NIHR CLAHRC for South Yorkshire, Department of Psychology, University of Sheffield, Sheffield, UK.
Diabet Med. 2013 Feb;30(2):199-208. doi: 10.1111/j.1464-5491.2012.03721.x.
To determine: (1) prevalence of depression among young people with Type 1 diabetes compared with control groups or population norms; (2) implications of depression for HbA(1c) level; and (3) the relationship between history of depressive symptoms and future depressive symptoms.
Among adults with Type 1 diabetes depression is higher than the general population, and has been associated with adverse implications for self-care and HbA(1c) level. The last published review of depression among young people with Type 1 diabetes only included studies up to 1999.
Systematic searches were conducted for articles published from January 1999 to December 2011 including young people (up to 25 years old) with Type 1 diabetes.
Twenty-three articles met the inclusion criteria. Of five studies that reported prevalence of depression compared with control groups, three found no differences. Of the three studies that investigated prevalence of depression making reference to population norms, all three showed higher rates of depressive symptoms. Fourteen of 15 studies found associations between more depressive symptoms and higher HbA(1c) level either cross-sectionally or longitudinally. Past depressive symptoms were associated with later depressive symptoms.
Current evidence is inconclusive about whether there is increased prevalence of depression among young adults with Type 1 diabetes, as established among adults, but those who are more depressed have higher HbA(1c) level. This review is limited by methodological problems and no identified work in the UK met the inclusion criteria. Given the adverse clinical outcomes, we conclude there is a case for routine mental health screening for young adults with Type 1 diabetes.
确定：（1）与对照组或人群正常值相比，1 型糖尿病青少年中抑郁的患病率；（2）抑郁对 HbA（1c）水平的影响；以及（3）抑郁症状史与未来抑郁症状之间的关系。
在 1 型糖尿病成年人中，抑郁的发病率高于普通人群，并且与自我护理和 HbA（1c）水平的不良预后相关。最后一次对 1 型糖尿病青少年抑郁的综述仅包括截至 1999 年的研究。
系统搜索了 1999 年 1 月至 2011 年 12 月期间发表的关于患有 1 型糖尿病的年轻人（最多 25 岁）的文章。
有 23 篇文章符合纳入标准。五项与对照组比较抑郁患病率的研究中，有三项未发现差异。在三项参照人群正常值调查抑郁患病率的研究中，所有三项均显示出更高的抑郁症状发生率。在 15 项研究中有 14 项发现，无论是横断面还是纵向研究，更多的抑郁症状与更高的 HbA（1c）水平之间存在关联。过去的抑郁症状与以后的抑郁症状有关。
目前的证据尚不能确定在 1 型糖尿病青少年中是否存在成年人中那样的抑郁发病率增加，但那些抑郁程度较高的人 HbA（1c）水平较高。本综述受到方法学问题的限制，并且在英国没有发现符合纳入标准的研究。鉴于不良的临床结局，我们得出的结论是，对 1 型糖尿病的年轻人进行常规心理健康筛查是合理的。
