Association between Major Depression and Type 2 Diabetes Mellitus: a Meta-Analysis and Meta-Regression of Observational Studies
The purpose of this review was to identify the prevalence of major depression in individuals with type 2 diabetes by means of a systematic review and meta-analysis. An electronic search was conducted for relevant studies published from January 1988 to December 2014. Cross-sectional and case-control studies in adults that evaluated the prevalence of major depression in individuals with type 2 Diabetes Mellitus were included. Meta-regression and sensitivity analyses were used to identify the sources of heterogeneity. Publication bias was assessed using a funnel plot and Egger’s test. After the selection process, 18 cross-sectional and four case-control studies were included in the meta-analysis. In total, the occurrence of major depression was investigated in 5554 patients with diabetes mellitus type 2. The prevalence of major depression varied from 6.67% (95% CI: 4.54% - 9.38%) to 55.38% (95% CI: 42.53% - 67.73%), with an overall average of 21.13% (95% CI: 15.80% -27.66%). In American continents, the prevalence was 20.83% (95% CI: 13.12% -31.43%; I²=96.8%), and in Europe it was 18.00% (95% CI: 8.58% -33.91%; I²=93.8%). Both were lower than the rate in Asia, which was 23.49% (95% CI: 15.63% -33.74%; I²=90.8%). Meta-regression analysis found no evidence that the analyzed cofactors represented the cause of the heterogeneity seen. The approximately symmetrical distribution of the points in Funnel Plot suggests an absence of publication bias that was confirmed by Egger's test (p=0.2345). Based on the data collected, we can infer that the prevalence of major depression in individuals with type 2 diabetes was high, independent of geographic location.
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