The detection rate of depression in Chinese with type 2 diabetes mellitus: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

LIU Xiaobo ¹ , ZHANG Huiling ¹ , LI Yuxi ² , ZHONG Dongling ¹ , LI Juan ¹ ,  JIN Rongjiang ¹

1. School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, P.R.China;
2. School of Acupuncture-Moxibustion and Tuina, the Third Afﬁliated Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, P.R.China;

Corresponding author：

JIN Rongjiang, Email: cdzyydxjrj@126.com

Keywords：

China; Type 2 diabetes mellitus; Depression; Detection rate; Meta-analysis; Systematic review

DOI：

10.7507/1672-2531.202002163

Video：

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Objectives To systematically review the detection rate of depression in Chinese individuals with type 2 diabetes mellitus (T2DM).Methods PubMed, EMbase, The Cochrane Library, CBM, CNKI, WanFang Data and VIP databases were electronically searched to collect observational studies on the detection rate of depression in Chinese with T2DM from inception to January, 2019. Two reviewers independently screened literature, extracted data and evaluated the quality of included studies. Meta-analysis was performed by R 3.6.1 software.Results A total of 29 studies involving 96 557 cases were included. Meta-analysis results showed that the total detection rate of depression in Chinese with T2DM was 27% (95%CI 24% to 30%). Subgroup analysis showed that the detection rate of depression in female was 32% (95%CI 20% to 45%), and in male was 26% (95%CI 18% to 37%). The detection rate of depression in rural areas was 36% (95%CI 18% to 54%), and in urban areas was 30% (95%CI 16% to 43%). The detection rate of depression in individuals aged 60 and above was 31% (95%CI 24% to 39%), and in individuals aged less than 60 was 23% (95%CI 10% to 36%). Individuals with a primary school education and below, a middle or high school education and college degree and above education had detection rate of 31%, 23% and 22%, respectively. Individuals with diabetes duration less than 5 years, 5 to 10 years and more than 10 years had detection rates of 23%, 25% and 30%, respectively. Individuals with and without complications had detection rates of 43% and 26%, respectively. The detection rates of mild and moderate to major depression were 20% and 10%, respectively.Conclusions The detection rate of depression in Chinese with T2DM is high. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusion.

Citation： LIU Xiaobo, ZHANG Huiling, LI Yuxi, ZHONG Dongling, LI Juan, JIN Rongjiang. The detection rate of depression in Chinese with type 2 diabetes mellitus: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2020, 20(8): 930-937. doi: 10.7507/1672-2531.202002163 Copy

