79 years, and included in the European Health Surveys carried out in Spain (EHIS) both in 2014 and 2020. The relationships between the variables were analysed with a chi-squared test. A z-test for independent proportions was performed to analyze differences in proportions between the sexes. A multiple binary logistic regression was carried out on the prevalence of depression. Linear regressions were performed on depressive symptoms and SPH. Dependent relationships were found between the SPH, self-reported depression, and depressive symptoms with PAF. Most of the very active participants reported a higher prevalence of self-reported depression. Physical inactivity increased the risk of depression, major depressive symptoms, and negative SPH.
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Affiliation(s)
- Angel Denche-Zamorano
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - Jorge Perez-Gomez
- Health, Economy, Motricity and Education (HEME) Research Group, Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - Sabina Barrios-Fernandez
- Occupation, Participation, Sustainability and Quality of Life (Ability Research Group), Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain
| | - Rafael Oliveira
- Sports Science School of Rio Maior, Polytechnic Institute of Santarém, 2040-413 Rio Maior, Portugal
- Research Center in Sport Sciences, Health Sciences and Human Development, Quinta de Prados, Edifício Ciências de Desporto, 5001-801 Vila Real, Portugal
- Life Quality Research Centre, 2040-413 Rio Maior, Portugal
| | - Jose C. Adsuar
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - João Paulo Brito
- Sports Science School of Rio Maior, Polytechnic Institute of Santarém, 2040-413 Rio Maior, Portugal
- Research Center in Sport Sciences, Health Sciences and Human Development, Quinta de Prados, Edifício Ciências de Desporto, 5001-801 Vila Real, Portugal
- Life Quality Research Centre, 2040-413 Rio Maior, Portugal
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Dowling E, Maidment DW. Assessing depressive symptoms and diabetes distress in Type 1 diabetic adults: A comparison of continuous subcutaneous insulin infusion (CSII) and multiple daily injections (MDI) users. J Health Psychol 2023; 28:149-161. [PMID: 35672927 DOI: 10.1177/13591053221098498] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This cross-sectional observational study assesses differences in depressive symptoms and diabetes-distress between adults with type 1 diabetes using continuous subcutaneous insulin infusion (CSII) or multiple daily injections (MDI) insulin delivery methods. Two-hundred and seventy-one adults with type 1 diabetes were recruited who used CSII (n = 104) or MDI (n = 167). Results show that, compared to CSII users, scores on the Severity Measure for Depression - Adult questionnaire and Management and Physician subscales on the Type 1 Diabetes Distress Scale were significantly greater in users of MDI. Thus, MDI users may require greater targetted support to improve these aspects of psychological wellbeing.
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Affiliation(s)
- Ella Dowling
- School of Sport, Exercise and Health Sciences, Loughborough University, UK
| | - David W Maidment
- School of Sport, Exercise and Health Sciences, Loughborough University, UK
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Habib S, Sangaraju SL, Yepez D, Grandes XA, Talanki Manjunatha R. The Nexus Between Diabetes and Depression: A Narrative Review. Cureus 2022; 14:e25611. [PMID: 35784974 PMCID: PMC9249007 DOI: 10.7759/cureus.25611] [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] [Accepted: 05/31/2022] [Indexed: 12/30/2022] Open
Abstract
Comorbid diabetes and depression are a significant public health burden as the consequences of both diseases are worsened by each other. In this study, we have compiled and analyzed findings from various studies to demonstrate that diabetes has a strong association with depression. Both have a significant impact on the quality of life, although the exact mechanisms through which these two chronic diseases affect each other remain unknown. This article discussed the shared etiological factors of comorbidity between diabetes and depression, including physiological (e.g., deregulation of the hypothalamic-pituitary-adrenal (HPA) axis, sympathetic nervous system (SNS) overactivity, microvascular dysfunction, arterial stiffening, inflammation, and cytokines), behavioral (e.g., diet and lifestyle modifications), and environmental (e.g., childhood adversity, poverty, and neighborhood environment). Included data from a range of settings have suggested that the prognosis of both diabetes and depression, in terms of complications, treatment efficacy, morbidity, and mortality, is worse for either disease when they occur concurrently than individually. The implication for the physical, mental, and social well-being of depression in diabetes causes poor self-care and adherence to medical treatment. This article also highlights the importance of regular screening and prompts the treatment of comorbid diabetes and depression with pharmacotherapy, face-to-face psychotherapy, and non-face-to-face models of alternative psychological interventions, including information and communication technologies (ICTs), computer-based diabetes self-management interventions, and digital mental health intervention, to improve the outcomes of both diseases.
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Affiliation(s)
- Salma Habib
- Internal Medicine, Institute of Applied Health Sciences (IAHS), Chittagong, BGD
| | - Sai Lahari Sangaraju
- Research, People's Education Society (PES) Institute of Medical Sciences and Research, Kuppam, IND
| | - Daniela Yepez
- General Medicine, Universidad Catolica de Santiago de Guayaquil, Guayaquil, ECU
| | - Xavier A Grandes
- General Medicine, Universidad Catolica de Santiago de Guayaquil, Guayaquil, ECU
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Kim YC, Um YH, Kim SM, Kim TW, Seo HJ, Hong SC, Jeong JH. Suicide Risk in Patients With Diabetes Varies by the Duration of Diabetes: The Korea National Health and Nutrition Examination Survey (2019). Psychiatry Investig 2022; 19:326-332. [PMID: 35500906 PMCID: PMC9058264 DOI: 10.30773/pi.2021.0396] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 03/01/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE The objectives of this study were to investigate the suicide risk in diabetes patients and evaluate the variations in suicide risk by the duration of diabetes using a large population sample in South Korea. METHODS Data from 6,296 adults in the 2019 Korea National Health and Nutrition Examination Survey were included. The suicidal ideation, suicide plans, and suicidal behavior of diabetes patients were compared to the general population. After classifying the patients into ≤1 year, 2 to 9 years, and ≥10 years of diabetes duration, we evaluated the relationship between the duration of diabetes and the suicide risk. RESULTS Diabetes patients had higher prevalences of suicidal ideation (9.1%, p<0.001) and suicide plans (3.6%, p<0.001) than the general population. After adjusting for potential confounding factors, suicide plans (adjusted odds ratio [aOR]=2.926, 95% confidence interval [CI]=1.325-6.463) were significantly associated with diabetes. In the 2 to 9 years group of diabetes patients, we found an increase in the risk of suicidal ideation (aOR=2.035, 95% CI=1.129-3.670), suicide plans (aOR=3.507, 95% CI=1.538-7.996), and suicidal behavior (aOR=7.130, 95% CI=2.035-24.978) after adjusting for the covariates. However, no increases in suicide risk were observed ≤1 year and ≥10 years after diabetes diagnosis. CONCLUSION In adults, diabetes is associated with an increase in suicide risk. Suicide risk in diabetes patients showed an inverted U-shaped depending upon the duration of diabetes.
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Affiliation(s)
- Young-Chan Kim
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yoo Hyun Um
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sung-Min Kim
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Tae-Won Kim
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ho-Jun Seo
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seung-Chul Hong
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jong-Hyun Jeong
- Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Xu J, Bian Z, Zhang Y, Pan J, Gao F, Wang C, Jia W. Depressive symptoms in Chinese adults with risk factors for diabetes: the Shanghai High-Risk Diabetic Screen (SHiDS) study. Diabet Med 2021; 38:e14375. [PMID: 32745282 DOI: 10.1111/dme.14375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/10/2020] [Accepted: 07/27/2020] [Indexed: 12/25/2022]
Abstract
AIMS To evaluate the relationship between newly diagnosed diabetes or prediabetes and depressive symptoms among individuals with risk factors for diabetes in China. We also investigated the associations of depressive symptoms with pancreatic β-cell function and insulin resistance. METHODS We used cross-sectional data from the Shanghai High-Risk Diabetic Screen (SHiDS) project. Between 2014 and 2017, a total of 1728 participants were enrolled in this study and underwent an oral glucose tolerance test to screen for diabetes and prediabetes. Insulin resistance was evaluated using the homeostatic model assessment of insulin resistance and the modified Matsuda index. Pancreatic β-cell function was calculated using the homeostatic model assessment of β-cell function, Stumvoll first- and second-phase indexes. Elevated depressive symptoms were determined using the Patient Health Questionnaire-9 (PHQ-9 score ≥ 10). RESULTS The prevalence of elevated depressive symptoms in the total study population was 4.8% (83 of 1728). Compared with the normal glucose tolerance group, individuals with newly diagnosed diabetes were less likely to have elevated depressive symptoms even after controlling for potential confounders [adjusted odds ratio (OR) 0.35, 95% confidence interval (CI) 0.18-0.68; P = 0.002]. However, prediabetes was not associated with depressive symptoms. The odds for elevated depressive symptoms were increased in individuals with higher levels of the Stumvoll first-phase index. No association was observed between depressive symptoms and insulin resistance. CONCLUSION Elevated depressive symptoms were less prevalent in Chinese individuals with newly diagnosed diabetes among a high-risk population for diabetes.
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Affiliation(s)
- J Xu
- Department of Health Statistics, Second Military Medical University, Shanghai, China
| | - Z Bian
- School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Y Zhang
- Metabolic Diseases Biobank, Shanghai, China
| | - J Pan
- Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - F Gao
- Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - C Wang
- Department of Endocrinology, Shanghai, China
- Translational Medical Center for Stem Cell Therapy, Shanghai East Hospital, Shanghai, China
- Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai, China
| | - W Jia
- Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
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Risk Factors of Undiagnosed Diabetes Mellitus among Korean Adults: A National Cross-Sectional Study Using the KNHANES Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031195. [PMID: 33572855 PMCID: PMC7908078 DOI: 10.3390/ijerph18031195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 01/22/2021] [Accepted: 01/23/2021] [Indexed: 11/17/2022]
Abstract
In this cross-sectional study, we investigated the baseline risk factors of diabetes mellitus (DM) in patients with undiagnosed DM (UDM). We utilized the Korean National Health and Nutrition Examination Survey (KNHANES) 2010–2017 data. Data regarding the participants’ demographic characteristics, health status, health determinants, healthcare accessibility, and laboratory tests were gathered to explore the differences between the DM, UDM, and without-DM groups. Among the 64,759 individuals who participated in the KNHANES 2010–2017, 32,611 individuals aged ≥20 years with fasting plasma glucose levels of <100 or ≥126 mg/dL were selected. The odds ratios (ORs) regarding family history of diabetes and the performance of national health and cancer screening tests were lower in the UDM group than in the DM group (adjusted OR: 0.54; 95% confidence interval (CI): 0.43, 0.66; adjusted OR: 0.74; 95% CI: 0.62, 0.89; adjusted OR: 0.71; 95% CI: 0.60, 0.85). The ORs of hypertension and obesity were higher in the UDM group than in the DM group (adjusted OR: 1.32; 95% CI: 1.06, 1.64; adjusted OR: 1.80; 95% CI: 1.37, 2.36, respectively). Patients with UDM were more likely to be exposed to DM-related risk factors than those with and without DM. Public health interventions to prevent UDM development are necessary.
