The comorbidity of mental and physical disorders is a major challenge for health care worldwide. Its prevalence is increasing and is likely to continue to grow due to the increase in life expectancy and a variety of other reasons. The comorbidity of depression and diabetes can be seen as a prototypical example of mental/physical comorbidity. The prevalence of both conditions is growing, and depression is twice as frequent in people with diabetes compared with those without diabetes. Health services are by and large inadequately prepared to deal with comorbid depression and diabetes, and the increasing specialization (and fragmentation) of medicine will probably make things worse. This paper reviews the epidemiology and risk factors of the comorbidity of depression and diabetes and describes areas that should be given attention in order to reduce problems arising as a result of the comorbidity of these two conditions.

Objective: To provide an estimate of the effect of interventions on comorbid depressive disorder (MDD) or subthreshold depression in type 1 and type 2 diabetes.Methods: Systematic review and meta‐analysis. We searched PubMed, PsycINFO, Embase, and the Cochrane Library for randomized controlled trials evaluating the outcome of depression treatments in diabetes and comorbid MDD or subthreshold symptoms published before August 2019 compared to care as usual (CAU), placebo, waiting list (WL), or active comparator treatment as in a comparative effectiveness trial (CET). Primary outcomes were depressive symptom severity and glycemic control. Cohen's d is reported.Results: Forty‐three randomized controlled trials (RCTs) were selected, and 32 RCTs comprising 3,543 patients were included in the meta‐analysis. Our meta‐analysis showed that, compared to CAU, placebo or WL, all interventions showed a significant effect on combined outcome 0,485 (95% CI 0.360; 0.609). All interventions showed a significant effect on depression. Pharmacological treatment, group therapy, psychotherapy, and collaborative care had a significant effect on glycemic control. High baseline depression score was associated with a greater reduction in HbA₁c and depressive outcome. High baseline HbA₁c was associated with a greater reduction in HbA₁c.Conclusion: All treatments are effective for comorbid depression in type 1 diabetes and type 2 diabetes. Over the last decade, new interventions with large effect sizes have been introduced, such as group‐based therapy, online treatment, and exercise. Although all interventions were effective for depression, not all treatments were effective for glycemic control. Effective interventions in comorbid depressive disorder may not be as effective in comorbid subthreshold depression. Baseline depression and HbA₁c scores modify the treatment effect. Based on the findings, we provide guidance for treatment depending on patient profile and desired outcome, and discuss possible avenues for further research.

The comorbidity of mental and physical disorders is a major challenge for health care worldwide. Its prevalence is increasing and is likely to continue to grow due to the increase in life expectancy and a variety of other reasons. The comorbidity of depression and diabetes can be seen as a prototypical example of mentallphysical comorbidity. The prevalence of both conditions is growing, and depression is twice as frequent in people with diabetes compared with those without diabetes. Health services are by and large inadequately prepared to deal with comorbid depression and diabetes, and the increasing specialization (and fragmentation) of medicine will probably make things worse. This paper reviews the epidemiology and risk factors of the comorbidity of depression and diabetes and describes areas that should be given attention in order to reduce problems arising as a result of the comorbidity of these two conditions. (C) 2018, AICH - Servier Research Group

Psychiatric disorders carry a stigma that usually leads to discrimination and resulting problems in many walks of life. People with mental illness thus have difficulties getting a job, finding housing, and making (or keeping) friends or partners. The stigma adds misery to the life of persons with a mental disorder. It affects their families as well as professionals and others who provide them with care.

Background Anxiety disorder, one of the highly disabling, prevalent and common mental disorders, is known to be more prevalent in persons with type 2 diabetes mellitus (T2DM) than the general population, and the comorbid presence of anxiety disorders is known to have an impact on the diabetes outcome and the quality of life. However, the information on the type of anxiety disorder and its prevalence in persons with T2DM is limited. Aims To assess the prevalence and correlates of anxiety disorder in people with type 2 diabetes in different countries. Methods People aged 18–65 years with diabetes and treated in outpatient settings were recruited in 15 countries and underwent a psychiatric interview with the Mini-International Neuropsychiatric Interview. Demographic and medical record data were collected. Results A total of 3170 people with type 2 diabetes (56.2% women; with mean (SD) duration of diabetes 10.01 (7.0) years) participated. The overall prevalence of anxiety disorders in type 2 diabetic persons was 18%; however, 2.8% of the study population had more than one type of anxiety disorder. The most prevalent anxiety disorders were generalised anxiety disorder (8.1%) and panic disorder (5.1%). Female gender, presence of diabetic complications, longer duration of diabetes and poorer glycaemic control (HbA1c levels) were significantly associated with comorbid anxiety disorder. A higher prevalence of anxiety disorders was observed in Ukraine, Saudi Arabia and Argentina with a lower prevalence in Bangladesh and India. Conclusions Our international study shows that people with type 2 diabetes have a high prevalence of anxiety disorders, especially women, those with diabetic complications, those with a longer duration of diabetes and poorer glycaemic control. Early identification and appropriate timely care of psychiatric problems of people with type 2 diabetes is warranted.