American Diabetes Association

Table 1 —

Prevalence of clinically significant depression in adults with diabetes: controlled studies (n = 20)

Study	Subjects (Diabetic: n) (Control: n)	Sex (% female)	Age (years)	Race (% white)	Depression assessment method	Prevalence of depression			Depression scale scores
Study	Subjects (Diabetic: n) (Control: n)	Sex (% female)	Age (years)	Race (% white)	Depression assessment method	Overall (%)	Males (%)	Females (%)	Depression scale scores
Kokkonen (62)	T1: 63^e	41.3	20.9 ± 1.9	—	PSE ID ≥5	14.3	—	—	Men: 9.3 ± 9.4^* Women: 14.2 ± 10.2
	Medically well: 123^a	51.2	21.9 ± 1.4	—		11.4^†	—	—	—
Songar et al. (25)	T1: 60^e	68.3	29.7	—	BDI ≥14	43.3	—	—	15.2
	Medically well: 30^c	60.0	29.2	—		3.3^*	—	—	4.1^*
Popkin et al. (63)	T1: 75^e	64.0	31	—	DIS/DSM-III	10.7	3.7	14.6	—
	1^st degree relatives: 34^f	55.9	36	—		2.9^†	0.0^†	5.3^†	—
Amato et al. (64)	T2: 197^a	68.0	73.9 ± 5.9	—	GDS ≥21	13.6	11.4	14.7	13.2 ± 6.8
	1142^a	55.9	74.2 ± 6.4	—		8.7^‡	6.6^*	10.6^§	11.1 ± 6.5^*
Eaton et al. (50)	T2: 148^a	—	—	—	DIS/DSM	6.1	—	—	—
	1600^a	—	—	—		5.3^†	—	—	—
Viinamäki et al. (65)	T2: 82^a	46.3	66.9 ± 0.7	—	Zung ≥50	11.0	11.4	10.5	39.4 ± 1.3
	115^a	55.7	65.6 ± 0.5	—		6.9^†	—	—	36.9 ± 0.8^†
Leedom et al. (26)	T2: 71^e	70.4	50 ± 2.0	18.3	BDI ≥10	49.3	—	—	12.2
	46^e	67.4	46 ± 1.7	23.9		21.7^§	—	—	5.9 ± 0.7
Palinkas et al. (28)	T2: 93^a	39.8	72.4 ± 8.7	—	BDI ≥13	11.5	8.8	13.6	6.5
	1284^a	54.5	68.5 ± 9.5	—		4.6^‡^‖	2.6^‡^¶	6.2^†^¶	5.4^§^‖
Wing et al. (29)	T2: 32^e	50.0	52.1 ± 7.7	—	BDI ≥16	21.8	—	—	10.6 ± 6.4
	Spouses: 32^e	50.0	50.8 ± 8.8	—		12.5^†	—	—	7.5 ± 6.2^‡
Weyerer et al. (66)	T2: 55^a	72.7	—	—	CIS/ICD 8	27.3	—	—	—
	Medically well: 122^a	54.1	—	—		10.6^§^‖	—	—	—
Tun et al. (32)^#	T2: 119^e	48.7	63.4	—	Zung##	—	—	—	39.3
	Nondiabetic out-patients: 25^e	56.0	63.0	—		—	—	—	34.0^§
Black (67)	T1 & 2: 636^a	58.2	—	0.0	CES-D ≥16	31.1	22.6	37.9	—
	2196^a	58.4	—	0.0		24.1^*	15.9^§	30.2^§	—
Penninx et al. (33)^#	T1 & 2: 204^a	52.9	73.3 ± 7.7	—	CES-D##	—	—	—	10.1 ± 9.2
	Medically well: 719^a	42.4	67.2 ± 8.6	—		—	—	—	5.4 ± 6.3^*
Bourdel-Marchasson et al. (68)	T1 & 2: 237^a	50.6	—	—	CES-D Men: ≥17 Women: ≥23	21.3	—	—	Men: 9.3 ± 9.4^* Women: 14.2 ± 10.2
Bourdel-Marchasson et al. (68)	2555^a	60.7	—	—		12.7^*^††	—	—	Men: 7.2 ± 7.6^§§ Women: 11.8 ± 9.6
Rajala et al. (69)	T1 & 2: 62^a	40.3	55	—	Zung ≥45	19.3	18.9	20.0	—
	480^a	58.5	55	—		11.7^†	10.1^†	12.8^†	—
Zhang et al. (70)	T1 & 2: 209^a	58.4	—	0.0	DIS/DSM-III + CES-D	3.8^¶	1.8^¶	5.1^¶	8.3^¶
	1289^a	55.6	—	0.0		3.6^†^¶	1.7^†^¶	5.1^†^¶	7.8^†^¶
Wells et al. (71)	T1 & 2: 154^a^‖‖	—	—	—	DIS/DSM-III	9.6	—	—	—
	Medically well: 1353^a^‖‖	—	—	48.5^¶^¶		4.4^†	—	—	—
Robinson et al. (72)	T1 & 2: 60:70^e	45.4	51 ± 6.6	56.9	PSE/Bedford Col. criteria	8.5	—	—	—
	130^f	45.4	44 ± 10.4	72.3		8.5^†	—	—	—
Friis et al. (73)	T1 & 2: 56^b	71.4	57.0	60.7	CES-D ≥16	60.7	—	—	20.4
	Medically ill: 56^b	73.2	53.0	63.2		48.2^†	—	—	14.2^‡
Murrell et al. (74)	T1 & 2: 175^a	65.7	—	92.9^¶¶	CES-D ≥20	21.7	15.5	25.4	—
	2277^a	61.5	—	—		16.0^‡	13.4	17.6	—