1.	Wang L, Gao P, Zhang M, et al. Prevalence and ethnic pattern of diabetes and prediabetes in China in 2013. JAMA, 2017, 317(24): 2515-2523.
2.	中华医学会糖尿病学分会. 中国 2 型糖尿病防治指南(2017 年版). 中国实用内科杂志, 2018, 38(4): 292-344.
3.	杨晓妍, 吴先萍. 2 型糖尿病危险因素研究进展. 预防医学情报杂志, 2001, 17(1): 12-13.
4.	Khaledi M, Haghighatdoost F, Feizi A, et al. 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(6): 631-650.
5.	Wang F, Wang S, Zong QQ, et al. Prevalence of comorbid major depressive disorder in Type 2 diabetes: a meta-analysis of comparative and epidemiological studies. Diabet Med, 2019, 36(8): 961-969.
6.	Roy T, Lloyd CE. Epidemiology of depression and diabetes: a systematic review. J Affect Disord, 2012, 142 Suppl: S8-S21.
7.	Egede LE, Ellis C. Diabetes and depression: global perspectives. Diabetes Res Clin Pract, 2010, 87(3): 302-312.
8.	Farooqi A, Khunti K, Abner S, et al. Comorbid depression and risk of cardiac events and cardiac mortality in people with diabetes: A systematic review and meta-analysis. Diabetes Res Clin Pract, 2019, 156: 107816.
9.	Naicker K, Johnson JA, Skogen JC, et al. Type 2 diabetes and comorbid symptoms of depression and anxiety: longitudinal associations with mortality risk. Diabetes Care, 2017, 40(3): 352-358.
10.	Hussain S, Habib A, Singh A, et al. Prevalence of depression among type 2 diabetes mellitus patients in India: A meta-analysis. Psychiatry Res, 2018, 270: 264-273.
11.	Khalighi Z, Badfar G, Mahmoudi L, et al. The prevalence of depression and anxiety in Iranian patients with diabetes mellitus: a systematic review and meta-analysis. Diabetes Metab Syndr, 2019, 13(4): 2785-2794.
12.	Anderson RJ, Freedland KE, Clouse RE, et al. The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care, 2001, 24(6): 1069-1078.
13.	曾宪涛, 刘慧, 陈曦, 等. Meta 分析系列之四: 观察性研究的质量评价工具. 中国循证心血管医学杂志, 2012, 4(4): 297-299.
14.	赵晶. 2 型糖尿病患者焦虑和抑郁现状及危险因素的研究. 中国糖尿病杂志, 2014, 22(7): 615-619.
15.	唐兢, 杨祺, 李潇, 等. 社区老年 2 型糖尿病患者的情绪及家庭功能评估. 医药前沿, 2018, 8(23): 381-382.
16.	Xiu S, Liao Q, Sun L, et al. Risk factors for cognitive impairment in older people with diabetes: a community-based study. Ther Adv Endocrinol Metab, 2019, 10: 2042018819836640.
17.	Lee CM, Chang CF, Pan MY, et al. Depression and its associated factors among rural diabetic residents. J Nurs Res, 2017, 25(1): 31-40.
18.	宁锋, 王玉美, 孙晓晖, 等. 青岛成人抑郁症和 2 型糖尿病患病率双向关联研究. 中华疾病控制杂志, 2016, 20(4): 357-361.
19.	Liu H, Xu X, Hall JJ, et al. Differences in depression between unknown diabetes and known diabetes: results from China health and retirement longitudinal study. Int Psychogeriatr, 2016, 28(7): 1191-1199.
20.	Wang L, Song R, Chen Z, et al. Prevalence of depressive symptoms and factors associated with it in type 2 diabetic patients: a cross-sectional study in China. BMC Public Health, 2015, 15: 188.
21.	Sun JC, Xu M, Lu JL, et al. Associations of depression with impaired glucose regulation, newly diagnosed diabetes and previously diagnosed diabetes in Chinese adults. Diabet Med, 2015, 32(7): 935-943.
22.	Zheng Y, Sun Q, Chen K, et al. Waist-to-hip ratio, dyslipidemia, glycemic levels, blood pressure and depressive symptoms among diabetic and non-diabetic Chinese women: a cross-sectional study. PLoS One, 2014, 9(10): e109765.