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Abdulai T, Runqi T, Lou Z, Amponsem-Boateng C, Zhang H, Liu X, Li L, Mao Z, Huo W, Hou J, Wang F, Wang C. Depressive symptoms are not associated with type 2 diabetes in a rural population in China: findings from the Henan rural cohort. J Affect Disord 2020; 274:841-847. [PMID: 32664023 DOI: 10.1016/j.jad.2020.05.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 04/13/2020] [Accepted: 05/10/2020] [Indexed: 01/28/2023]
Abstract
BACKGROUND Depression is one of the most prevalent mental health challenges that affect all groups of persons. This study examines the association between type 2 diabetes and depressive symptoms (using PHQ-2) in a rural population. Other risk factors of depressive symptoms are examined. METHODS Data from 30,001 participants from the Henan rural cohort was analyzed. Multivariable logistic regression analyses were performed to examine the associations between depressive symptoms (DS) and type 2 diabetes and other risk factors. Adjusted odds ratios (aOR) with confidence intervals (CI) at 95% are reported. RESULTS The prevalence of DS in the study population is 5.86%, 6.69% in women, 4.74% in men, 5.80% in persons without diabetes and 6.81% in persons with diabetes (diagnosed and undiagnosed). DS prevalence was highest in persons with previously diagnosed diabetes (8.27%). No association was found between DS and diabetes (aOR = 0.95, CI at 95% 0.61-1.48; p=0.836). DS was associated with poor glycemic control (aOR=1.43, CI at 95% 1.04- 1.98; p= 0.034) in persons with previously diagnosed diabetes, persons with elevated triglycerides (aOR=1.19, CI at 95% 1.08-1.30; p<0.001), household income (aOR= 0.78, CI at 95% 0.63-0.97; p=0.027), marital status (aOR=1.37, CI at 95% 1.01-1.88, p=0.049) and hypertension treatment with medication (aOR=1.94, CI at 95% 1.48-2.55; p<0.001). LIMITATIONS DS was assessed through self-report and may suffer recall or information bias. CONCLUSIONS DS was not associated with diabetes in our study population. The association between poor glycemic control and DS calls for the integration of screening for depression among patients with diabetes.
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Affiliation(s)
- Tanko Abdulai
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China; University for Development Studies, Department of Community Health and Family Medicine, School of Medicine and Health Sciences, Tamale, Ghana
| | - Tu Runqi
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Zhicheng Lou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Cecilia Amponsem-Boateng
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Haiqing Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Linlin Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Zhenxing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Wenqian Huo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Fang Wang
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, PR. China.
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
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Doroodgar M, Doroodgar M, Tofangchiha S. Evaluation of Relation between HbA1c Level with Cognitive Disorders and Depression in Type 2 Diabetes Mellitus Patients. Open Access Maced J Med Sci 2019; 7:2462-2466. [PMID: 31666848 PMCID: PMC6814457 DOI: 10.3889/oamjms.2019.658] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/01/2019] [Accepted: 07/05/2019] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND: The role of HbA1c level in cognition decline and depression in type 2 diabetic patients is reported in some studies. AIM: We evaluated the possible significant relationship between HbA1c level and cognition decline and depression in type 2 diabetic patients. MATERIAL AND METHODS: This descriptive-analytic study was performed on 512 patients with a different HbA1c level and ages range. All subjects were administered a structured clinical interview. Cognitive functions and depressive disorders were assessed through the Mini-Mental Status Exam (MMSE) and Patient Health Questionnaire-9 (PHQ-9) respectively. Chi-square test was used for relationships between variables. RESULTS: HbA1c mean in all patients was 7.58%. MMSE score mean in total was 27.28. 83.3% of patients had a depressive disorder, and 8.59% of patients had an MMSE score < 24. There was no significant relationship between HbA1c level and cognitive problems, but there was a significant relationship between recent memory declines with the level of HbA1c (P = 0.03). Also, there was no significant relationship between attention-deficit with HbA1c level. CONCLUSION: Our finding provides that even though there is no significant difference between HbA1c level and cognitive problems and depression, recent memory state in these patients are more affected than the normal population and these patients have a worse state of depressive disorders.
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Affiliation(s)
- Masoud Doroodgar
- Department of Internal Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Moein Doroodgar
- Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahnaz Tofangchiha
- AJA Cancer Epidemiology Research and Treatment Center (AJA-CERTC), AJA University of Medical Sciences, Tehran, Iran
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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: 172] [Impact Index Per Article: 28.7] [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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Graham EA, Thomson KH, Bambra CL. The association between diabetes and depressive symptoms varies by quality of diabetes care across Europe. Eur J Public Health 2019; 28:872-878. [PMID: 29617999 PMCID: PMC6148969 DOI: 10.1093/eurpub/cky050] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background Depressive symptoms are more common in adults with diabetes and may arise from the physical and psychosocial burden of disease. Better quality of diabetes care may be associated with a reduced disease burden and fewer depressive symptoms. Methods This cross-sectional study included 34 420 participants from 19 countries in the European Social Survey Round 7 (2014-2015). Countries were grouped into quartiles based on their quality of diabetes care as measured in the Euro Diabetes Index 2014. Individual-level depressive symptoms were measured using the 8-item Center for Epidemiologic Studies-Depression Scale. Negative binomial regression was used to compare the number of depressive symptoms between adults with and without diabetes in each quartile of diabetes care quality. Analyses included adjustment for covariates and survey weights. Results In countries with the highest quality of diabetes care, having diabetes was associated with only a 3% relative increase in depressive symptoms (95% CI 1.00-1.05). In countries in the second, third and fourth (lowest) quartiles of diabetes care quality, having diabetes was associated with a 13% (95% CI 1.08-1.17), 13% (1.08-1.19) and 22% (1.14-1.31) relative increase in depressive symptoms, respectively. Conclusion The association between diabetes and depressive symptoms appears stronger in European countries with lower quality of diabetes care. Potential pathways for this association include the financial aspects of diabetes care, access to services and differential exposure to the social determinants of heath. Further research is needed to unpack these mechanisms and improve the quality of life of people with diabetes across Europe.
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Affiliation(s)
- Eva A Graham
- Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada.,Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Katie H Thomson
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Clare L Bambra
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
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Abstract
Although some studies have been conducted on the association between diabetes and anxiety symptoms, the data on this association remain controversial. The purpose of this meta-analysis was to examine the association between diabetes and anxiety symptoms. The authors systematically searched PubMed, Scopus, and Google Scholar databases until July 2018. After the screening process, 23 studies were included in the meta-analysis. Stata-14 was used for meta-analyzing. Forest plot was calculated for the whole 23 studies and subgroups, and publication bias was also examined. Overall, diabetes was positively associated with anxiety; pooled odds ratio was equal to1.48; 95% confidence interval was 1 .27-1.74. In cross-sectional study, the result was odds ratio = 1.50; 95% confidence interval = 1.26-1.77, and in prospective-cohort study, the result was odds ratio = 1.34; 95% confidence interval = 1.21-1.49. There was small evidence of publication bias. Overall, our findings indicate that diabetes is a risk factor for anxiety symptoms. Therefore, having a healthy medical condition can be an anxiety prevention agent.
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13
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Mueller PL, Pritchett CE, Wiechman TN, Zharikov A, Hajnal A. Antidepressant-like effects of insulin and IGF-1 are mediated by IGF-1 receptors in the brain. Brain Res Bull 2018; 143:27-35. [DOI: 10.1016/j.brainresbull.2018.09.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 09/14/2018] [Accepted: 09/25/2018] [Indexed: 12/11/2022]
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14
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Bashkin O, Horne R, Bridevaux IP. Influence of Health Status on the Association Between Diabetes and Depression Among Adults in Europe: Findings From the SHARE International Survey. Diabetes Spectr 2018; 31:75-82. [PMID: 29456429 PMCID: PMC5813307 DOI: 10.2337/ds16-0063] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The association between diabetes and depression, a common health comorbidity in people with diabetes, has been recognized but not well understood. The purpose of this study was to explore the association between diabetes and depression in a large international sample of adults, adjusting for demographics, socioeconomic status, behavioral risks, and current health status. METHODS The association between diabetes and depression was assessed in a sample of 57,004 Europeans ≥50 years of age from 15 European countries using data from the fifth wave of SHARE (the Survey of Health, Ageing, and Retirement in Europe). Multiple logistic regression models of the association between diabetes and depression were conducted, adjusting for potential confounders. RESULTS Analyses showed that, despite diabetes being associated with depression in crude and partially adjusted models, further adjustment for self-perceived health made the association between diabetes and depression no longer statistically significant (odds ratio 1.0, 95% CI 0.9-1.0). CONCLUSION Adjustment for a variety of demographic, socioeconomic, behavioral risk, and health status variables reduced the estimated association between diabetes and depression until it was no longer significant. Further research should explore the specific symptoms of distress characterized in people with diabetes.