Study	Subjects (Diabetic: n) (Control: n)	Sex (% female)	Age (years)	Race (% white)	Depression assessment method	Prevalence of depression			Depression scale scores
Study	Subjects (Diabetic: n) (Control: n)	Sex (% female)	Age (years)	Race (% white)	Depression assessment method	Overall (%)	Males (%)	Females (%)	Depression scale scores
Kokkonen (62)	T1: 63^e	41.3	20.9 ± 1.9	—	PSE ID ≥5	14.3	—	—	Men: 9.3 ± 9.4^* Women: 14.2 ± 10.2
	Medically well: 123^a	51.2	21.9 ± 1.4	—		11.4^†	—	—	—
Songar et al. (25)	T1: 60^e	68.3	29.7	—	BDI ≥14	43.3	—	—	15.2
	Medically well: 30^c	60.0	29.2	—		3.3^*	—	—	4.1^*
Popkin et al. (63)	T1: 75^e	64.0	31	—	DIS/DSM-III	10.7	3.7	14.6	—
	1^st degree relatives: 34^f	55.9	36	—		2.9^†	0.0^†	5.3^†	—
Amato et al. (64)	T2: 197^a	68.0	73.9 ± 5.9	—	GDS ≥21	13.6	11.4	14.7	13.2 ± 6.8
	1142^a	55.9	74.2 ± 6.4	—		8.7^‡	6.6^*	10.6^§	11.1 ± 6.5^*
Eaton et al. (50)	T2: 148^a	—	—	—	DIS/DSM	6.1	—	—	—
	1600^a	—	—	—		5.3^†	—	—	—
Viinamäki et al. (65)	T2: 82^a	46.3	66.9 ± 0.7	—	Zung ≥50	11.0	11.4	10.5	39.4 ± 1.3
	115^a	55.7	65.6 ± 0.5	—		6.9^†	—	—	36.9 ± 0.8^†
Leedom et al. (26)	T2: 71^e	70.4	50 ± 2.0	18.3	BDI ≥10	49.3	—	—	12.2
	46^e	67.4	46 ± 1.7	23.9		21.7^§	—	—	5.9 ± 0.7
Palinkas et al. (28)	T2: 93^a	39.8	72.4 ± 8.7	—	BDI ≥13	11.5	8.8	13.6	6.5
	1284^a	54.5	68.5 ± 9.5	—		4.6^‡^‖	2.6^‡^¶	6.2^†^¶	5.4^§^‖
Wing et al. (29)	T2: 32^e	50.0	52.1 ± 7.7	—	BDI ≥16	21.8	—	—	10.6 ± 6.4
	Spouses: 32^e	50.0	50.8 ± 8.8	—		12.5^†	—	—	7.5 ± 6.2^‡
Weyerer et al. (66)	T2: 55^a	72.7	—	—	CIS/ICD 8	27.3	—	—	—
	Medically well: 122^a	54.1	—	—		10.6^§^‖	—	—	—
Tun et al. (32)^#	T2: 119^e	48.7	63.4	—	Zung##	—	—	—	39.3
	Nondiabetic out-patients: 25^e	56.0	63.0	—		—	—	—	34.0^§
Black (67)	T1 & 2: 636^a	58.2	—	0.0	CES-D ≥16	31.1	22.6	37.9	—
	2196^a	58.4	—	0.0		24.1^*	15.9^§	30.2^§	—
Penninx et al. (33)^#	T1 & 2: 204^a	52.9	73.3 ± 7.7	—	CES-D##	—	—	—	10.1 ± 9.2
	Medically well: 719^a	42.4	67.2 ± 8.6	—		—	—	—	5.4 ± 6.3^*
Bourdel-Marchasson et al. (68)	T1 & 2: 237^a	50.6	—	—	CES-D Men: ≥17 Women: ≥23	21.3	—	—	Men: 9.3 ± 9.4^* Women: 14.2 ± 10.2
Bourdel-Marchasson et al. (68)	2555^a	60.7	—	—		12.7^*^††	—	—	Men: 7.2 ± 7.6^§§ Women: 11.8 ± 9.6
Rajala et al. (69)	T1 & 2: 62^a	40.3	55	—	Zung ≥45	19.3	18.9	20.0	—
	480^a	58.5	55	—		11.7^†	10.1^†	12.8^†	—
Zhang et al. (70)	T1 & 2: 209^a	58.4	—	0.0	DIS/DSM-III + CES-D	3.8^¶	1.8^¶	5.1^¶	8.3^¶
	1289^a	55.6	—	0.0		3.6^†^¶	1.7^†^¶	5.1^†^¶	7.8^†^¶
Wells et al. (71)	T1 & 2: 154^a^‖‖	—	—	—	DIS/DSM-III	9.6	—	—	—
	Medically well: 1353^a^‖‖	—	—	48.5^¶^¶		4.4^†	—	—	—
Robinson et al. (72)	T1 & 2: 60:70^e	45.4	51 ± 6.6	56.9	PSE/Bedford Col. criteria	8.5	—	—	—
	130^f	45.4	44 ± 10.4	72.3		8.5^†	—	—	—
Friis et al. (73)	T1 & 2: 56^b	71.4	57.0	60.7	CES-D ≥16	60.7	—	—	20.4
	Medically ill: 56^b	73.2	53.0	63.2		48.2^†	—	—	14.2^‡
Murrell et al. (74)	T1 & 2: 175^a	65.7	—	92.9^¶¶	CES-D ≥20	21.7	15.5	25.4	—
	2277^a	61.5	—	—		16.0^‡	13.4	17.6	—

