Type 2 diabetes mellitus as a risk factor for the onset of depression: a systematic review and meta-analysis

• Published in: Diabetologia Vol. 53; no. 12; pp. 2480 - 2486
• Main Authors: Nouwen, A, Winkley, K, Twisk, J, Lloyd, C. E, Peyrot, M, Ismail, K, Pouwer, F
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Berlin/Heidelberg : Springer-Verlag 01.12.2010; Springer-Verlag; Springer; Springer Nature B.V
• Subjects: Adult and adolescent clinical studies; Age of Onset; Biological and medical sciences; Consortia; Critical review; Depression; Depression - epidemiology; Depression - etiology; Diabetes; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - epidemiology; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Human Physiology; Humans; incidence; Internal Medicine; Longitudinal studies; Longitudinal Studies - statistics & numerical data; Medical sciences; Medicine; Medicine & Public Health; Mental depression; Meta-Analysis; Metabolic Diseases; Mood disorders; noninsulin-dependent diabetes mellitus; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Questionnaires; Risk Factors; Systematic review; Netherlands; United Kingdom > UK; United States > US; Baltimore Maryland; Type 2 diabetes; Depression; Systematic review; Critical review; Incidence; Meta-analysis; Endocrinopathy; Mood disorder; Risk factor; Metabolic diseases; Review
• ISSN: 0012-186X; 1432-0428; 1432-0428
• DOI: 10.1007/s00125-010-1874-x

Aims/hypothesis An earlier meta-analysis showed that diabetes is a risk factor for the development and/or recurrence of depression. Yet whether this risk is different for studies using questionnaires than for those relying on diagnostic criteria for depression has not been examined. This study examined the association of diabetes and the onset of depression by reviewing the literature and conducting a meta-analysis of longitudinal studies on this topic. Methods EMBASE, MEDLINE and PsycInfo were searched for articles published up to September 2009. All studies that examined the relationship between type 2 diabetes and the onset of depression were included. Pooled relative risks were calculated using fixed and random effects models. Results Eleven studies met our inclusion criteria for this meta-analysis. Based on the pooled data, including 48,808 cases of type 2 diabetes without depression at baseline, the pooled relative risk was 1.24 (95% CI 1.09-1.40) for the random effects model. This risk was significantly higher for studies relying on diagnostic criteria of depression than for studies using questionnaires. However, this difference was no longer significant when controlled for year of publication. Conclusions/interpretation Compared with non-diabetic controls, people with type 2 diabetes have a 24% increased risk of developing depression. The mechanisms underlying this relationship are still unclear and warrant further research.