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Affiliation(s)
- Osnat Bashkin
- Department of Public Health, School of Health Sciences, Ashkelon Academic College, Ashkelon, Israel
| | - Ron Horne
- Statistical Consulting & Analytical Tools, London, UK
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15
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Chowdhury SH, Karim MN, Selim S, Ahmed F, Azad AK, Maksud SA, Rahaman MFU, Uddin MF, Chowdhury MAJ. Risk of depression among Bangladeshi type 2 diabetic patients. Diabetes Metab Syndr 2017; 11 Suppl 2:S1009-S1012. [PMID: 28736257 DOI: 10.1016/j.dsx.2017.07.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 07/16/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The objective of this study was to examine the strength and consistency of the relationship between depression and diabetes in Bangladeshi population. METHODS The study was conducted at the medicine department of Bangabandhu Shiekh Mujib Medical University (BSMMU) during May 2012 to May 2013. Equal number of type 2 diabetes mellitus (T2DM) patients and non-diabetic subjects (patient attendants) were recruited from outpatient department matching for age (±2 years) and gender. Demographic and anthropometric data were collected from all the subjects. Depression was assessed using, Hospital Anxiety and Depression Scale (HADS) questionnaire. A subject with a score above 8 was considered as depressive. Baseline characteristics of diabetic and non-diabetic participants were compared using chi square test. Multivariable logistic regression was performed to assess the association between diabetes and depression adjusting for all plausible confounders in the model. RESULTS 24.8% non-diabetic and 56.2% diabetic subjects were found to have depression. Statistically significant difference was found in income, waist-to-hip ratio between diabetic and non-diabetic subjects (P<0.001). Diabetic patients show 7-fold greater odds of having depression in comparison to their non-diabetic counterpart [OR 7.0, 95% CI (3.4, 14.3)]. Female gender appeared as significant predictor of depression [OR 4.3, 95% CI (2.1, 8.9)]. CONCLUSIONS In Bangladeshi population, people with diabetes are 7 times more likely to have co-existing depression in comparison to non-diabetic subjects. Further studies are required to establish the nature of the relationship between depression and T2DM.
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Affiliation(s)
| | - M N Karim
- Department of Epidemiology and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, Australia.
| | - S Selim
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - F Ahmed
- National Institute of Cardiovascular Diseases, Dhaka, Bangladesh
| | - A K Azad
- Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - S A Maksud
- Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - M F U Rahaman
- Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - M F Uddin
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - M A J Chowdhury
- Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
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Cooney LG, Lee I, Sammel MD, Dokras A. High prevalence of moderate and severe depressive and anxiety symptoms in polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod 2017; 32:1075-1091. [DOI: 10.1093/humrep/dex044] [Citation(s) in RCA: 224] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 02/17/2017] [Indexed: 01/16/2023] Open
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Khambaty T, Callahan CM, Perkins AJ, Stewart JC. Depression and Anxiety Screens as Simultaneous Predictors of 10-Year Incidence of Diabetes Mellitus in Older Adults in Primary Care. J Am Geriatr Soc 2017; 65:294-300. [PMID: 27641686 PMCID: PMC5311025 DOI: 10.1111/jgs.14454] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES To examine depression and anxiety screens and their individual items as simultaneous predictors of incident diabetes mellitus. DESIGN Ten-year follow-up study of individuals screened for the Improving Mood-Promoting Access to Collaborative Treatment (IMPACT) trial. SETTING Two large urban primary care clinics in Indianapolis, Indiana. PARTICIPANTS Diverse sample (53% African American, 80% of lower socioeconomic status) of 2,156 older adults initially free of diabetes mellitus. MEASUREMENTS Depression and anxiety screens were completed during routine primary care visits between 1999 and 2001. Incident diabetes mellitus data were obtained from an electronic medical record system and the Centers for Medicare and Medicaid Services analytical files though 2009. RESULTS Over the 10-year period, 558 (25.9%) participants had diabetes mellitus onset. Cox proportional hazards models adjusted for demographic and diabetes mellitus risk factors revealed that a positive screen for anxiety, but not for depression, predicted incident diabetes mellitus when entered into separate models (anxiety: hazard ratio (HR) = 1.36, 95% confidence interval (CI) = 1.15-1.61, P < .001; depression: HR = 1.18, 95% CI = 0.95-1.46, P = .13) and when entered simultaneously into one model (anxiety: HR = 1.35, 95% CI = 1.12-1.61, P < .001; depression: HR = 1.04, 95% CI = 0.83-1.31, P = .73). The feeling anxious (P = .03) and the worry (P = .02) items predicted incident diabetes mellitus independent of the depression screen. CONCLUSION These findings suggest that screening positive for anxiety is a risk factor for diabetes mellitus in older adults independent of depression and traditional diabetes mellitus risk factors. Anxiety requires greater consideration and awareness in the context of diabetes mellitus risk assessment and primary prevention.
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Affiliation(s)
| | - Christopher M. Callahan
- Indiana University Center for Aging Research, Indiana University School of Medicine, Indianapolis, IN
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
- Regenstrief Institute, Inc., Indianapolis, IN
| | - Anthony J. Perkins
- Indiana University Center for Aging Research, Indiana University School of Medicine, Indianapolis, IN
- Regenstrief Institute, Inc., Indianapolis, IN
| | - Jesse C. Stewart
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), Indianapolis, IN
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Chen S, Zhang Q, Dai G, Hu J, Zhu C, Su L, Wu X. Association of depression with pre-diabetes, undiagnosed diabetes, and previously diagnosed diabetes: a meta-analysis. Endocrine 2016; 53:35-46. [PMID: 26832340 DOI: 10.1007/s12020-016-0869-x] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 01/13/2016] [Indexed: 01/19/2023]
Abstract
We performed a meta-analysis to analyze the associations of depression with pre-diabetes (PreDM), undiagnosed diabetes (UDM), and previously diagnosed diabetes (PDM), and whether the association was affected by important study characteristics. We searched relevant articles published in PubMed and EMBASE up to August, 2015. Studies reporting cross-sectional associations of depression with PreDM, UDM, or PDM compared with normal glucose metabolism (NGM) were included. Odds ratios (ORs) were pooled with random-effect and fixed-effect models. Subgroup analyses by sex, study mean age, different degrees of adjustment, publication year, quality score, and depression assessment scales were also performed. Twenty studies were eligible and included in current analysis. Summary estimates showed that compared with NGM individuals, prevalence of depression was moderately increased in PreDM (random-effect odds ratio (OR) 1.11, 95 % confidence interval (CI) 1.03-1.19) and UDM (OR 1.27, 95 % CI 1.02-1.59), and markedly increased in PDM (OR 1.80, 95 % CI 1.40-2.31). Subgroup analyses showed that the positive association remained only among studies with mean age <60 years old but not among those with mean age ≥60 years old. Summary estimates of ORs with cardiovascular disease adjustment substantially attenuated the association. Our findings suggested that risk of prevalent depression was gradually increased with the deterioration of glucose metabolism among younger age groups but not among older age groups. Comorbid cardiovascular diseases might be an important intermediate factor underlying the association between depression and diabetes.
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Affiliation(s)
- Shengguang Chen
- Department of Emergency, Tongji Hospital Affiliated to Tongji University, Shanghai, China
| | - Qian Zhang
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Shanghai, China
| | - Guoxing Dai
- Department of Emergency, Tongji Hospital Affiliated to Tongji University, Shanghai, China
| | - Jiawen Hu
- Department of Emergency, Tongji Hospital Affiliated to Tongji University, Shanghai, China
| | - Chenting Zhu
- Department of Emergency, Tongji Hospital Affiliated to Tongji University, Shanghai, China
| | - Lijie Su
- Department of Emergency, Tongji Hospital Affiliated to Tongji University, Shanghai, China
| | - Xianzheng Wu
- Department of Emergency, Tongji Hospital Affiliated to Tongji University, Shanghai, China.
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Islam SMS, Rawal LB, Niessen LW. Prevalence of depression and its associated factors in patients with type 2 diabetes: A cross-sectional study in Dhaka, Bangladesh. Asian J Psychiatr 2015; 17:36-41. [PMID: 26259893 DOI: 10.1016/j.ajp.2015.07.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 07/03/2015] [Accepted: 07/10/2015] [Indexed: 10/23/2022]
Abstract
Depression is a common feature in patients with type 2 diabetes and often remains undetected and untreated, causing increased morbidity and mortality. We explored the prevalence of co-morbid depression and its associated factors, including major life-events among patients with type 2 diabetes in Bangladesh. We conducted a cross-sectional study among 515 patients with type 2 diabetes between September 2013 and July 2014 in a tertiary hospital in Dhaka city. We assessed depression using Patient Health Questionnaire-9 (PHQ-9) with predefined cut-off scores of 5, 10, 15 and 20 to indicate minimal, mild, moderate, moderately-severe, and severe depression. Associations between depression and its associated factors were explored using univariate and multivariate regression. Overall, 61.9% participants had depressive symptoms, and the prevalence was higher among females (70.9%) compared to males (50.6%). One-third (35.7%) of participants had mild depression and 36.2% had moderate to severe depression. In the multivariate analysis, factors significantly associated with depression were: age≤60 years (OR: 2.1, 95% CI=1.2-3.6; p≤0.006), female gender (OR=1.9, 95% CI=1.3-3.0; p≤0.002), those having 1-3 complications (OR=2.3, 95% CI=1.2-4.3; p=0.010), experienced loss of business or crop failure (OR=2.1, 95% CI=1.2-3.6; p=0.006), major family conflicts (OR=2.2, 95% CI=1.4-3.5; p≤0.001), separation or deaths of family members or divorce (OR=2.2, 95% CI=1.4-3.5; p≤0.001), and those who experienced unavailability of food or medicines (OR=2.2, 95% CI=1.0-4.5; p=0.038). Patients with diabetes, especially females, those having other complications, and major life-events should routinely be screened for symptoms of depression with adequate management of these conditions.
