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Prevalence of depression and anxiety among children with type 1 and type 2 diabetes: a systematic review and meta-analysis

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Abstract

Background

Evaluation of psychiatric disorders in children is essential in timely treatment. Despite individual studies, there is no information on the exact status of psychiatric disorders in children. The present study was conducted to determine the prevalence of depression among children with type 1 and type 2 diabetes.

Methods

This meta-analysis is registered with PROSPERO (CRD42021231491). Several databases (Web of Science, Scopus, and PubMed) were searched from January 1, 2000 to December 15, 2020. The key words included: depression, anxiety, children, and diabetes. The steps of search, comprising screening, risk of bias, and extraction of study data, were performed separately by two researchers.

Results

It was found that a total of 109 studies had been conducted involving 52,493 children with type 1 and type 2 diabetes. These studies were included in the present review study. The prevalence of depression, anxiety among children with type 1 diabetes were 22.2% [95% confidence interval (CI) 19.2–25.2], and 17.7% (95% CI 15.2–20.1), respectively. The prevalence of depression was higher among girls (29.7%) than boys (19.7%). The prevalence of depression was higher in lower-middle-income countries at 29.3% (95% CI 18.6–40.0). The prevalence of depression among children with type 2 diabetes was 22.7% (95% CI 17.3–28.0).

Conclusion

The results of the present study indicate the importance of paying attention to extensive periodic screening and appropriate activities to reduce pediatric depression.

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Data availability

The data that support the findings of this study are available on request from the corresponding author.

References

  1. Lin X, Xu Y, Pan X, Xu J, Ding Y, Sun X, et al. Global, regional, and national burden and trend of diabetes in 195 countries and territories: an analysis from 1990 to 2025. Sci Rep. 2020;10:14790.

    CAS  PubMed  PubMed Central  Google Scholar 

  2. Borgnakke WS. IDF diabetes atlas: diabetes and oral health–A two-way relationship of clinical importance. Diabetes Res Clin Pract. 2019;157:107839.

    PubMed  Google Scholar 

  3. Sperling MA. Pediatric endocrinology. London: Elsevier; 2014.

    Google Scholar 

  4. Fazeli Farsani S, van der Aa MP, van der Vorst MMJ, Knibbe CAJ, de Boer A. Global trends in the incidence and prevalence of type 2 diabetes in children and adolescents: a systematic review and evaluation of methodological approaches. Diabetologia. 2013;56:1471–88.

    CAS  PubMed  Google Scholar 

  5. Scherrer IRS, Alves CRL. Association of maternal depression, family composition and poverty with maternal care and physical health of children in the first year of life. J Hum Growth Dev. 2021;31:18–27.

    Google Scholar 

  6. Peris TS, Thamrin H, Rozenman MS. Family intervention for child and adolescent anxiety: a meta-analytic review of therapy targets, techniques, and outcomes. J Affect Disord. 2021;286:282–95.

    PubMed  Google Scholar 

  7. Vos SR, Clark-Ginsberg A, Puente-Duran S, Salas-Wright CP, Duque MC, Herrera IC, et al. The family crisis migration stress framework: a framework to understand the mental health effects of crisis migration on children and families caused by disasters. New Dir Child Adoles. 2021;1:41–59.

    Google Scholar 

  8. Uddin J, Alharbi N, Uddin H, Hossain MB, Hatipoğlu SS, Long DL, et al. Parenting stress and family resilience affect the association of adverse childhood experiences with children’s mental health and attention-deficit/hyperactivity disorder. J Affect Disord. 2020;272:104–9.

    PubMed  Google Scholar 

  9. Solmi M, Miola A, Croatto G, Pigato G, Favaro A, Fornaro M, et al. How can we improve antidepressant adherence in the management of depression? A targeted review and 10 clinical recommendations. Braz J Psychiat. 2020;43:189–202.

    Google Scholar 

  10. Mahamid F, Berte DZ. Happiness, sadness, and hope for the future in narratives of Palestinian refugee children. Int J Ment Health Ad. 2020;18:1638–51.

