[Depression and diabetes: from epidemiology to neurobiology].
BACKGROUND
Worldwide, diabetes mellitus and depression are among the most prevalent diseases in their respective fields, metabolism and psychiatry. However, there is evidence that patients with diabetes are at increased risk of developing depression, although a bidirectional relationship might also exist.


OBJECTIVE
To present a comprehensive review of the clinical, epidemiological, psychosocial, emotional, and neurobiological basis of the relation between diabetes and depression.


METHODS
Epidemiological studies indicate that there is not only an augmented risk of developing depression in diabetic patients, but that this association increases the morbidity and mortality of these patients. While there is a considerable number of clinical studies that support this relation, little is known about the neurochemical mechanisms that would constitute its biological basis.


CONCLUSIONS
Alterations in monoamines (serotonin and noradrenaline), the increases in cortisol by the hypothalamus-pituitary-adrenal axis, and trophic agents such as the brain-derived neurotrophic factor, through glycogen synthase kinase-3, constitute some of the abnormalities documented in diabetic patients and in animal models that could explain the association between depression and diabetes. Additionally, we briefly consider the psychoemotional factors that might underlie the depression-diabetes relation. The effects (most of them deleterious) of the antidepressive therapy in glucometabolic control are also discussed.
Castillo-Quan
Jorge I
JI
Departamento de Neurociencias, Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatán, Mérida,Yucatán, México.
Barrera-Buenfil
Divia J
DJ
Pérez-Osorio
Julia M
JM
Alvarez-Cervera
Fernando J
FJ
D000818:Animals; D000928:Antidepressive Agents / Q000627:therapeutic use; D015306:Biogenic Monoamines / Q000378:metabolism; D019208:Brain-Derived Neurotrophic Factor / Q000378:metabolism; D003866:Depressive Disorder / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology* / Q000523:psychology*; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology; D007328:Insulin / Q000378:metabolism; D010913:Pituitary-Adrenal System / Q000502:physiology
D000928:Antidepressive Agents; D015306:Biogenic Monoamines; D019208:Brain-Derived Neurotrophic Factor; D007328:Insulin; D006854:Hydrocortisone