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Affiliation(s)
- Sheikh Mohammed Shariful Islam
- Chronic Non-Communicable Diseases Unit, Center for Equity and Health Systems, International Center for Diarrhoeal Diseases Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh; Center for International Health (CIH), Ludwig-Maximilians-Universität (LMU), Leopoldstrasse 7, 80802 Munich, Germany.
| | - Lal B Rawal
- Universal Health Coverage, Center for Equity and Health Systems, International Center for Diarrhoeal Diseases Research, Bangladesh (icddr,b), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh.
| | - Louis W Niessen
- Centre for Applied Health Research and Delivery, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
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20
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Depression and Risk for Diabetes: A Meta-Analysis. Can J Diabetes 2015; 39:266-72. [DOI: 10.1016/j.jcjd.2014.11.006] [Citation(s) in RCA: 115] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 11/28/2014] [Accepted: 11/28/2014] [Indexed: 12/20/2022]
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21
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Ford AH, Flicker L, Hankey GJ, Yeap BB, Chubb SAP, Golledge J, Almeida OP. Insulin resistance and depressive symptoms in older men: the health in men study. Am J Geriatr Psychiatry 2015; 23:872-80. [PMID: 25532417 DOI: 10.1016/j.jagp.2014.10.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 10/21/2014] [Accepted: 10/30/2014] [Indexed: 01/19/2023]
Abstract
OBJECTIVE A positive association between depression and diabetes has been reported, but the direction and nature of this association is unclear. Insulin resistance is a state of reduced responsiveness of target tissues to normal circulating levels of insulin and predisposes to diabetes in the presence of beta cell dysfunction. METHODS We conducted this cross-sectional and prospective study in a community representative sample of 3,140 older men free of diabetes to determine if insulin resistance was associated with prevalent and incident depressive symptoms. RESULTS Men with insulin resistance had increased odds of depression cross-sectionally (odds ratio [OR]: 1.61; 95% confidence interval [CI]: 1.08-2.40), although this was not significant after adjustment for possible confounding (OR: 1.32; 95% CI: 0.85-2.03). In the longitudinal analysis, men with insulin resistance were more likely to develop clinically significant depressive symptoms (adjusted risk ratio [RR]: 2.33; 95% CI: 1.17-4.62), and this risk was greatest for men in the highest quartile of insulin resistance compared with those in the lowest quartile (adjusted RR: 2.54; 95% CI: 1.04-6.18). CONCLUSION Older men with clinically significant depressive symptoms were more likely to have higher markers of insulin resistance. Additionally, the odds of depression increased with increasing levels of insulin resistance, and insulin resistance increased the risk of developing depression over 5 years later. Because depression is now a leading cause of disability worldwide, addressing the rising challenge of insulin resistance may prove important in improving the future health of our communities.
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Affiliation(s)
- Andrew H Ford
- WA Centre for Health & Ageing, Centre for Medical Research & School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, WA, Australia.
| | - Leon Flicker
- WA Centre for Health & Ageing, Centre for Medical Research & School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia
| | - Graeme J Hankey
- School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia
| | - Bu B Yeap
- School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia; Department of Endocrinology and Diabetes, Fremantle and Royal Perth Hospitals, Perth, WA, Australia
| | - S A Paul Chubb
- School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia; Path West Laboratory Medicine, Fremantle and Royal Perth Hospitals, Perth, WA, Australia
| | - Jonathan Golledge
- Queensland Research Centre for Peripheral Vascular Disease, School of Medicine and Dentistry, James Cook University and Department of Vascular and Endovascular Surgery, The Townsville Hospital, Townsville, Queensland, Australia
| | - Osvaldo P Almeida
- WA Centre for Health & Ageing, Centre for Medical Research & School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, WA, Australia
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22
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Sun JC, Xu M, Lu JL, Bi YF, Mu YM, Zhao JJ, Liu C, Chen LL, Shi LX, Li Q, Yang T, Yan L, Wan Q, Wu SL, Liu Y, Wang GX, Luo ZJ, Tang XL, Chen G, Huo YN, Gao ZN, Su Q, Ye Z, Wang YM, Qin GJ, Deng HC, Yu XF, Shen FX, Chen L, Zhao LB, Wang TG, Lai SH, Li DH, Wang WQ, Ning G. Associations of depression with impaired glucose regulation, newly diagnosed diabetes and previously diagnosed diabetes in Chinese adults. Diabet Med 2015; 32:935-43. [PMID: 25439630 DOI: 10.1111/dme.12649] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/25/2014] [Indexed: 12/29/2022]
Abstract
AIM To examine the association between depression and impaired glucose regulation, newly diagnosed diabetes and previously diagnosed diabetes in middle-aged and elderly Chinese people, and whether depression was associated with different treatment regimens or durations of diabetes. METHODS A cross-sectional study was performed among 229,047 adults living in the community aged ≥ 40 years from 25 centres in China. The self-reported depression rating scale Patient Health Questionnaire 9 (PHQ-9) was used to diagnose probable and sub-threshold depression. Glucose metabolism status was determined according to World Health Organization 1999 diagnostic criteria. RESULTS The numbers of participants with normal glucose regulation, impaired glucose regulation, newly diagnosed diabetes and previously diagnosed diabetes were 120,458, 59,512, 24,826 and 24,251, respectively. The prevalence of sub-threshold depression in the total sample of participants was 4.8% (4.8%, 4.8%, 4.4% and 5.6% from normal glucose regulation to previously diagnosed diabetes, respectively), and the prevalence of probable depression was 1.1% (1.1%, 1.0%, 0.9% and 1.8% from normal glucose regulation to previously diagnosed diabetes, respectively). Compared with participants with normal glucose regulation, those with previously diagnosed diabetes had increased odds of probable depression [odds ratio (OR) = 1.61, 95% confidence interval (CI) 1.39-1.87] and sub-threshold depression (OR = 1.14, 95% CI 1.06-1.24), after adjustment for multiple confounding factors. Newly diagnosed diabetes or impaired glucose regulation was not associated with depression. Among those with previously diagnosed diabetes, insulin treatment was associated with greater odds of depression compared with no treatment or oral anti-diabetic medicine. CONCLUSION Previously diagnosed diabetes, but not newly diagnosed diabetes or impaired glucose regulation, was associated with a higher prevalence of depression. Patients receiving insulin were more likely to have depression than those not receiving treatment or being treated with oral anti-diabetic medicine.
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Affiliation(s)
- J C Sun
- Laboratory of Endocrine and Metabolic Diseases, Institute of Health Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, and Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - M Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - J L Lu
- Department of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Y F Bi
- Department of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Y M Mu
- People's Liberation Army General Hospital, Beijing, China
| | - J J Zhao
- Shandong Provincial Hospital, Jinan, China
| | - C Liu
- Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China
| | - L L Chen
- Wuhan Xiehe Hospital, Huazhong University of Science and Technology School of Medicine, Wuhan, China
| | - L X Shi
- Affiliated Hospital of Guiyang Medical College, Guiyang, China
| | - Q Li
- The Second Affilliated Hospital of Haerbin Medical University, Haerbin, China
| | - T Yang
- The First Affiliated Hospital with Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - L Yan
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Q Wan
- The Affiliated Hospital of Luzhou Medical College, Luzhou, China
| | - S L Wu
- Xinjiang Kelamayi Peoples Hospital, Kelamayi, China
| | - Y Liu
- The First Hospital of Jilin University, Changchun, China
| | - G X Wang
- The First Hospital of Jilin University, Changchun, China
| | - Z J Luo
- The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - X L Tang
- The First Hospital of Lanzhou University, Lanzhou, China
| | - G Chen
- Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China
| | - Y N Huo
- Jiangxi Peoples Hospital, Nanchang, China
| | - Z N Gao
- Dalian Municipal Central Hospital, Dalian, China
| | - Q Su
- Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Z Ye
- Zhejiang Center for Disease Control and Prevention, Hangzhou, China
| | - Y M Wang
- The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - G J Qin
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - H C Deng
- The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - X F Yu
- Wuhan Tongji Hospital, Huazhong University of Science and Technology School of Medicine, Wuhan, China
| | - F X Shen
- The First Affiliated Hospital of Wenzhou Medical University, The First Provincial Wenzhou Hospital of Zhejiang, Wenzhou, China
| | - L Chen
- Qilu Hospital, University of Shandong School of Medicine, Jinan, China
| | - L B Zhao
- Department of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - T G Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - S H Lai
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - D H Li
- Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, >TX, USA
| | - W Q Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - G Ning
- Laboratory of Endocrine and Metabolic Diseases, Institute of Health Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, and Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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23
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Kohn N, Toygar T, Weidenfeld C, Berthold-Losleben M, Chechko N, Orfanos S, Vocke S, Durst A, Laoutidis ZG, Karges W, Schneider F, Habel U. In a sweet mood? Effects of experimental modulation of blood glucose levels on mood-induction during fMRI. Neuroimage 2015; 113:246-56. [PMID: 25795339 DOI: 10.1016/j.neuroimage.2015.03.024] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 03/09/2015] [Accepted: 03/10/2015] [Indexed: 01/21/2023] Open
Abstract
Glucose is the primary source of energy for the human brain. Previous literature has shown that varying blood glucose levels may have a strong impact on behaviour, subjective mood, and the intensity of the BOLD signal measured in fMRI. Therefore, blood glucose levels varying even within the normal range may interact with cognitive and emotional processing as well as BOLD signal. Here, in a placebo-controlled, double-blind crossover study on 20 healthy women, we show that overnight fasting, compared to an elevated glucose condition, influences brain activation and the affective state during mood induction. Results indicate that our brain may compensate for low glucose levels during fasting by stronger recruitment of the brain areas relevant to the task at hand. Additionally, we systematically tested the effect of prior cognitive effort on behavioural and neural patterns and found that elevated activation is only associated with maintained performance as long as no prior cognitively challenging task is administered. Prior cognitive effort leads to deteriorated performance and a further increase in emotion-associated brain activation in the pregenual anterior and posterior cingulate, the superior frontal gyrus, and the pre-SMA. These results are in line with the strength model of self-regulation. Our results corroborate the strength model of self-regulation and extend it to affect regulation processes. Additionally, our observations suggest that experimentally controlling for fasting state or glucose levels may be beneficial, especially when studying processes that involve self-regulation.