23.	许卫红, 刘文锋, 曾惠涛. 农村 2 型糖尿病患者心理状况分析及干预策略研究. 按摩与康复医学, 2014, (7): 224-225, 226.
24.	王从菊, 金建华, 晁湘琴, 等. 苏州市社区糖尿病人群抑郁症的相关因素分析. 职业与健康, 2014, 30(5): 681-683.
25.	Liu Y, Maier M, Hao Y, et al. Factors related to quality of life for patients with type 2 diabetes with or without depressive symptoms - results from a community-based study in China. J Clin Nurs, 2013, 22(1-2): 80-88.
26.	Mezuk B, Chen Y, Yu C, et al. Depression, anxiety, and prevalent diabetes in the Chinese population: findings from the China Kadoorie Biobank of 0.5 million people. J Psychosom Res, 2013, 75(6): 511-517.
27.	王桂荣. 2 型糖尿病合并精神疾病的风险因素调查. 成都医学院学报, 2012, 07(1): 118-120.
28.	张娟. 老年 2 型糖尿病患者抑郁状况调查及相关危险性分析. 中外健康文摘, 2011, 8(9): 91-92.
29.	杨成龙, 蔡文治, 黄海刚, 等. 2 型糖尿病共病抑郁症的危险因素分析. 中国全科医学, 2011, 14(26): 2956-2958.
30.	徐娜. 2 型糖尿病并发抑郁症相关因素研究. 天津: 天津医科大学, 2007.
31.	钱湘毅, 王海琴, 魏新萍. 社区 2 型糖尿病患者抑郁和焦虑情绪危险因素流行病学调查. 中国现代药物应用, 2011, 5(22): 132-134.
32.	刘宇, 何国平, 秦月兰, 等. 社区 2 型糖尿病合并抑郁患者生活质量影响因素研究. 中国全科医学, 2010, 13(25): 2829-2833.
33.	孙士杰, 董砚虎. 2 型糖尿病患者抑郁患病率调查与分析. 医学与哲学(临床决策论坛版), 2009, 30(12): 75-76.
34.	陈成华, 董砚虎, 郭玉岩. 糖调节受损、新诊断 2 型糖尿病患者抑郁患病调查与相关因素分析. 中国糖尿病杂志, 2010, 18(5): 384-386.
35.	黄华玲, 李红, 赵惠芬, 等. 城乡结合部老年 2 型糖尿病患者抑郁症状及其影响因素的调查. 中国实用护理杂志, 2009, 25(10): 62-65.
36.	汪菲, 孙亚丽, 戴建业, 等. 北京市 2 型糖尿病患者抑郁状况的横断面调查及其危险因素分析. 现代生物医学进展, 2018, 18(5): 902-906.
37.	任蕾. 郑州市 2 型糖尿病患者并发抑郁症的流行病学分析. 郑州大学, 2018.
38.	李苑, 李晓淳, 贾睿. 基于社区的 2 型糖尿病伴发抑郁现况及生命质量的研究. 成都医学院学报, 2015, 10(6): 755-757.
39.	高炬, 曾庆枝, 何燕玲, 等. 上海市 2012 年社区在册糖尿病和高血压患者抑郁、焦虑阳性率及其影响因素. 中国公共卫生, 2018, 34(2): 223-229.
40.	Sun N, Lou P, Shang Y, et al. Prevalence and determinants of depressive and anxiety symptoms in adults with type 2 diabetes in China: a cross-sectional study. BMJ Open, 2016, 6(8): e012540.
41.	Li Z, Guo X, Jiang H, et al. Diagnosed but not undiagnosed diabetes is associated with depression in rural areas. Int J Environ Res Public Health, 2016, 13(11): pii: E1136.
42.	Chou KL, Chi I. Prevalence of depression among elderly Chinese with diabetes. Int J Geriatr Psychiatry, 2005, 20(6): 570-575.
43.	Roy T, Lloyd CE, Parvin M, et al. Prevalence of co-morbid depression in out-patients with type 2 diabetes mellitus in Bangladesh. BMC Psychiatry, 2012, 12: 123.
44.	Wang Y, Lopez JM, Bolge SC, et al. Depression among people with type 2 diabetes mellitus, US National Health and Nutrition Examination Survey (NHANES), 2005-2012. BMC Psychiatry, 2016, 16: 88.
45.	陈向宇, 钟节鸣, 郭丽花, 等. 社区管理糖尿病患者抑郁, 焦虑状况及影响因素研究. 预防医学, 2019, 31(7): 683-687.
46.	Nouwen A, Nefs G, Caramlau I, et al. Prevalence of depression in individuals with impaired glucose metabolism or undiagnosed diabetes: a systematic review and meta-analysis of the European Depression in Diabetes (EDID) Research Consortium. Diabetes Care, 2011, 34(3): 752-762.
47.	Zhang Y, Ting RZ, Yang W, et al. Depression in Chinese patients with type 2 diabetes: associations with hyperglycemia, hypoglycemia, and poor treatment adherence. J Diabetes, 2015, 7(6): 800-808.
48.	罗美玲, 谭红专, 周权, 等. 在 R 软件中实现单个率的 Meta 分析. 循证医学, 2013, 13(3): 181-184, 188.

