Depression and diabetes treatment nonadherence: a meta-analysis.

American Diabetes Association
American Diabetes Association
Publication date:
01 December 2008


Full reference:
Gonzalez, J. S., Peyrot, M., McCarl, L. A., Collins, E. M., Serpa, L., Mimiaga, M. J. & Safren, S. A. (2008) Depression and Diabetes Treatment Nonadherence: A Meta-Analysis. Diabetes Care, 31, 2398-2403.


Conclusion: There is a significant association between depression and treatment non adherence in patients with diabetes. Studies that used stronger methodologies had larger effects. Treatment no adherence may represent an important pathway between depression and worse diabetes clinical outcomes.


Method: Meta-analysis of 47 studies which fulfilled the inclusion criteria.  Literature search to June 2007.


Results: Depression is significantly associated with nonadherence to the diabetes treatment regimen (z = 9.97, P < 0.0001). The weighted effect size was near the medium range (r = 0.21, 95% CI 0.17–0.25). Moderator analyses showed that the effect was significantly larger in studies that measured self-care as a continuous versus categorical variable (P = 0.001). Effect sizes were largest for missed medical appointments and composite measures of self-care (r values = 0.31, 0.29). Moderation analyses suggest that effects for most other types of self-care are also near the medium range, especially in studies with stronger methodologies.


Publication history information: Published in December 2008.