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Affiliation(s)
- N Kohn
- Institute of Neuroscience and Medicine (INM-6), Jülich Research Centre, Jülich, Germany; JARA Brain - Translational Brain Medicine, Jülich-Aachen, Germany.
| | - T Toygar
- Department of Psychiatry, Psychotherapy and Psychosomatics, Uniklinik RWTH Aachen, 52074 Aachen, Germany; Department of Biology, RWTH Aachen University, 52074 Aachen, Germany
| | - C Weidenfeld
- Department of Psychiatry, Psychotherapy and Psychosomatics, Uniklinik RWTH Aachen, 52074 Aachen, Germany; JARA Brain - Translational Brain Medicine, Jülich-Aachen, Germany
| | - M Berthold-Losleben
- Department of Psychiatry, Psychotherapy and Psychosomatics, Uniklinik RWTH Aachen, 52074 Aachen, Germany; JARA Brain - Translational Brain Medicine, Jülich-Aachen, Germany
| | - N Chechko
- Department of Psychiatry, Psychotherapy and Psychosomatics, Uniklinik RWTH Aachen, 52074 Aachen, Germany; JARA Brain - Translational Brain Medicine, Jülich-Aachen, Germany
| | - S Orfanos
- Department of Psychiatry, Psychotherapy and Psychosomatics, Uniklinik RWTH Aachen, 52074 Aachen, Germany; JARA Brain - Translational Brain Medicine, Jülich-Aachen, Germany
| | - S Vocke
- Department of Psychiatry, Psychotherapy and Psychosomatics, Uniklinik RWTH Aachen, 52074 Aachen, Germany; JARA Brain - Translational Brain Medicine, Jülich-Aachen, Germany
| | - A Durst
- Department of Psychiatry, Psychotherapy and Psychosomatics, Uniklinik RWTH Aachen, 52074 Aachen, Germany; JARA Brain - Translational Brain Medicine, Jülich-Aachen, Germany
| | - Z G Laoutidis
- Department of Psychiatry, Psychotherapy and Psychosomatics, Uniklinik RWTH Aachen, 52074 Aachen, Germany; Department of Psychiatry and Psychotherapy, University of Düsseldorf, Bergische Landstrasse 2, 40629 Düsseldorf, Germany
| | - W Karges
- Division of Endocrinology and Diabetes, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany
| | - F Schneider
- Department of Psychiatry, Psychotherapy and Psychosomatics, Uniklinik RWTH Aachen, 52074 Aachen, Germany; JARA Brain - Translational Brain Medicine, Jülich-Aachen, Germany
| | - U Habel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Uniklinik RWTH Aachen, 52074 Aachen, Germany; JARA Brain - Translational Brain Medicine, Jülich-Aachen, Germany
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Berge LI, Riise T. Comorbidity between Type 2 Diabetes and Depression in the Adult Population: Directions of the Association and Its Possible Pathophysiological Mechanisms. Int J Endocrinol 2015; 2015:164760. [PMID: 26457080 PMCID: PMC4589629 DOI: 10.1155/2015/164760] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 08/26/2015] [Accepted: 08/31/2015] [Indexed: 12/16/2022] Open
Abstract
Type 2 diabetes and depression are regarded as comorbid conditions, and three possible directions of the association between the diseases can underlie this observation of comorbidity. First, common etiology can increase a person's risk of both diseases; second, persons with type 2 diabetes have increased prevalence or risk of future development of depression; or third, persons with depression have increased prevalence or risk of development of type 2 diabetes. This review gives an overview over possible pathophysiological mechanisms for each of the directions of the association between type 2 diabetes and depression and further discusses epigenetics as an additional, direction independent approach. We argue that unspecific pathophysiological mechanisms involved in the stress response might, at least to some extent, explain each of the directions of the association between type 2 diabetes and depression, while changes in brain structure and function among persons with diabetes and possible increased risk of development of type 2 diabetes after use of antidepressant agents could represent more disease specific mechanisms underlying the comorbidity.
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Affiliation(s)
- Line Iden Berge
- Department of Global Public Health and Primary Care, University of Bergen, 5018 Bergen, Norway
- Psychiatric Division, Bergen University Hospital, 5021 Bergen, Norway
- *Line Iden Berge:
| | - Trond Riise
- Department of Global Public Health and Primary Care, University of Bergen, 5018 Bergen, Norway
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Zhang W, Xu H, Zhao S, Yin S, Wang X, Guo J, Zhang S, Zhou H, Wang F, Gu L, Zhu L, Yu H, Qu Z, Tian D. Prevalence and influencing factors of co-morbid depression in patients with type 2 diabetes mellitus: a General Hospital based study. Diabetol Metab Syndr 2015; 7:60. [PMID: 26167205 PMCID: PMC4499190 DOI: 10.1186/s13098-015-0053-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 06/17/2015] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Depression and diabetes have been recognized as major public health issues in China, however, no studies to date examined the factors associated with the development of depression in patients with diabetes in China. This study aimed to estimate the prevalence of co-morbid depression among adults with type 2 diabetes mellitus (DM) and to examine the influence factors of co-morbid depression in a group of patients with type 2 DM. METHODS The study was conducted from March l to May 31, 2012, in the Department of Endocrinology of the First Affiliated Hospital of the General Hospital of the People's Liberation Army (PLA). A systematic random sample of 412 type 2 DM patients aged over 18 years was selected. A structured questionnaire was used for collecting the information about socio-demographic data, lifestyle factors and clinical characteristics. Depression and social support was evaluated by using the Chinese version of Beck Depression Inventory (BDI) and Social Support Rate Scale (SSRS), respectively. Weights and heights were measured. Hemoglobin A1c (HbA1c) was abstracted from each patient directly after the interview. RESULTS Of the total sample, 142 patients had depression according to the BDI scores (BDI scores ≥14), the prevalence of co-morbid depression in this study population was 5.7 % (142/2500). Of which, 56 had major depression (BDI ≥ 21), and 86 had moderate depression (BDI ≥ 14&BDI < 21). Logistic regression analysis indicated that a high HbA1c level, a high BMI, low quality health insurance, and being single, were significantly associated with the development of depression. However, a family history of diabetes and a high social support level are likely protective factors. CONCLUSIONS The prevalence of co-morbid depression was 5.7 % among Chinese subjects with type 2 DM in this study. High HbA1c level, high BMI score, being single, low social support level, and low quality health insurance were associated with the presence of depression. These findings support a recommendation for routine screening and management in China for depression in patients with diabetes, especially for those in primary care, to reduce the number of the depressed or the misrecognized depressed diabetic patients.
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Affiliation(s)
- Weijun Zhang
- />School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875 China
| | - Huiwen Xu
- />Department of Public Health Sciences, University of Rochester School of Medicine & Dentistry, Rochester, NY 14642 USA
| | - Shuliang Zhao
- />School of Public Administration, Yunnan University of Finance and Economics, Kunming, 650221 China
| | - Shinan Yin
- />Department of Endocrinology, First Affiliated Hospital of the General Hospital of the People’s Liberation Army (PLA), Beijing, 100853 China
| | - Xiaohua Wang
- />School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875 China
| | - Jing Guo
- />Department of Sociology, Huazhong University of Science and Technology, 1037 Luoyu Road, Wuhan, 430074 China
| | - Shengfa Zhang
- />School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875 China
| | - Huixuan Zhou
- />School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875 China
| | - Fugang Wang
- />School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875 China
| | - Linni Gu
- />School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875 China
| | - Lei Zhu
- />School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875 China
| | - Haibo Yu
- />School of Government, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875 China
| | - Zhiyong Qu
- />School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875 China
| | - Donghua Tian
- />School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, 19, Xinjiekou Wai Street, Beijing, 100875 China
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Jeffery AN, Hyland ME, Hosking J, Wilkin TJ. Mood and its association with metabolic health in adolescents: a longitudinal study, EarlyBird 65. Pediatr Diabetes 2014; 15:599-605. [PMID: 24552539 DOI: 10.1111/pedi.12125] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 01/06/2014] [Accepted: 01/08/2014] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Mood comprises two main traits - positive and negative affect, both associated with depression and anxiety. Studies in children have linked depression with obesity, but the association with metabolic health is unclear. OBJECTIVE To explore the relationship between mood and metabolic health in adolescents. METHODS We studied 208 healthy children (115 boys) enrolled in the longitudinal EarlyBird Diabetes Study, and reviewed at 7 and 16 yr. Participants completed the Positive Affect and Negative Affect Schedule - Child Form (PANAS-C) at 16yr to assess positive and negative affect, together representing mood. Measures at 7 and 16 yr: body mass index (BMI), fat (%; dual energy X-ray absorptiometry), physical activity (accelerometer), metabolic risk z-score comprising homeostasis model assessment-insulin resistance (HOMA-IR), triglycerides, total cholesterol/high density lipoprotein (HDL) ratio and blood pressure. Pubertal development was determined by age at peak height velocity. RESULTS Positive affect was higher in boys than girls, (50 vs. 46, p = 0.001), negative affect higher in girls than boys (26 vs. 22, p < 0.001). Those with lower mood were fatter (r = -0.24, p < 0.001), had higher HOMA-IR (r = -0.12, p = 0.05), higher cholesterol:HDL ratio (r = -0.14, p = 0.02), were less active (r = 0.20, p = 0.003) and had earlier pubertal development (r = 0.19, p = 0.004). Inverse associations between mood and metabolic risk z-score and change in metabolic risk z-score 7-16yr (β = -0.26, p = 0.006, and -0.40, p = 0.004, respectively) were independent of adiposity, physical activity and puberty and sex. CONCLUSIONS Low mood in healthy children is associated with poorer metabolic health independently of adiposity. These findings may have implications for the physical and mental health of contemporary youngsters, given their increasing obesity and cardiometabolic risk.
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Affiliation(s)
- Alison N Jeffery
- Institute of Translational and Stratified Medicine, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
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Meng Z, Molyneaux L, McGill M, Shen X, Yue DK. Impact of sociodemographic and diabetes-related factors on the presence and severity of depression in immigrant chinese Australian people with diabetes. Clin Diabetes 2014; 32:163-9. [PMID: 25646942 PMCID: PMC4220593 DOI: 10.2337/diaclin.32.4.163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The coexistence of depression with diabetes significantly increases the likelihood of developing complications. This study aimed to describe the presence and severity of depression in immigrant Chinese Australian people with diabetes and explore its relationship to sociodemographic and diabetes-related factors. This study found that approximately one-fifth of immigrant Chinese Australian people with diabetes had symptoms consistent with moderate to severe depression and that individuals who are socially isolated and have more complex treatment and complications of diabetes are particularly at risk.
