Depression and diabetes mellitus as comorbid disorders
Starostina E.G.¹, Volodina M.N.¹, Starostin I.V.², Bobrov A.E.<sup>3

1</sup> Moscow Regional Research and Clinical Institute named after M.F. Vladimirskiy
² National Medical Research Center of Cardiology, Moscow
³ Moscow Scientific Research Institute of Psychiatry - a branch of the Federal Medical Research Center of Psychiatry and Narcology named after V.P. Serbsky

The literature review presents the recent data on epidemiology, clinical significance and pathophysiological association of diabetes mellitus and depressive disorders. Based on the analysis of the prevalence of depression in various groups of patients with diabetes mellitus, we discuss the discrepancies in the prevalence rates related to differences in diagnostic approaches to depression and study designs, as well as to social and cultural characteristics in various countries. The review contains ample evidence proving the negative impact of comorbid depression on the development of late diabetes complications, quality of life, loss of productivity and mortality of diabetic patients. We review psychological aspects of the association between depression and diabetes, as well as its main common pathophysiological aspects, including genetic, neurochemical, neuroendocrine, metabolic, immune, inflammatory and vascular. The term “metabolic depression” is discussed that reflects a close association of the metabolic syndrome with depressive disorders and being a major predictor of subsequent type 2 diabetes mellitus. Taking into account the data on potential positive impact of depression treatment on the course of diabetes and the analysis of medical care for patients with diabetes and depression in various countries, we conclude that screening and treatment of depression should become the necessary component of routine care for diabetic patients. 

Key words: diabetes mellitus, depression, comorbidity, risk factors, antidepressants.
For citation: Starostina E.G., Volodina M.N., Starostin I.V., Bobrov A.E. Depression and diabetes mellitus as comorbid disorders // RMJ. 2017. № 22. P. 1613–1620.