Elsevier

General Hospital Psychiatry

Volume 35, Issue 3, May–June 2013, Pages 217-225
General Hospital Psychiatry

Psychiatric–Medical Comorbidity1
Depression and risk of mortality in individuals with diabetes: a meta-analysis and systematic review

https://doi.org/10.1016/j.genhosppsych.2013.01.006Get rights and content
Under a Creative Commons license
open access

Abstract

Objectives

To estimate risk of comorbid depression on all-cause mortality over time among individuals with diabetes.

Methods

The Medline, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Embase and Science Direct databases were searched through September 30, 2012. We limited our search to longitudinal or prospective studies reporting all-cause mortality among those having depression and diabetes, compared with those having diabetes alone that used hazard ratios (HRs) as the main outcome. Two reviewers independently extracted primary data and evaluated the quality of studies using predetermined criteria. The pooled random effects adjusted HRs were estimated using meta-analysis. The impact of moderator variables on study effect size was examined with meta-regression.

Results

A total of 42,363 respondents from 10 studies were included in the analysis. Depression was significantly associated with risk of mortality (pooled HR=1.50, 95% confidence interval=1.35–1.66). Little evidence for heterogeneity was found across the studies (Cochran Q=13.52, P= .20, I2= 26.03). No significant possibility of publication bias was detected (Egger's regression intercept=0.98, P= .23).

Conclusion

Depression significantly increases the risk of mortality among individuals with diabetes. Early detection and treatment of depression may improve health outcomes in this population.

Keywords

Depression
Diabetes mellitus
Mortality
Meta-analysis
Systematic review

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1

The Psychiatric–Medical Comorbidity section will focus on the prevalence and impact of psychiatric disorders in patients with chronic medical illness as well as the prevalence and impact of medical disorders in patients with chronic psychiatric illness.