Depression and Diabetes: a two-way street?

Depression is often found in people with chronic long-term conditions such as diabetes.  Sometimes this can be a consequence of how the disease affects their lifestyle, difficulties of managing complications and coping with the unrelenting nature of chronic disease.

However, there is recent evidence to show that depression is a risk factor for diabetes, partly because it affects a person’s ability to self-care, but also possibly because of biochemical changes in the body.

This systematic review examines the evidence behind the complex web of cause and effect between depression and diabetes and proposes some diagnostic tools for high risk patients.

Appraisal hints

Users of this research should consider:

  • The comprehensiveness of the literature search:  could they have missed any important evidence?
  • Did the reviewers carry out blind, independent evaluations of the quality of the studies they found?
  • How strong are the associations and are they statistically significant?
  • Is there important heterogeneity between the studies and their results?
  • Have the diagnostic tools been validated in a test-set of patients?


Renn BN, Feliciano L, Segal DL.  The bidirectional relationship of depression and diabetes: A systematic review. Clin Psychol Rev. 2011 Aug 24;31(8):1239-1246