1. Wang L, Gao P, Zhang M, et al. Prevalence and ethnic pattern of diabetes and prediabetes in China in 2013. JAMA, 2017, 317(24): 2515-2523.
2. 中华医学会糖尿病学分会. 中国 2 型糖尿病防治指南(2017 年版). 中国实用内科杂志, 2018, 38(4): 292-344.
3. 杨晓妍, 吴先萍. 2 型糖尿病危险因素研究进展. 预防医学情报杂志, 2001, 17(1): 12-13.
4. Khaledi M, Haghighatdoost F, Feizi A, et al. 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(6): 631-650.
5. Wang F, Wang S, Zong QQ, et al. Prevalence of comorbid major depressive disorder in Type 2 diabetes: a meta-analysis of comparative and epidemiological studies. Diabet Med, 2019, 36(8): 961-969.
6. Roy T, Lloyd CE. Epidemiology of depression and diabetes: a systematic review. J Affect Disord, 2012, 142 Suppl: S8-S21.
7. Egede LE, Ellis C. Diabetes and depression: global perspectives. Diabetes Res Clin Pract, 2010, 87(3): 302-312.
8. Farooqi A, Khunti K, Abner S, et al. Comorbid depression and risk of cardiac events and cardiac mortality in people with diabetes: A systematic review and meta-analysis. Diabetes Res Clin Pract, 2019, 156: 107816.
9. Naicker K, Johnson JA, Skogen JC, et al. Type 2 diabetes and comorbid symptoms of depression and anxiety: longitudinal associations with mortality risk. Diabetes Care, 2017, 40(3): 352-358.
10. Hussain S, Habib A, Singh A, et al. Prevalence of depression among type 2 diabetes mellitus patients in India: A meta-analysis. Psychiatry Res, 2018, 270: 264-273.
11. Khalighi Z, Badfar G, Mahmoudi L, et al. The prevalence of depression and anxiety in Iranian patients with diabetes mellitus: a systematic review and meta-analysis. Diabetes Metab Syndr, 2019, 13(4): 2785-2794.
12. Anderson RJ, Freedland KE, Clouse RE, et al. The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care, 2001, 24(6): 1069-1078.
13. 曾宪涛, 刘慧, 陈曦, 等. Meta 分析系列之四: 观察性研究的质量评价工具. 中国循证心血管医学杂志, 2012, 4(4): 297-299.
14. 赵晶. 2 型糖尿病患者焦虑和抑郁现状及危险因素的研究. 中国糖尿病杂志, 2014, 22(7): 615-619.
15. 唐兢, 杨祺, 李潇, 等. 社区老年 2 型糖尿病患者的情绪及家庭功能评估. 医药前沿, 2018, 8(23): 381-382.
16. Xiu S, Liao Q, Sun L, et al. Risk factors for cognitive impairment in older people with diabetes: a community-based study. Ther Adv Endocrinol Metab, 2019, 10: 2042018819836640.
17. Lee CM, Chang CF, Pan MY, et al. Depression and its associated factors among rural diabetic residents. J Nurs Res, 2017, 25(1): 31-40.
18. 宁锋, 王玉美, 孙晓晖, 等. 青岛成人抑郁症和 2 型糖尿病患病率双向关联研究. 中华疾病控制杂志, 2016, 20(4): 357-361.
19. Liu H, Xu X, Hall JJ, et al. Differences in depression between unknown diabetes and known diabetes: results from China health and retirement longitudinal study. Int Psychogeriatr, 2016, 28(7): 1191-1199.
20. Wang L, Song R, Chen Z, et al. Prevalence of depressive symptoms and factors associated with it in type 2 diabetic patients: a cross-sectional study in China. BMC Public Health, 2015, 15: 188.
21. Sun JC, Xu M, Lu JL, et al. Associations of depression with impaired glucose regulation, newly diagnosed diabetes and previously diagnosed diabetes in Chinese adults. Diabet Med, 2015, 32(7): 935-943.
22. Zheng Y, Sun Q, Chen K, et al. Waist-to-hip ratio, dyslipidemia, glycemic levels, blood pressure and depressive symptoms among diabetic and non-diabetic Chinese women: a cross-sectional study. PLoS One, 2014, 9(10): e109765.
