Department of Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia.
Department of Midwifery, College of Medicine and Health Science, Wolaita Sodo University, Wolita Sodo, Ethiopia.
BMC Psychiatry. 2023 Mar 29;23(1):209. doi: 10.1186/s12888-023-04655-6.
Primary studies have estimated the prevalence of depression and its determinants among diabetes patients. However, studies synthesizing this primary evidence are limited. Hence, this systematic review aimed to determine the prevalence of depression and identify determinants of depression among diabetes in Ethiopia.
This systematic review and meta-analysis included a search of PubMed, Google Scholar, Scopus, Science Direct, PsycINFO, and Cochrane library. Data were extracted using Microsoft Excel and analyzed using STATA statistical software (v. 14). Data were pooled using a random-effects model. Forest plots, and Egger's regression test were all used to check for publication bias. Heterogeneity (I) was computed. Subgroup analysis was done by region, publication year, and depression screening instrument. In addition, the pooled odds ratio for determinants was calculated.
Sixteen studies, including 5808 participants were analyzed. The prevalence of depression in diabetes was estimated to be 34.61% (95% CI: 27.31-41.91). According to subgroup analysis by study region, publication year, and screening instrument, the highest prevalence was observed in Addis Ababa (41.98%), studies published before 2020 (37.91%), and studies that used Hospital Anxiety and Depression Scale (HADS-D) (42.42%,) respectively. Older age > 50 years (AOR = 2.96; 95% CI: 1.71-5.11), being women (AOR = 2.31; 95% CI: 1.57, 3.4), longer duration with diabetes (above 5 years) (AOR = 1.98; 95% CI: 1.03-3.8), and limited social support (AOR = 2.37; 95% CI: 1.68-3.34), were the determinants of depression in diabetic patients.
The results of this study suggest that the prevalence of depression in diabetes is substantial. This result underscores the importance of paying particular attention to prevent depression among diabetes. Being older, not attending formal education, longer duration with diabetes, having comorbidity, and low adherence to diabetes management were all associated. These variables may help clinicians identify patients at high risk of depression. Future studies focusing on the causal association between depression and diabetes are highly recommended.
初步研究估计了糖尿病患者中抑郁的患病率及其决定因素。然而，综合这些初步证据的研究有限。因此，本系统评价旨在确定埃塞俄比亚糖尿病患者中抑郁的患病率，并确定抑郁的决定因素。
本系统评价和荟萃分析包括对 PubMed、Google Scholar、Scopus、Science Direct、PsycINFO 和 Cochrane 图书馆的检索。使用 Microsoft Excel 提取数据，并使用 STATA 统计软件（v. 14）进行分析。使用随机效应模型汇总数据。使用森林图和 Egger 回归检验检查发表偏倚。计算异质性 (I)。按地区、发表年份和抑郁筛查工具进行亚组分析。此外，还计算了决定因素的汇总优势比。
分析了 16 项研究，共纳入 5808 名参与者。糖尿病患者中抑郁的患病率估计为 34.61%（95%CI：27.31-41.91）。根据研究地区、发表年份和筛查工具的亚组分析，亚组分析显示，在亚的斯亚贝巴（41.98%）、发表于 2020 年之前的研究（37.91%）和使用医院焦虑和抑郁量表（HADS-D）（42.42%）的研究中，抑郁的患病率最高。年龄较大（>50 岁）（OR=2.96；95%CI：1.71-5.11）、女性（OR=2.31；95%CI：1.57-3.4）、糖尿病病程较长（>5 年）（OR=1.98；95%CI：1.03-3.8）和社会支持有限（OR=2.37；95%CI：1.68-3.34）是糖尿病患者抑郁的决定因素。
本研究结果表明，糖尿病患者中抑郁的患病率较高。这一结果强调了特别关注预防糖尿病患者抑郁的重要性。年龄较大、未接受正规教育、糖尿病病程较长、合并症和糖尿病管理依从性低均与之相关。这些变量可能有助于临床医生识别高风险抑郁的患者。强烈建议未来的研究关注抑郁与糖尿病之间的因果关系。