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Blanchard E, Samaras K. Double jeopardy: diabetes and severe mental illness. Addressing the special needs of this vulnerable group. ACTA ACUST UNITED AC 2014. [DOI: 10.2217/dmt.14.24] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Risk of suicidal ideation in diabetes varies by diabetes regimen, diabetes duration, and HbA1c level. J Psychosom Res 2014; 76:275-9. [PMID: 24630176 DOI: 10.1016/j.jpsychores.2014.02.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 02/05/2014] [Accepted: 02/09/2014] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To investigate patient subgroups based on the clinical characteristics of diabetes to evaluate risk factors for suicidal ideation using a large population-based sample in South Korea. METHODS Data from the Fifth Korea National Health and Nutrition Examination Survey, a cross-sectional, nationally representative survey, were analyzed. The participants were 9159 subjects aged ≥40years. We defined patients with diabetes based on self-reported physician-diagnosed diabetes. We evaluated clinical risk factors for suicidal ideation according to diabetes regimen, diabetes duration, and glycated hemoglobin (HbA1c) level compared with no diabetes. Given the complex sample design and unequal weights, we analyzed weighted percentages and used survey logistic regression. RESULTS Diabetes per se was not associated with suicidal ideation. However, suicidal ideation was significantly more prevalent among patients who had injected insulin, had a duration of diabetes ≥5years and had HbA1c levels ≥6.5 compared with those without diabetes. Depressive symptoms were the most prominent predictor of suicidal ideation. CONCLUSIONS Insulin therapy, diabetes of long duration, and unsatisfactory glycemic control were identified as risk factors for suicidal ideation; thus, patients with these characteristics warrant special attention. Our findings suggest the need to integrate efforts to manage emotional distress into diabetes care.
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Tovar E, Rayens MK, Gokun Y, Clark M. Mediators of adherence among adults with comorbid diabetes and depression: The role of self-efficacy and social support. J Health Psychol 2013; 20:1405-15. [DOI: 10.1177/1359105313512514] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Depression and diabetes have been linked in a variety of ways, and the presence of depression in those with diabetes can negatively affect adherence to care recommendations. A sample of 201 participants with Type 2 Diabetes completed a cross-sectional survey that assessed depressive symptoms, adherence, self-efficacy, social support, and personal characteristics. Multiple regression analysis was used to test whether self-efficacy and social support mediate the relationship between depressive symptoms and adherence. The findings suggest complete mediation via self-efficacy and some types of social support. Intervening to bolster self-efficacy and social support may decrease the negative effect of depression on adherence.
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Hasan SS, Thiruchelvam K, Ahmed SI, Clavarino AM, Mamun AA, Kairuz T. Pregnancy complications, mental health-related problems and type 2 diabetes mellitus in Malaysian women. Diabetes Metab Syndr 2013; 7:191-197. [PMID: 24290082 DOI: 10.1016/j.dsx.2013.10.023] [Citation(s) in RCA: 4] [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] [Indexed: 10/26/2022]
Abstract
AIMS The aim of this study was to investigate the association between pregnancy complications, mental health-related problems, and type 2 diabetes mellitus (T2DM) in Malaysian women. MATERIALS AND METHODS A case-control study of women with T2DM (n=160) matched by age range to controls without T2DM (n=160). Data were collected in the Negeri Sembilan and PutraJaya regions in Malaysia, from two hospital outpatient clinics, PutraJaya Hospital and Tuanku Jaa'far Hospital Seremban, and one health clinic at Seremban. Validated, interviewer-administered questionnaires were used to obtain the data. The unadjusted and adjusted estimates were calculated using the Mantel-Haenszel method. RESULTS Neither depression (RR 0.74, 95% CI: 0.39-1.41) nor anxiety (RR 1.00, 95% CI: 0.53-1.88) symptoms increased the risk of T2DM significantly. However, gestational diabetes (RR 1.35, 95% CI: 1.02-1.79), and ≥3 pregnancies (RR 1.39, 95% CI: 1.08-1.79) were significant risk factors for the development of T2DM. T2DM was not a significant risk factor for either depression (RR 1.26, 95% CI: 0.91-1.74) or anxiety symptoms (RR 1.13, 95% CI: 0.59-2.19). CONCLUSION In this study, T2DM is not a significant risk factor for depression and anxiety; similarly, neither are depression and anxiety significant risk factors for T2DM. Although prevalence of depression and anxiety is not alarming, the findings reported here should alert clinicians to screen and treat anxiety and depression in people with diabetes and also note the importance of monitoring women with complications in pregnancy for risk of later T2DM.
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Affiliation(s)
- Syed Shahzad Hasan
- The University of Queensland, 20 Cornwall Street, Woolloongabba 4102, Queensland, Australia.
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Mezuk B, Johnson-Lawrence V, Lee H, Rafferty JA, Abdou CM, Uzogara EE, Jackson JS. Is ignorance bliss? Depression, antidepressants, and the diagnosis of prediabetes and type 2 diabetes. Health Psychol 2013; 32:254-63. [PMID: 23437855 DOI: 10.1037/a0029014] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To examine the association between clinically identified and undiagnosed prediabetes and Type 2 diabetes with depression and antidepressant medication use. METHODS Data come from the National Health and Nutrition Examination Study (2005 and 2007), a population-based cross-sectional survey. Analysis is limited to adults aged 30 and older (n = 3,183, Mean age = 52.1 year). Depression syndrome was measured by the Patient Health Questionnaire-9. Participants were categorized using fasting glucose levels as normoglycemic (glucose <100 mg/dL), undiagnosed prediabetes (glucose 100-125.9), clinically identified prediabetes (glucose 100-125.9 plus clinician diagnosis), undiagnosed Type 2 diabetes (glucose >126), and clinically identified Type 2 diabetes (glucose >126 plus clinician diagnosis or use of antidiabetic medications). Health behaviors included smoking, poor diet, excessive alcohol use, and obesity. Health promotion behaviors included efforts to change diet, lose weight, and increase physical activity. RESULTS Clinically identified diabetes was associated with 4.3-fold greater odds of depression, but undiagnosed diabetes was not significantly associated with depression. This relationship was more pronounced for prediabetes. Clinically identified diabetes was associated with 1.8-fold greater odds of antidepressant use, but undiagnosed diabetes was not significantly associated with antidepressant use. Health behaviors were not consistently related to depression syndrome. CONCLUSION The relationship between diabetes status and depression and antidepressant use depends on whether the diabetes has been clinically identified. Findings are consistent with the hypothesis that the relationship between diabetes and depression may be attributable to factors related to disease management. Previous reports linking antidepressants and diabetes may be attributable to clinical ascertainment bias.
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Affiliation(s)
- Briana Mezuk
- Department of Epidemiology and Community Health, Virginia Commonwealth University, Richmond, VA 23298, USA.
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Abstract
Comorbidity of depression and diabetes is common, and each disorder has a negative impact on the outcome of the other. The direction of causality is not certain as each disorder seems to act as both a risk factor and consequence for the other in longitudinal studies. This bidirectional association is possibly mediated by shared environmental and genetic risk factors. Comorbid depression is associated with reduced adherence to medication and self-care management, poor glycaemic control, increased health care utilization, increased costs and elevated risk of complications, as well as mortality in patients with diabetes. Psychological and pharmacological interventions are shown to be effective in improving depression symptoms; however, collaborative care programs that simultaneously manage both disorders seem to be most effective in improving diabetes-related outcomes.
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Affiliation(s)
- Bibilola D Oladeji
- Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria.
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Akbaraly TN, Kumari M, Head J, Ritchie K, Ancelin ML, Tabák AG, Brunner E, Chaudieu I, Marmot MG, Ferrie JE, Shipley MJ, Kivimäki M. Glycemia, insulin resistance, insulin secretion, and risk of depressive symptoms in middle age. Diabetes Care 2013; 36:928-34. [PMID: 23230097 PMCID: PMC3609527 DOI: 10.2337/dc12-0239] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The extent to which abnormal glucose metabolism increases the risk of depression remains unclear. In this study, we investigated prospective associations of levels of fasting glucose and fasting insulin and indices of insulin resistance and secretion with subsequent new-onset depressive symptoms (DepS). RESEARCH DESIGN AND METHODS In this prospective cohort study of 3,145 adults from the Whitehall II Study (23.5% women, aged 60.6 ± 5.9 years), baseline examination included fasting glucose and insulin level, the homeostasis model assessment of insulin resistance (HOMA2-%IR), and the homeostasis model assessment of β-cell insulin secretion (HOMA2-%B). DepS (Center for Epidemiologic Studies Depression Scale ≥16 or use of antidepressive drugs) were assessed at baseline and at 5-year follow-up. RESULTS Over the 5-year follow-up, DepS developed in 142 men and 84 women. Women in the lowest quintile of insulin secretion (HOMA2-%B ≤55.3%) had 2.18 (95% CI 1.25-3.78) times higher odds of developing DepS than those with higher insulin secretion. This association was not accounted for by inflammatory markers, cortisol secretion, or menopausal status and hormone replacement therapy. Fasting insulin measures were not associated with DepS in men, and fasting glucose measures were not associated with new-onset DepS in either sex. CONCLUSIONS Low insulin secretion appears to be a risk factor for DepS in middle-aged women, although further work is required to confirm this finding.
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Affiliation(s)
- Tasnime N Akbaraly
- Department of Epidemiology and Public Health, University College London, London, UK.