    Google Scholar 

  11. Carter T, Pascoe M, Bastounis A, Morres I, Callaghan P, Parker AG. The effect of physical activity on anxiety in children and young people: a systematic review and meta-analysis. J Affect Disord. 2021;285:10–21.

    PubMed  Google Scholar 

  12. Belvederi Murri M, Folesani F, Zerbinati L, Nanni MG, Ounalli H, Caruso R, et al. Physical activity promotes health and reduces cardiovascular mortality in depressed populations: a literature overview. Int J Environ Res Public Health. 2020;17:5545.

    PubMed Central  Google Scholar 

  13. Akbari M, Alavi M, Irajpour A, Maghsoudi J. Challenges of family caregivers of patients with mental disorders in Iran: a narrative review. Iran J Nurs Midwifery Res. 2018;23:329.

    PubMed  PubMed Central  Google Scholar 

  14. Grey M, Whittemore R, Tamborlane W. Depression in type 1 diabetes in children: natural history and correlates. J Psychosom Res. 2002;53:907–11.

    PubMed  Google Scholar 

  15. Johnson B, Eiser C, Young V, Brierley S, Heller S. Prevalence of depression among young people with type 1 diabetes: a systematic review. Diabet Med. 2013;30:199–208.

    CAS  PubMed  Google Scholar 

  16. Martino G, Catalano A, Bellone F, Russo GT, Vicario CM, Lasco A, et al. As time goes by: anxiety negatively affects the perceived quality of life in patients with type 2 diabetes of long duration. Front Psychol. 2019;10:1779.

    PubMed  PubMed Central  Google Scholar 

  17. Gulley LD, Shomaker LB. Depression in youth-onset type 2 diabetes. Curr Diab Rep. 2020. https://doi.org/10.1007/s11892-020-01334-8.

    Article  PubMed  Google Scholar 

  18. Buchberger B, Huppertz H, Krabbe L, Lux B, Mattivi JT, Siafarikas A. Symptoms of depression and anxiety in youth with type 1 diabetes: a systematic review and meta-analysis. Psychoneuroendocrinology. 2016;70:70–84.

    PubMed  Google Scholar 

  19. Cumpston M, Li T, Page MJ, Chandler J, Welch VA, Higgins JP, et al. Updated guidance for trusted systematic reviews: a new edition of the cochrane handbook for systematic reviews of interventions. Cochrane Database Syst Rev 2019;10:000142.

  20. Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6:e1000097.

    Google Scholar 

  21. Hoy D, Brooks P, Woolf A, Blyth F, March L, Bain C, et al. Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement. J Clin Epidemiol. 2012;65:934–9.

    PubMed  Google Scholar 

  22. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJM, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials. 1996;17:1–12.

    CAS  PubMed  Google Scholar 

  23. Higgins JPT, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21:1539–58.

    PubMed  Google Scholar 

  24. Schroll JB, Moustgaard R, Gøtzsche PC. Dealing with substantial heterogeneity in cochrane reviews cross-sectional study. BMC Med Res Methodol. 2011;11:22.

    PubMed  PubMed Central  Google Scholar 

  25. Glick BA, Hong KMC, Obrynba K, Kamboj MK, Hoffman RP. Identifying depressive symptoms among diabetes type and the impact on hemoglobin A1c. J Pediatr Endocrinol Metab. 2018;31:39–44.

    CAS  PubMed  Google Scholar 

  26. Cullum K, Howland LC, Instone S. Depressive symptoms and social support in adolescents with type 2 diabetes. J Pediatr Health Care. 2016;30:57–64.

    PubMed  Google Scholar 

  27. Weinstock RS, Trief PM, El Ghormli L, Goland R, McKay S, Milaszewski K, et al. Parental characteristics associated with outcomes in youth with type 2 diabetes: results from the TODAY clinical trial. Diabetes Care. 2015;38:784–92.

    PubMed  PubMed Central  Google Scholar 

  28. Bernaras E, Jaureguizar J, Garaigordobil M. Child and adolescent depression: a review of theories, evaluation instruments, prevention programs, and treatments. Front Psychol. 2019;10:543.

