Table 1

Characteristics of included studies

Author (year)DesignStudy settingNo. of patientsMean age, yearsCountryMale, %Depression prevalence, %Depression assessmentCompared groupsSource of estimatesAdjusted factors
Katon et al 21 Cross-sectionalCommunity419365USA5120.5PHQ-9Insulin versus non-drugAdjustedAge, sex, education, marital status, employment, race, BMI and smoking, Rx Risk Score, HbA1c, duration of diabetes, treatment intensity, number of complications
Bell et al 20 Cross-sectionalCommunity69674USA50.715.8CES-DInsulin versus oral medication; insulin versus non-drugAdjustedAge, sex, ethnicity, education, marital status, income, diabetes duration, number of medications, BMI, HbA1c, chronic conditions, PCS Score
Noh et al 17 Hospital-basedHospital20453Korean5332.4BDIInsulin versus oral medicationAdjustedAge, sex, BMI, duration of diabetes, HbA1c, occupation, education, marital status, family history of diabetes, hypertension, diabetic complications, cerebrovascular disease, IHD
Hermanns et al 40 Cross-sectionalHospital23652.2Germany60.633BDI; CES-DInsulin versus non-insulinUnadjustedNA
Pawaskar et al 31 Prospective cohortMedicare Health Maintenance Organisation79272USA4417.3CESInsulin versus sulfonylureaAdjustedAge, sex, number of prescriptions, antidiabetic medication, perceived health status, health-related quality of life, number of hospitalisations, ER visits
Li et al 18 Cross-sectionalSurveillance Programme16 651≥18USA4214.4PHQInsulin versus non-insulinUnadjustedNA
Ali et al 33 Cross-sectionalHospital3845NAMixed (South Asia and UK)52.89.3Medical recordsInsulin versus non-insulinAdjustedAge, gender, comorbidities, complications, insulin and oral anti-diabetic medication use, BMI, HbA1c, duration of diabetes and deprivation
Raval et al 36 Cross-sectionalHospital30054India4941PHQ-9Insulin versus non-insulinAdjustedAge, gender, obesity, diabetic complications, blood pressure, duration of disease, income, education, BMI, HbA1c, diabetic complications, dyslipidaemia, number of medicines
Zuberi et al 42 Cross-sectionalHospital28652Pakistan39.250HADSInsulin versus oral medicationUnadjustedNA
Stanković et al 41 Cross-sectionalHospital9055.5Serbia34.451.1PHQ, BDI or interviewInsulin versus oral medicationUnadjustedNA
Lynch et al 43 Cross-sectionalHospital201NAUSA27.419.9CES-DInsulin versus non-insulinUnadjustedNA
Osme et al 44 Cross-sectionalOutpatient clinic138≥30Brazil27.544.6HADInsulin versus non-insulinUnadjustedNA
Trento et al 45 Cross-sectionalOutpatient clinic49867.6Italy52.614.2ZSDSInsulin versus non-insulinUnadjustedNA
Roy et al 37 Cross-sectionalOutpatient clinic41753.2Bangladesh50.634PHQ-9Insulin versus oral medication+diet;
medication versus oral
AdjustedAge, gender, education, income, region, CVD, hypertension, diabetic complications, BMI, HbA1c
Joseph et al 46 Cross-sectionalHospital23053.6India51.745.2PHQ-9Insulin versus oral medicationUnadjustedNA
Hayashino et al 47 Cross-sectionalHospital357366Japan61.13.4PHQ-9Insulin versus oral medication or dietUnadjustedNA
Gorska-Ciebiada et al 34 Cross-sectionalOutpatient clinic27674Poland4629.7GDSInsulin versus oral medicationAdjustedAge, sex, education, marital status, smoking, physical activity, duration of diabetes, BMI, HbA1c, lipid levels, diabetic complications, previous HA or use of HA drugs, hyperlipidaemia, number of comorbid conditions, hypoglycaemia
Sweileh et al 48 Cross-sectionalHospital29460Palestine44.240.2BDIInsulin versus non-insulinUnadjustedNA
YY Zhang et al 52 Cross-sectionalHospital253856.4China536.1PHQ-9Insulin versus oral drugsUnadjustedNA
Rodriguez Calvin et al 51 Cross-sectionalHospital27564.5Spain56.432.7BDIInsulin versus oral medicationUnadjustedNA
Camara et al 35 Cross-sectionalOutpatient clinic49158Guinea3734.4HADSInsulin versus oral medicationAdjustedAge, HbA1c, hypertension, BMI, residence zone, socioeconomic status
Sun et al 39 Cross-sectionalCommunity229 04757.4China34.45.9PHQ-9Insulin versus oral medication or dietAdjustedAge, sex, BMI, HbA1c, smoking, alcohol, physical activity, education, occupation, marital status, self-report cardiometabolic disorders, diabetes treatment, diabetes duration
WJ Zhang et al 32 Cross-sectionalHospital41259.8China50.25.7BDIInsulin versus oral medicationAdjustedAge, gender, education, marital status, occupation, insurance, HbA1c, BMI, DM history, diabetic complications, duration of DM, smoking, alcohol, exercise, sleeping hours
Luca et al 50 Cross-sectionalHospital12864.7Italy58.650.8HAM-DInsulin versus oral medication or dietUnadjustedNA
Kikuchi et al 49 Cross-sectionalCommunity421865.5Japan57.110.6CES-DInsulin versus non-insulinUnadjustedNA
Jacob et al 38 Cross-sectionalCommunity90 41265.5Germany50.230.3Medical recordsInsulin versus non-insulinAdjustedAge, gender, insurance, diabetic complications, CVD, HbA1c
Cols-Sagarra et al 53 Cross-sectionalCommunity41170.8Spain46.229.2PHQ-9Insulin versus oral medications or dietUnadjustedNA
Habtewold et al 54 Cross-sectionalHospital27644Ethiopia4744.7PHQ-9Insulin versus oral medicationUnadjustedNA
  • BDI, Beck Depression Inventory; BMI, body mass index; CES-D, Centre for Epidemiologic Studies-Depression; CVD, cardiovascular disease; DM, diabetes mellitus; ER, emergency room; GDS, Geriatric Depression Scale; HADS, Hospital Anxiety and Depression Scale; HAM-D, Hamilton Rating Scale for Depression; IHD, ischaemic heart disease; PCS, Physical Component Summary Score; PHQ, Patient Health Questionnaire; ZSDS, Zung Self-Rating Depression Scale.