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 Af?liated 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.	中華醫學會糖尿病學分會. 中國 2 型糖尿病防治指南(2017 年版). 中國實用內科雜志, 2018, 38(4): 292-344.
3.	楊曉妍, 吳先萍. 2 型糖尿病危險因素研究進展. 預防醫學情報雜志, 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.	曾憲濤, 劉慧, 陳曦, 等. Meta 分析系列之四: 觀察性研究的質量評價工具. 中國循證心血管醫學雜志, 2012, 4(4): 297-299.
14.	趙晶. 2 型糖尿病患者焦慮和抑郁現狀及危險因素的研究. 中國糖尿病雜志, 2014, 22(7): 615-619.
15.	唐兢, 楊祺, 李瀟, 等. 社區老年 2 型糖尿病患者的情緒及家庭功能評估. 醫藥前沿, 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.	寧鋒, 王玉美, 孫曉暉, 等. 青島成人抑郁癥和 2 型糖尿病患病率雙向關聯研究. 中華疾病控制雜志, 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.	許衛紅, 劉文鋒, 曾惠濤. 農村 2 型糖尿病患者心理狀況分析及干預策略研究. 按摩與康復醫學, 2014, (7): 224-225, 226.
24.	王從菊, 金建華, 晁湘琴, 等. 蘇州市社區糖尿病人群抑郁癥的相關因素分析. 職業與健康, 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.	王桂榮. 2 型糖尿病合并精神疾病的風險因素調查. 成都醫學院學報, 2012, 07(1): 118-120.
28.	張娟. 老年 2 型糖尿病患者抑郁狀況調查及相關危險性分析. 中外健康文摘, 2011, 8(9): 91-92.
29.	楊成龍, 蔡文治, 黃海剛, 等. 2 型糖尿病共病抑郁癥的危險因素分析. 中國全科醫學, 2011, 14(26): 2956-2958.
30.	徐娜. 2 型糖尿病并發抑郁癥相關因素研究. 天津: 天津醫科大學, 2007.
31.	錢湘毅, 王海琴, 魏新萍. 社區 2 型糖尿病患者抑郁和焦慮情緒危險因素流行病學調查. 中國現代藥物應用, 2011, 5(22): 132-134.
32.	劉宇, 何國平, 秦月蘭, 等. 社區 2 型糖尿病合并抑郁患者生活質量影響因素研究. 中國全科醫學, 2010, 13(25): 2829-2833.
33.	孫士杰, 董硯虎. 2 型糖尿病患者抑郁患病率調查與分析. 醫學與哲學(臨床決策論壇版), 2009, 30(12): 75-76.
34.	陳成華, 董硯虎, 郭玉巖. 糖調節受損、新診斷 2 型糖尿病患者抑郁患病調查與相關因素分析. 中國糖尿病雜志, 2010, 18(5): 384-386.
35.	黃華玲, 李紅, 趙惠芬, 等. 城鄉結合部老年 2 型糖尿病患者抑郁癥狀及其影響因素的調查. 中國實用護理雜志, 2009, 25(10): 62-65.
36.	汪菲, 孫亞麗, 戴建業, 等. 北京市 2 型糖尿病患者抑郁狀況的橫斷面調查及其危險因素分析. 現代生物醫學進展, 2018, 18(5): 902-906.
37.	任蕾. 鄭州市 2 型糖尿病患者并發抑郁癥的流行病學分析. 鄭州大學, 2018.
38.	李苑, 李曉淳, 賈睿. 基于社區的 2 型糖尿病伴發抑郁現況及生命質量的研究. 成都醫學院學報, 2015, 10(6): 755-757.
39.	高炬, 曾慶枝, 何燕玲, 等. 上海市 2012 年社區在冊糖尿病和高血壓患者抑郁、焦慮陽性率及其影響因素. 中國公共衛生, 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.	陳向宇, 鐘節鳴, 郭麗花, 等. 社區管理糖尿病患者抑郁, 焦慮狀況及影響因素研究. 預防醫學, 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.	羅美玲, 譚紅專, 周權, 等. 在 R 軟件中實現單個率的 Meta 分析. 循證醫學, 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. 中華醫學會糖尿病學分會. 中國 2 型糖尿病防治指南(2017 年版). 中國實用內科雜志, 2018, 38(4): 292-344.
