The global distribution of comorbid depression and anxiety in people with diabetes mellitus: Risk‑adjusted estimates

Background: Previous reports suffer from the problem that they simply pooled data using aggregate means or standard meta‑analytic method. The aim of the current study was to re‑estimate the point prevalence of comorbid depression and anxiety in people with diabetes. Methods: The estimates were calculated using recently introduced directly standardized effect estimate method, which gives corrected risk‑adjusted estimates for the population of interests. Reported are global and regional burden of prevalence, presented as risk‑adjusted prevalence estimates with 95% confidence intervals. Results: Globally, the burden of comorbid depression was higher than the burden of anxiety (23.36% vs. 17.58%) symptoms and/or disorder in people with diabetes. There was a higher burden of comorbid depression in people living in developing regions (26.32%), in women (15.41%), and when assessed by self‑report scales (SRS) (22.66%). The burden of anxiety was higher in developed regions in people with Type 2 diabetes mellitus (20.15%) and when assessed by SRS (20.75%). No statistically significant differences were observed due to gross heterogeneity across countries. Conclusions: There are wide‑ranging differences in studies in developed and developing regions, regarding the burden of comorbid depression and of anxiety among people with diabetes and both conditions affect approximately a fifth of the diabetic population.