The epidemiology of depression in diabetes

Depression is characterised by a period of low mood and loss of interest in everyday activities, and its prevalence in people with diabetes is thought to be twice as high as for those without the condition. Depression in diabetes is associated with a number of adverse outcomes such as increased morbidity, mortality and poor quality of life. As diabetes is increasingly common amongst the economically active, this has serious implications for health services and in the UK, the National Health Service (NHS) has recognised that depression in people with diabetes is a significant problem and recommends screening for depression in this group. Risk factors for depression in diabetes are almost identical to those in people without diabetes, but less is known about its course when people have diabetes, although the available evidence suggests it is more chronic. Research into the mechanisms by which depression is bad for people with diabetes suggests that biological, psychological and social factors play a part but the inter-relationships between these factors are likely to be complex and are not yet fully understood. Depression in people with diabetes can be treated successfully with pharmacological and psychological treatments at least in the short-term, but we do not yet know which treatments are successful in the long-term. Further research into the pathological mechanisms of depression and its treatment are needed if we are to continue to improve the health and lives of people with diabetes.