    PubMed  PubMed Central  Google Scholar 

  29. Jelínek M, Květon P, Burešová I, Klimusová H. Measuring depression in adolescence: evaluation of a hierarchical factor model of the Children’s Depression Inventory and measurement invariance across boys and girls. PLoS One. 2021;16:e0249943.

    PubMed  PubMed Central  Google Scholar 

  30. Roy T, Lloyd CE. Epidemiology of depression and diabetes: a systematic review. J Affect Disord. 2012;142:S8-21.

    PubMed  Google Scholar 

  31. Fisher L, Skaff MM, Mullan JT, Arean P, Glasgow R, Masharani U. A longitudinal study of affective and anxiety disorders, depressive affect and diabetes distress in adults with type 2 diabetes. Diabet Med. 2008;25:1096–101.

    CAS  PubMed  PubMed Central  Google Scholar 

  32. Golden SH, Lazo M, Carnethon M, Bertoni AG, Schreiner PJ, Roux AVD, et al. Examining a bidirectional association between depressive symptoms and diabetes. JAMA. 2008;299:2751–9.

    PubMed  PubMed Central  Google Scholar 

  33. Polanczyk GV, Salum GA, Sugaya LS, Caye A, Rohde LA. Annual research review: a meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. J Child Psychol Psychiatry. 2015;56:345–65.

    PubMed  Google Scholar 

  34. Björntorp P. Do stress reactions cause abdominal obesity and comorbidities? Obes Rev. 2001;2:73–86.

    PubMed  Google Scholar 

  35. Vogelzangs N, Kritchevsky SB, Beekman ATF, Newman AB, Satterfield S, Simonsick EM, et al. Depressive symptoms and change in abdominal obesity in older persons. Arch Gen Psychiatry. 2008;65:1386–93.

    PubMed  PubMed Central  Google Scholar 

  36. Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study Research Group, Jacobson AM, Musen G, Ryan CM, Silvers N, Cleary P, et al. Long-term effect of diabetes and its treatment on cognitive function. N Engl J Med. 2007;356:1842–52.

    Google Scholar 

  37. Hood KK, Huestis S, Maher A, Butler D, Volkening L, Laffel LM. Depressive symptoms in children and adolescents with type 1 diabetes: association with diabetes-specific characteristics. Diabetes Care. 2006;29:1389–91.

    PubMed  Google Scholar 

  38. Hackett ML, Yapa C, Parag V, Anderson CS. Frequency of depression after stroke: a systematic review of observational studies. Stroke. 2005;36:1330–40.

    PubMed  Google Scholar 

  39. Pilevarzadeh M, Amirshahi M, Afsargharehbagh R, Rafiemanesh H, Hashemi SM, Balouchi A. Global prevalence of depression among breast cancer patients: a systematic review and meta-analysis. Breast Cancer Res Treat. 2019;176:519–33.

    PubMed  Google Scholar 

  40. Li Z, Li Y, Chen L, Chen P, Hu Y. Prevalence of depression in patients with hypertension: a systematic review and meta-analysis. Medicine. 2015;94:1317.

    Google Scholar 

  41. Cameron FJ, Northam EA, Ambler GR, Daneman D. Routine psychological screening in youth with type 1 diabetes and their parents: a notion whose time has come? Diabetes Care. 2007;30:2716–24.

    PubMed  Google Scholar 

  42. Grigsby AB, Anderson RJ, Freedland KE, Clouse RE, Lustman PJ. Prevalence of anxiety in adults with diabetes: a systematic review. J Psychosom Res. 2002;53:1053–60.

    PubMed  Google Scholar 

  43. Price RB, Wallace M, Kuckertz JM, Amir N, Graur S, Cummings L, et al. Pooled patient-level meta-analysis of children and adults completing a computer-based anxiety intervention targeting attentional bias. Clin Psychol Rev. 2016;50:37–49.

    PubMed  PubMed Central  Google Scholar 

  44. Garrison MM, Katon WJ, Richardson LP. The impact of psychiatric comorbidities on readmissions for diabetes in youth. Diabetes Care. 2005;28:2150–4.

    PubMed  Google Scholar 

  45. Herzer M, Vesco A, Ingerski LM, Dolan LM, Hood KK. Explaining the family conflict-glycemic control link through psychological variables in adolescents with type 1 diabetes. J Behav Med. 2011;34:268–74.

