Association of depression and diabetes complications: A meta-analysis

Mary De Groot, Ryan Anderson, Kenneth E. Freedland, Ray E. Clouse, Patrick J. Lustman

Research output: Contribution to journalArticle

1158 Citations (Scopus)

Abstract

Objective: The objective of this study was to examine the strength and consistency of the relationship between depression and diabetes complications in studies of type 1 and type 2 adult patients with diabetes. Method: MEDLINE and PsycINFO databases were searched for articles examining depression and diabetes complications in type 1 and type 2 diabetes samples published between 1975 and 1999. Meta-analytic procedures were used. Studies were reviewed for diabetes type, sample size, statistical tests, and measures of diabetes complications and depression. Significance values, weighted effect sizes r, 95% confidence intervals (CI), and tests of homogeneity of variance were calculated for the overall sample (k = 27) and for subsets of interest. Results: A total of 27 studies (total combined N = 5374) met the inclusion criteria. A significant association was found between depression and complications of diabetes (p < .00001, z = 5.94). A moderate and significant weighted effect size (r = 0.25; 95% CI: 0.22-0.28) was calculated for all studies reporting sufficient data (k = 22). Depression was significantly associated with a variety of diabetes complications (diabetic retinopathy, nephropathy, neuropathy, macrovascular complications, and sexual dysfunction). Effect sizes were in the small to moderate range (r = 0.17 to 0.32). Conclusions: These findings demonstrate a significant and consistent association of diabetes complications and depressive symptoms. Prospective, longitudinal studies are needed to identify the pathways that mediate this association.

Original languageEnglish (US)
Pages (from-to)619-630
Number of pages12
JournalPsychosomatic Medicine
Volume63
Issue number4
DOIs
StatePublished - Jan 1 2001

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Diabetes Complications
Meta-Analysis
Depression
Confidence Intervals
Diabetic Nephropathies
Diabetic Retinopathy
Type 1 Diabetes Mellitus
MEDLINE
Sample Size
Type 2 Diabetes Mellitus
Longitudinal Studies
Research Design
Databases
Prospective Studies

Keywords

  • Depression
  • Diabetes mellitus
  • Meta-analysis

ASJC Scopus subject areas

  • Applied Psychology
  • Psychiatry and Mental health

Cite this

Association of depression and diabetes complications : A meta-analysis. / De Groot, Mary; Anderson, Ryan; Freedland, Kenneth E.; Clouse, Ray E.; Lustman, Patrick J.

In: Psychosomatic Medicine, Vol. 63, No. 4, 01.01.2001, p. 619-630.

Research output: Contribution to journalArticle

De Groot, Mary ; Anderson, Ryan ; Freedland, Kenneth E. ; Clouse, Ray E. ; Lustman, Patrick J. / Association of depression and diabetes complications : A meta-analysis. In: Psychosomatic Medicine. 2001 ; Vol. 63, No. 4. pp. 619-630.
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