23. 许卫红, 刘文锋, 曾惠涛. 农村 2 型糖尿病患者心理状况分析及干预策略研究. 按摩与康复医学, 2014, (7): 224-225, 226.
24. 王从菊, 金建华, 晁湘琴, 等. 苏州市社区糖尿病人群抑郁症的相关因素分析. 职业与健康, 2014, 30(5): 681-683.
25. Liu Y, Maier M, Hao Y, et al. Factors related to quality of life for patients with type 2 diabetes with or without depressive symptoms - results from a community-based study in China. J Clin Nurs, 2013, 22(1-2): 80-88.
26. Mezuk B, Chen Y, Yu C, et al. Depression, anxiety, and prevalent diabetes in the Chinese population: findings from the China Kadoorie Biobank of 0.5 million people. J Psychosom Res, 2013, 75(6): 511-517.
27. 王桂荣. 2 型糖尿病合并精神疾病的风险因素调查. 成都医学院学报, 2012, 07(1): 118-120.
28. 张娟. 老年 2 型糖尿病患者抑郁状况调查及相关危险性分析. 中外健康文摘, 2011, 8(9): 91-92.
29. 杨成龙, 蔡文治, 黄海刚, 等. 2 型糖尿病共病抑郁症的危险因素分析. 中国全科医学, 2011, 14(26): 2956-2958.
30. 徐娜. 2 型糖尿病并发抑郁症相关因素研究. 天津: 天津医科大学, 2007.
31. 钱湘毅, 王海琴, 魏新萍. 社区 2 型糖尿病患者抑郁和焦虑情绪危险因素流行病学调查. 中国现代药物应用, 2011, 5(22): 132-134.
32. 刘宇, 何国平, 秦月兰, 等. 社区 2 型糖尿病合并抑郁患者生活质量影响因素研究. 中国全科医学, 2010, 13(25): 2829-2833.
33. 孙士杰, 董砚虎. 2 型糖尿病患者抑郁患病率调查与分析. 医学与哲学(临床决策论坛版), 2009, 30(12): 75-76.
34. 陈成华, 董砚虎, 郭玉岩. 糖调节受损、新诊断 2 型糖尿病患者抑郁患病调查与相关因素分析. 中国糖尿病杂志, 2010, 18(5): 384-386.
35. 黄华玲, 李红, 赵惠芬, 等. 城乡结合部老年 2 型糖尿病患者抑郁症状及其影响因素的调查. 中国实用护理杂志, 2009, 25(10): 62-65.
36. 汪菲, 孙亚丽, 戴建业, 等. 北京市 2 型糖尿病患者抑郁状况的横断面调查及其危险因素分析. 现代生物医学进展, 2018, 18(5): 902-906.
37. 任蕾. 郑州市 2 型糖尿病患者并发抑郁症的流行病学分析. 郑州大学, 2018.
38. 李苑, 李晓淳, 贾睿. 基于社区的 2 型糖尿病伴发抑郁现况及生命质量的研究. 成都医学院学报, 2015, 10(6): 755-757.
39. 高炬, 曾庆枝, 何燕玲, 等. 上海市 2012 年社区在册糖尿病和高血压患者抑郁、焦虑阳性率及其影响因素. 中国公共卫生, 2018, 34(2): 223-229.
40. Sun N, Lou P, Shang Y, et al. Prevalence and determinants of depressive and anxiety symptoms in adults with type 2 diabetes in China: a cross-sectional study. BMJ Open, 2016, 6(8): e012540.
41. Li Z, Guo X, Jiang H, et al. Diagnosed but not undiagnosed diabetes is associated with depression in rural areas. Int J Environ Res Public Health, 2016, 13(11): pii: E1136.
42. Chou KL, Chi I. Prevalence of depression among elderly Chinese with diabetes. Int J Geriatr Psychiatry, 2005, 20(6): 570-575.
43. Roy T, Lloyd CE, Parvin M, et al. Prevalence of co-morbid depression in out-patients with type 2 diabetes mellitus in Bangladesh. BMC Psychiatry, 2012, 12: 123.
44. Wang Y, Lopez JM, Bolge SC, et al. Depression among people with type 2 diabetes mellitus, US National Health and Nutrition Examination Survey (NHANES), 2005-2012. BMC Psychiatry, 2016, 16: 88.
45. 陈向宇, 钟节鸣, 郭丽花, 等. 社区管理糖尿病患者抑郁, 焦虑状况及影响因素研究. 预防医学, 2019, 31(7): 683-687.
46. Nouwen A, Nefs G, Caramlau I, et al. Prevalence of depression in individuals with impaired glucose metabolism or undiagnosed diabetes: a systematic review and meta-analysis of the European Depression in Diabetes (EDID) Research Consortium. Diabetes Care, 2011, 34(3): 752-762.
47. Zhang Y, Ting RZ, Yang W, et al. Depression in Chinese patients with type 2 diabetes: associations with hyperglycemia, hypoglycemia, and poor treatment adherence. J Diabetes, 2015, 7(6): 800-808.
48. 罗美玲, 谭红专, 周权, 等. 在 R 软件中实现单个率的 Meta 分析. 循证医学, 2013, 13(3): 181-184, 188.

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