    PubMed  Google Scholar 

  46. Naar-King S, Podolski CL, Ellis DA, Frey MA, Templin T. Social ecological model of illness management in high-risk youths with type 1 diabetes. J Consult Clin Psychol. 2006;74:785–9.

    PubMed  Google Scholar 

  47. Talbot F, Nouwen A. A review of the relationship between depression and diabetes in adults: is there a link? Diabetes Care. 2000;23:1556–62.

    CAS  PubMed  Google Scholar 

  48. Khaledi M, Haghighatdoost F, Feizi A, Aminorroaya A. The prevalence of comorbid depression in patients with type 2 diabetes: an updated systematic review and meta-analysis on huge number of observational studies. Acta Diabetol. 2019;56:631–50.

    PubMed  Google Scholar 

  49. Semenkovich K, Brown ME, Svrakic DM, Lustman PJ. Depression in type 2 diabetes mellitus: prevalence, impact, and treatment. Drugs. 2015;75:577–87.

    CAS  PubMed  Google Scholar 

  50. Ali SS, Stone MA, Peters JL, Davies MJ, Khunti KK. The prevalence of co-morbid depression in adults with type 2 diabetes: a systematic review and meta-analysis. Diabetic Med. 2006;23:1165–73.

    CAS  PubMed  Google Scholar 

  51. Ehrenthal JC, Düx A, Baie L, Burgmer M. Levels of personality functioning and not depression predict decline of plasma glucose concentration in patients with type 2 diabetes mellitus. Diabetes Res Clin Pract. 2019;151:106–13.

    CAS  PubMed  Google Scholar 

  52. Mathew CS, Dominic M, Isaac R, Jacob JJ. Prevalence of depression in consecutive patients with type 2 diabetes mellitus of 5-year duration and its impact on glycemic control. Indian J Endocrinol Metab. 2012;16:764–8.

    PubMed  PubMed Central  Google Scholar 

  53. Galler A, Tittel SR, Baumeister H, Reinauer C, Brosig B, Becker M, et al. Worse glycemic control, higher rates of diabetic ketoacidosis, and more hospitalizations in children, adolescents, and young adults with type 1 diabetes and anxiety disorders. Pediatr Diabetes. 2021;22:519–28.

    CAS  PubMed  Google Scholar 

  54. Vesco AT, Howard KR, Anderson LM, Papadakis JL, Hood KK, Weissberg-Benchell J. Examining indirect effects of anxiety on glycated hemoglobin via automatic negative thinking and diabetes-specific distress in adolescents with type 1 diabetes. Can J Diabetes. 2021;45:473–80.

    PubMed  Google Scholar 

  55. Ozougwu J, Obimba K, Belonwu C, Unakalamba C. The pathogenesis and pathophysiology of type 1 and type 2 diabetes mellitus. J Physiol Pathophysiol. 2013;4:46–57.

    Google Scholar 

  56. Butalia S, Kaplan GG, Khokhar B, Rabi DM. Environmental risk factors and type 1 diabetes: past, present, and future. Can J Diabetes. 2016;40:586–93.

    PubMed  Google Scholar 

  57. Jaiswal M, Divers J, Dabelea D, Isom S, Bell RA, Martin CL, et al. Prevalence of and risk factors for diabetic peripheral neuropathy in youth with type 1 and type 2 diabetes: SEARCH for diabetes in Youth Study. Diabetes Care. 2017;40:1226–32.

    CAS  PubMed  PubMed Central  Google Scholar 

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Contributions

AM contributed to conceptualization, reviewing and editing. NM and GF contributed to original draft preparation, reviewing and editing. All authors have read and agreed to the published version of the manuscript.

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Correspondence to Fereshteh Ghaljaei.

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Akbarizadeh, M., Naderi far, M. & Ghaljaei, F. Prevalence of depression and anxiety among children with type 1 and type 2 diabetes: a systematic review and meta-analysis. World J Pediatr 18, 16–26 (2022). https://doi.org/10.1007/s12519-021-00485-2

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