3. 楊曉妍, 吳先萍. 2 型糖尿病危險因素研究進展. 預防醫學情報雜志, 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. 曾憲濤, 劉慧, 陳曦, 等. Meta 分析系列之四: 觀察性研究的質量評價工具. 中國循證心血管醫學雜志, 2012, 4(4): 297-299.
14. 趙晶. 2 型糖尿病患者焦慮和抑郁現狀及危險因素的研究. 中國糖尿病雜志, 2014, 22(7): 615-619.
15. 唐兢, 楊祺, 李瀟, 等. 社區老年 2 型糖尿病患者的情緒及家庭功能評估. 醫藥前沿, 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. 寧鋒, 王玉美, 孫曉暉, 等. 青島成人抑郁癥和 2 型糖尿病患病率雙向關聯研究. 中華疾病控制雜志, 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. 許衛紅, 劉文鋒, 曾惠濤. 農村 2 型糖尿病患者心理狀況分析及干預策略研究. 按摩與康復醫學, 2014, (7): 224-225, 226.
24. 王從菊, 金建華, 晁湘琴, 等. 蘇州市社區糖尿病人群抑郁癥的相關因素分析. 職業與健康, 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. 王桂榮. 2 型糖尿病合并精神疾病的風險因素調查. 成都醫學院學報, 2012, 07(1): 118-120.
28. 張娟. 老年 2 型糖尿病患者抑郁狀況調查及相關危險性分析. 中外健康文摘, 2011, 8(9): 91-92.
29. 楊成龍, 蔡文治, 黃海剛, 等. 2 型糖尿病共病抑郁癥的危險因素分析. 中國全科醫學, 2011, 14(26): 2956-2958.
30. 徐娜. 2 型糖尿病并發抑郁癥相關因素研究. 天津: 天津醫科大學, 2007.
31. 錢湘毅, 王海琴, 魏新萍. 社區 2 型糖尿病患者抑郁和焦慮情緒危險因素流行病學調查. 中國現代藥物應用, 2011, 5(22): 132-134.
32. 劉宇, 何國平, 秦月蘭, 等. 社區 2 型糖尿病合并抑郁患者生活質量影響因素研究. 中國全科醫學, 2010, 13(25): 2829-2833.
33. 孫士杰, 董硯虎. 2 型糖尿病患者抑郁患病率調查與分析. 醫學與哲學(臨床決策論壇版), 2009, 30(12): 75-76.
34. 陳成華, 董硯虎, 郭玉巖. 糖調節受損、新診斷 2 型糖尿病患者抑郁患病調查與相關因素分析. 中國糖尿病雜志, 2010, 18(5): 384-386.
35. 黃華玲, 李紅, 趙惠芬, 等. 城鄉結合部老年 2 型糖尿病患者抑郁癥狀及其影響因素的調查. 中國實用護理雜志, 2009, 25(10): 62-65.
36. 汪菲, 孫亞麗, 戴建業, 等. 北京市 2 型糖尿病患者抑郁狀況的橫斷面調查及其危險因素分析. 現代生物醫學進展, 2018, 18(5): 902-906.
37. 任蕾. 鄭州市 2 型糖尿病患者并發抑郁癥的流行病學分析. 鄭州大學, 2018.
38. 李苑, 李曉淳, 賈睿. 基于社區的 2 型糖尿病伴發抑郁現況及生命質量的研究. 成都醫學院學報, 2015, 10(6): 755-757.
39. 高炬, 曾慶枝, 何燕玲, 等. 上海市 2012 年社區在冊糖尿病和高血壓患者抑郁、焦慮陽性率及其影響因素. 中國公共衛生, 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. 陳向宇, 鐘節鳴, 郭麗花, 等. 社區管理糖尿病患者抑郁, 焦慮狀況及影響因素研究. 預防醫學, 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. 羅美玲, 譚紅專, 周權, 等. 在 R 軟件中實現單個率的 Meta 分析. 循證醫學, 2013, 13(3): 181-184, 188.

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