Prevalence of depression among young people with Type 1 diabetes: a systematic review.
OBJECTIVE
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.


BACKGROUND
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
NIHR CLAHRC for South Yorkshire, Department of Psychology, University of Sheffield, Sheffield, UK. b.johnson@sheffield.ac.uk
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Johnson
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Eiser
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Young
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Brierley
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Heller
D000293:Adolescent; D003863:Depression / Q000097:blood / Q000453:epidemiology* / Q000523:psychology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D015995:Prevalence; D011788:Quality of Life; D012648:Self Care / Q000523:psychology / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D055815:Young Adult
D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human