Data are means ± SD, unless otherwise indicated. T1 = type 1 diabetes, T2 = type 2 diabetes, n = sample size, PSE = Present State Examination, DIS/DSM-III = Diagnostic Interview Schedule/Diagnostic and Statistical Manual-III, GDS = Geriatric Depression Scale, Zung = Zung Self-Rating Depression Scale, CIS = Clinical Interview Schedule, CES-D = Center for Epidemiologic Studies-Depression Scale.

Sample randomly selected from a ^acommunity, ^bclinic or hospital, or ^cunspecified setting.

Sample not randomly selected from a ^dcommunity, ^eclinic or hospital, or ^funspecified setting.

P ≤ .001 vs. the prevalence of the overall or sex-specific diabetic group;

†

nonsignificant vs. the prevalence of the overall or sex-specific diabetic group;

‡

P ≤ .05 vs. the prevalence of the overall or sex-specific diabetic group;

P ≤ .01 vs. the prevalence of the overall or sex-specific diabetic group;

‖

age- and sex-adjusted;

age-adjusted;

these studies reported only mean depression scale scores for diabetic and nondiabetic subjects, and thus were not included in the prevalence calculations;

††

sex-adjusted;

§§

greater (P < .001) in nondiabetic females vs. male counterparts;

‖‖

prevalences are any affective disorder including major depression, dysthmia, and mania. Mania represented just 2% of all affective disorders in this study.

¶¶

the number is the percentage of Caucasian subjects in the entire sample.

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