Work

Autoimmunity to mental health: Risk of depression in type 1 diabetes and celiac disease patients – A systematic review, meta-analysis, and bias assessment

Year: 2026

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: Depression is expected to become the world's largest disease burden by 2030. However, the incidence of depression in individuals with Type 1 diabetes mellitus (T1DM) or Celiac disease (CD) remains poorly studied. To address this gap, a systematic review and meta-analysis was carried out. This systematic review was approved at PROSPERO on February 9, 2025, and followed the PRISMA and MOOSE guidelines. The literature search considered all peer-reviewed quantitative studies from relevant databases up to February 7, 2025. Study-specific risk of bias was assessed using the ROBINS-E tool. Inverse variance weighted random-effects models were applied on the hazard ratio (HR) scale to pool estimates of included studies. Heterogeneity was quantified by Cochran's Q and I 2 statistics. Sensitivity analyses consisted of influence, outlier, and subgroup analyses. E-values were calculated to assess the reliability of results regarding unmeasured confounding. Out of 17,095 articles screened, eight studies for T1DM and two for CD were included in the study. Both T1DM (HR = 2.77; 95 % CI: [1.82; 4.21]; P < 0.0001; I 2 = 98.5 %) and CD (HR = 1.66; 95 % CI: [1.51; 1.84]; P < 0.0001; I 2 = 35.3 %) were consistently associated with the onset of depression. Despite the high heterogeneity, which could not be fully explained for T1DM, the sensitivity analyses confirmed the results, while the E-values underscored their robustness against unmeasured confounding. This meta-analysis indicates a significant increase in the incidence of depression in individuals with either T1DM or CD. Depression screening for these population is recommended. Further research is needed to clarify the underlying mechanisms for these associations. • Depression was observed in Type 1 Diabetes (T1DM) and Celiac Disease (CD) patients. • Previous systematic reviews and meta-analyses assessed the prevalence of depression. • This study focused on associations with the incidence of depression. • T1DM and CD were associated with the occurrence of depression later in life. • Sensitivity analyses and bias assessment ensured the robustness of results.

Source: Journal of Autoimmunity

DOI: 10.1016/j.jaut.2026.103524

Authors: Dagem Desalegn, Simone Fischer, Yeabsira Bedada, Dennis Freuer, Christa Meisinger

Institutions: University of Augsburg, Charité - Universitätsmedizin Berlin, University of Turku

Language: English

Topic: Diabetes Management and Education

Subfield: Endocrinology, Diabetes and Metabolism

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $5,420