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Bot M, Pouwer F, De Jonge P, Nolan J, Mari A, Højlund K, Golay A, Balkau B, Dekker J. Depressive symptoms, insulin sensitivity and insulin secretion in the RISC cohort study. DIABETES & METABOLISM 2013. [DOI: 10.1016/j.diabet.2012.09.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Kan C, Silva N, Golden SH, Rajala U, Timonen M, Stahl D, Ismail K. A systematic review and meta-analysis of the association between depression and insulin resistance. Diabetes Care 2013; 36:480-9. [PMID: 23349152 PMCID: PMC3554272 DOI: 10.2337/dc12-1442] [Citation(s) in RCA: 244] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Depression is associated with the onset of type 2 diabetes. A systematic review and meta-analysis of observational studies, controlled trials, and unpublished data was conducted to examine the association between depression and insulin resistance (IR). RESEARCH DESIGN AND METHODS Medline, EMBASE, and PsycINFO were searched for studies published up to September 2011. Two independent reviewers assessed the eligibility of each report based on predefined inclusion criteria (study design and measure of depression and IR, excluding prevalent cases of diabetes). Individual effect sizes were standardized, and a meta-analysis was performed to calculate a pooled effect size using random effects. Subgroup analyses and meta-regression were conducted to explore any potential source of heterogeneity between studies. RESULTS Of 967 abstracts reviewed, 21 studies met the inclusion criteria of which 18 studies had appropriate data for the meta-analysis (n = 25,847). The pooled effect size (95% CI) was 0.19 (0.11-0.27) with marked heterogeneity (I(2) = 82.2%) using the random-effects model. Heterogeneity between studies was not explained by age or sex, but could be partly explained by the methods of depression and IR assessments. CONCLUSIONS A small but significant cross-sectional association was observed between depression and IR, despite heterogeneity between studies. The pathophysiology mechanisms and direction of this association need further study using a purposively designed prospective or intervention study in samples at high risk for diabetes.
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Affiliation(s)
- Carol Kan
- Institute of Psychiatry, King’s College London, London, UK.
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Smith KJ, Béland M, Clyde M, Gariépy G, Pagé V, Badawi G, Rabasa-Lhoret R, Schmitz N. Association of diabetes with anxiety: a systematic review and meta-analysis. J Psychosom Res 2013; 74:89-99. [PMID: 23332522 DOI: 10.1016/j.jpsychores.2012.11.013] [Citation(s) in RCA: 281] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 11/12/2012] [Accepted: 11/30/2012] [Indexed: 01/15/2023]
Abstract
OBJECTIVES Anxiety has been shown to be associated with poor outcomes in people with diabetes. However, there has been little research which has specifically examined whether diabetes mellitus is associated with an increased likelihood of co-morbid anxiety. The aim of this systematic review and meta-analysis was to determine whether people with diabetes are more likely to have anxiety disorders or elevated anxiety symptoms than people who do not have diabetes. METHODS A systematic review was performed by three independent reviewers who searched for articles that examined the association between anxiety and diabetes in adults 16 or older. Those studies that met eligibility criteria were put forward for meta-analysis using a random-effects model. RESULTS A total of twelve studies with data for 12,626 people with diabetes were eligible for inclusion in the systematic review and meta-analysis. Significant and positive associations were found for diabetes with both anxiety disorders, 1.20 (1.10-1.31), and elevated anxiety symptoms, 1.48 (1.02-1.93). The pooled OR for all studies that assessed anxiety was 1.25 (1.10-1.39). CONCLUSIONS Results from this meta-analysis provide support that diabetes is associated with an increased likelihood of having anxiety disorders and elevated anxiety symptoms.
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Affiliation(s)
- Kimberley J Smith
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
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Chen PC, Chan YT, Chen HF, Ko MC, Li CY. Population-based cohort analyses of the bidirectional relationship between type 2 diabetes and depression. Diabetes Care 2013; 36:376-82. [PMID: 23150281 PMCID: PMC3554286 DOI: 10.2337/dc12-0473] [Citation(s) in RCA: 102] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This study addresses the strength of association for the bidirectional relationship between type 2 diabetes and depression. RESEARCH DESIGN AND METHODS We used two cohort studies with the same source of database to determine the link between depression and type 2 diabetes. The data analyzed included a random sample of 1 million beneficiaries selected from the National Health Insurance claims in 2000. The analysis of diabetes predicting the depression onset consisted of 16,957 diabetic patients and the same number of sex- and age-matched nondiabetic control subjects. The analysis of depression predicting diabetes onset included 5,847 depressive patients and 5,847 sex- and age-matched nondepressive control subjects. The follow-up period was between 2000 and 2006, and onset of end points was identified from ambulatory care claims. The Cox proportional hazards regression model adjusted for potential confounders was used to estimate relative hazards. RESULTS The first cohort analysis noted an incidence density (ID) of 7.03 per 1,000 person-years (PY) and 5.04 per 1,000 PY for depression in diabetic and nondiabetic subjects, respectively, representing a covariate-adjusted hazard ratio (HR) of 1.43 (95% CI 1.16-1.77). The second cohort analysis noted an ID of 27.59 per 1,000 PY and 9.22 per 1,000 PY for diabetes in depressive and nondepressive subjects, respectively. The covariate-adjusted HR was stronger at 2.02 (1.80-2.27) for incident diabetes associated with baseline depression. CONCLUSIONS The two cohort studies provided evidence for the bidirectional relationship between diabetes and depression, with a stronger association noted for the depression predicting onset of diabetes.
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Affiliation(s)
- Pei-Chun Chen
- Institute of Epidemiology and Preventive Medicine, National Taiwan University College of Public Health, Taipei, Taiwan
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Barnard K, Davis N, Taylor C. Implementing psychological assessments required by the Best Practice Tariff for Paediatric Diabetes. PRACTICAL DIABETES 2012. [DOI: 10.1002/pdi.1718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Abstract
BACKGROUND Research suggests that co-morbid diabetes and depression is common; however, the implications for clinical practice remain unclear. This paper reviews the current epidemiological evidence on comorbid diabetes and depression, in order to identify the key publications which could both inform practice and identify gaps in knowledge and research. METHODS A systematic review was conducted to identify published literature on the epidemiology of diabetes and depression. In order to review evidence on up-to-date knowledge of recent research and innovations in care literature searches for the last five years (August 2006-August 2011) were conducted. To identify relevant literature, electronic databases MEDLINE, Psych-INFO and EMBASE were searched for English language articles in peer-reviewed journals. RESULTS High rates of co-morbidity of depression and diabetes have been reported. The prevalence rate of depression is more than three-times higher in people with type 1 diabetes (12%, range 5.8-43.3% vs. 3.2%, range 2.7-11.4%) and nearly twice as high in people with type 2 diabetes (19.1%, range 6.5-33% vs. 10.7%, range 3.8-19.4%) compared to those without. Women with diabetes and also women without diabetes experience a higher prevalence of depression than men. Reviewed studies provide support for a modest relationship between diabetes and depressive symptoms, but the exact direction of this relationship remains unclear. LIMITATIONS Most studies reviewed were cross-sectional and this limits any conclusions about the causal nature and direction of the relationship between diabetes and depression. Variation in measurement methods, lack of longitudinal data and few studies outside Europe and America limit the generalizability of the findings of this review. CONCLUSIONS Current research suggests that the risk of developing depression is increased in people with diabetes; however, further studies are required in order to establish the nature of the relationship between depression, glycaemic control and the development of diabetes complications, and make appropriate recommendations for treatment and to support self-management of diabetes.
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Affiliation(s)
- Tapash Roy
- BRAC Health Programme, Dhaka, Bangladesh & The University of Nottingham, Nottingham, UK
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Freeman JS, Gross B. Potential drug interactions associated with treatments for type 2 diabetes and its comorbidities: a clinical pharmacology review. Expert Rev Clin Pharmacol 2012; 5:31-42. [PMID: 22142157 DOI: 10.1586/ecp.11.64] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Type 2 diabetes is a disease of glucose metabolism that commonly involves multiple comorbidities, including lipid dyscrasias and hypertension. Each concurrent disorder contributes some risk of complications and requires therapeutic intervention. The simultaneous management of so many coexisting illnesses can be complex and commonly results in patients being prescribed multiple medications--referred to as polypharmacy--which may further complicate treatment. To ensure the best patient outcomes, the treating physician must be aware of all the therapeutic agents that a patient is taking to assess possible drug interactions that such a plethora of medications may confer. This article addresses the underlying comorbidites, the drugs commonly used to treat them and the interactions that may arise from concomitant administration.
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Affiliation(s)
- Jeffrey S Freeman
- Division of Endocrinology and Metabolism, Philadelphia College of Osteopathic Medicine 4190 City Avenue, Philadelphia, PA 19131-1626, USA.
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Roy T, Lloyd CE, Parvin M, Mohiuddin KGB, Rahman M. Prevalence of co-morbid depression in out-patients with type 2 diabetes mellitus in Bangladesh. BMC Psychiatry 2012; 12:123. [PMID: 22909306 PMCID: PMC3502134 DOI: 10.1186/1471-244x-12-123] [Citation(s) in RCA: 50] [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: 01/19/2012] [Accepted: 08/16/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Little is known about the prevalence of depression in people with diabetes in Bangladesh. This study examined the prevalence and factors associated with depression in out-patients with Type 2 diabetes in Bangladesh. METHODS In this cross-sectional study a random sample of 483 diabetes out-patients from three diabetes clinics in Bangladesh was invited to participate. Of them 417 patients took part. Depressive symptoms were measured using previously developed and culturally standardized Bengali and Sylheti versions of the World HealthOrganization-5 Well Being Index (WHO-5) and the Patient Health Questionairre-9 (PHQ-9) with predefined cut-off scores. Data was collected using two different modes; e.g. standard assisted collection and audio questionnaire methods. Associations between depression and patient characteristics were explored using regression analysis. RESULTS The prevalence of depressive symptoms was 34% (PHQ-9 score ≥ 5) and 36% (WHO-5 score < 52) with audio questionnaire delivery method. The prevalence rates were similar regardless of the type (PHQ-9 vs. WHO-5) and language (Sylheti vs. Bengali) of the questionnaires, and methods of delivery (standard assisted vs. audio methods). The significant predictors of depressive symptoms using either the PHQ-9 or WHO-5 questionnaires were; age, income, gender, treatment intensity, and co-morbid cardiovascular disease. Further, depression was strongly associated with poor glycaemic control and number of co-morbid conditions. CONCLUSIONS This study demonstrated that depression prevalence is common in out-patients with type 2 diabetes in Bangladesh. In a setting where recognition, screening and treatment levels remain low, health care providers need to focus their efforts on diagnosing, referring and effectively treating this important disease in order to improve service delivery.
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Affiliation(s)
- Tapash Roy
- BRAC Health Programme, Dhaka, Bangladesh & Division of Research in Medicines and Health, University of Nottingham, Nottingham, UK.
| | - Cathy E Lloyd
- Faculty of Health & Social Care, The Open University, Milton Keynes, UK
| | - Masuma Parvin
- Medical Education & Research Unit, Ministry of Health, Government of Bangladesh, Dhaka, Bangladesh
| | | | - Mosiur Rahman
- BRAC Health Programme, BRAC Centre (16th Floor), 75 Mohakhali, Dhaka, 1212, Bangladesh
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Jadoon NA, Shahzad MA, Munir W, Bashir I. Sociodemographic, clinical and lifestyle factors associated with psychiatric illness among individuals with diabetes. Int J Diabetes Dev Ctries 2012. [DOI: 10.1007/s13410-012-0076-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Silva N, Atlantis E, Ismail K. A review of the association between depression and insulin resistance: pitfalls of secondary analyses or a promising new approach to prevention of type 2 diabetes? Curr Psychiatry Rep 2012; 14:8-14. [PMID: 22094982 DOI: 10.1007/s11920-011-0245-8] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
We review the validity of the evidence for an association between depression and the risk of insulin resistance (IR). We describe the potentially plausible biological and behavioral mechanisms that explain how depression increases the risk of IR and consequent overt diabetes. We have identified gaps in the literature to guide future research. Evidence for bidirectional associations between depression and IR is inconsistent. Results showing positive associations between depression and IR are derived from cross-sectional studies, whereas negative findings are typically reported in cohort studies. On the other hand, tentative trial evidence suggests that the effective treatment of depression can improve IR, and that lifestyle programs improve IR and reduce depressive symptoms. These emerging themes could lead to potential new multidisciplinary approaches to preventing diabetes.
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Affiliation(s)
- Naomi Silva
- School of Medicine, King's College London, London SE1 1UL, England, UK.
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Depression and type 2 diabetes: Inflammatory mechanisms of a psychoneuroendocrine co-morbidity. Neurosci Biobehav Rev 2012; 36:658-76. [DOI: 10.1016/j.neubiorev.2011.10.001] [Citation(s) in RCA: 168] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Revised: 10/01/2011] [Accepted: 10/05/2011] [Indexed: 01/28/2023]
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Lloyd CE, Roy T, Begum S, Mughal S, Barnett AH. Measuring psychological well-being in South Asians with diabetes; a qualitative investigation of the PHQ-9 and the WHO-5 as potential screening tools for measuring symptoms of depression. Diabet Med 2012; 29:140-7. [PMID: 21988640 DOI: 10.1111/j.1464-5491.2011.03481.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND People from South Asian backgrounds living in the UK have a greatly increased risk of developing Type 2 diabetes. Whether or not this patient group also experience high rates of depressive symptoms (known to be the case in Caucasian populations with diabetes) remains unknown, partly because it is unclear whether the screening tools used are culturally relevant. The aim of this study was to develop culturally competent translations (in both written and audio formats) of two screening tools used to measure symptoms of depression in languages with no written form and establish their face validity. METHODS Adults with Type 2 diabetes from two South Asian minority ethnic groups (from Bangladesh and Pakistan) whose main language is only spoken (Sylheti and Mirpuri) were recruited via the Birmingham Heartlands Hospital Diabetes Centre. Participants attended two focus group meetings to consider the content and method of delivery of two questionnaires measuring symptoms of depression, the Patient Health Questionnaire (PHQ-9) and the World Health Organization Well-being Index (WHO-5). RESULTS Culturally equivalent content was achieved for both questionnaires in both languages. The Mirpuri men and women groups did not indicate a clear preference for either mode of questionnaire delivery; however, the Sylheti groups' preference was for independent audio-delivery in their spoken language. CONCLUSIONS The face validity of the PHQ-9 and the WHO-5 was established for Sylheti and Mirpuri in an audio delivery format. Psychometric testing is now needed among minority ethnic populations so that the feasibility of wider use can be determined.
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Affiliation(s)
- C E Lloyd
- Faculty of Health and Social Care, The Open University, Milton Keynes, UK.
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Abstract
Metabolic syndrome (MS) seems to be associated with both depression and increased cardiovascular risk. This article emphasizes the most relevant findings on the link between MS and psychological cardiovascular risk factors, focusing on the impact of anxiety. There is evidence for an association between psychological disorders and the development of MS, which could eventually increase cardiovascular risk. However, the coexistence of anxiety in MS patients seems to be a byproduct of anxiety-depression comorbidity, stress and negative health behaviors. Endocannabinoid receptors, and hypothalamic-pituitary-adrenal axis dysregulation and sympathetic hyperactivation are the most commonly mentioned plausible underlying pathways.
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Affiliation(s)
| | - Antonio E Nardi
- a Institute of Psychiatry - Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil and INCT - Translational Medicine (CNPq), Avenida Venceslau Brás, 71, Fundos, Campus Praia Vermelha, Rio de Janeiro, Brazil
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Guruprasad KG, Niranjan MR, Ashwin S. A study of association of depressive symptoms among the type 2 diabetic outpatients presenting to a tertiary care hospital. Indian J Psychol Med 2012; 34:30-3. [PMID: 22661804 PMCID: PMC3361839 DOI: 10.4103/0253-7176.96153] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The prevalence of diabetes mellitus is increasing among Indian population over time. There are varying reports about the association of depression among type 2 diabetic individuals. However, there is limited data about this in India. AIMS To study the association of depression, demographic and socio-medical factors in type 2 diabetes patients. SETTINGS AND DESIGN Cross-sectional, epidemiological study. MATERIALS AND METHODS All the consenting type 2 diabetes mellitus patients attending to Medical OPD (n=210) were screened for symptoms of depression using beck depression inventory. All the participants were physically examined and a detailed psychiatric assessment were done. The relevant investigations were advised to identify comorbid conditions. STATISTICAL ANALYSIS Chi-square test with odd's ratio. RESULTS One-fourth of the screened diabetic patients were found to be having depression. Females and overweight individuals were found to have features of depression. Patients with long duration of diabetes and on combination of antidiabetic drugs were significantly associated with depression. Among depressed diabetics 25.9% were having Ischemic heart disease as a comorbid medical illness. CONCLUSIONS This study shows there is increased rate of depression among type 2 diabetic individuals. The interesting association of depression with several demographic and sociomedical factors have an important implication in type 2 diabetics.
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Affiliation(s)
- K G Guruprasad
- Department of Psychiatry, Hassan Institute of Medical Sciences, Hassan, Karnataka, India
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Sublette ME, Ellis SP, Geant AL, Mann JJ. Meta-analysis of the effects of eicosapentaenoic acid (EPA) in clinical trials in depression. J Clin Psychiatry 2011; 72:1577-84. [PMID: 21939614 PMCID: PMC3534764 DOI: 10.4088/jcp.10m06634] [Citation(s) in RCA: 312] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2010] [Accepted: 12/16/2010] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Randomized trials of omega-3 polyunsaturated fatty acid (PUFA) treatment for depression have differed in outcome. Recent meta-analyses ascribe discrepancies to differential effects of eicosapentaenoic acid (EPA) versus docosahexaenoic acid (DHA) and to diagnostic heterogeneity. This meta-analysis tests the hypothesis that EPA is the effective component in PUFA treatment of major depressive episodes. DATA SOURCES PubMed/MeSH was searched for studies published in English from 1960 through June 2010 using the terms fish oils (MeSH) AND (depressive disorder [MeSH] OR bipolar depression) AND randomized controlled trial (publication type). The search was supplemented by manual bibliography review and examination of relevant review articles. STUDY SELECTION The search yielded 15 trials involving 916 participants. Studies were included if they had a prospective, randomized, double-blinded, placebo-controlled study design; if depressive episode was the primary complaint (with or without comorbid medical conditions); if omega-3 PUFA supplements were administered; and if appropriate outcome measures were used to assess depressed mood. DATA EXTRACTION Extracted data included study design, sample sizes, doses and percentages of EPA and DHA, mean ages, baseline and endpoint depression ratings and standard deviations for PUFA and placebo groups, and P values. The clinical outcome of interest was the standardized mean difference in the change from baseline to endpoint scores on a depression rating scale in subjects taking PUFA supplements versus subjects taking placebo. DATA SYNTHESIS In a mixed-effect model, percentage of EPA in the supplements was the fixed-effect predictor, dichotomized into 2 groups: EPA < 60% or EPA ≥ 60% of the total EPA + DHA. Secondary analyses explored the relevance of treatment duration, age, and EPA dose. RESULTS Supplements with EPA ≥ 60% showed benefit on standardized mean depression scores (effect size = 0.532; 95% CI, 0.277-0.733; t = 4.195; P < .001) versus supplements with EPA < 60% (effect size = -0.026; 95% CI, -0.200 to 0.148; t = -0.316; P = .756), with negligible contribution of random effects or heteroscedasticity and with no effects of treatment duration or age. Supplements with EPA < 60% were ineffective. Exploratory analyses supported a nonlinear model, with improvement determined by the dose of EPA in excess of DHA, within the range of 200 to 2,200 mg/d of EPA. CONCLUSIONS Supplements containing EPA ≥ 60% of total EPA + DHA, in a dose range of 200 to 2,200 mg/d of EPA in excess of DHA, were effective against primary depression. Translational studies are needed to determine the mechanisms of EPA's therapeutic benefit.
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Affiliation(s)
- M. Elizabeth Sublette
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, NY, NY,Department of Psychiatry, Columbia University, NY, NY
| | - Steven P. Ellis
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, NY, NY,Department of Psychiatry, Columbia University, NY, NY
| | - Amy L. Geant
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, NY, NY
| | - J. John Mann
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, NY, NY,Department of Psychiatry, Columbia University, NY, NY,Department of Radiology, Columbia University, NY, NY
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