Short Report: Epidemiology Diabetes mellitus and comorbid depression in Zambia G. Hapunda 1,2 , A. Abubakar 2,3,4 , F. Pouwer 5 and F. van de Vijver 2,6,7 1 Department of Psychology, University of Zambia, Lusaka, Zambia, 2 Department of Culture Studies, Tilburg University, Tilburg, The Netherlands, 3 Department of Psychology, Lancaster University, Lancaster, UK, 4 Centre for Geographic Medicine (Coast), Kenya Medical Research Institute, Neuroassessment Unit, Kilifi, Kenya, 5 Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands, 6 Work Well Unit, North-West University, Potchefstroom, South Africa and 7 School of Psychology, University of Queensland, Brisbane, Australia Accepted 25 November 2014 Abstract Aims To replicate, in Zambia, a recent global study by the WHO, which reported that the odds of depression were not increased in African people with diabetes, and to explore the sociodemographic and clinical factors associated with depression. Methods A total of 773 control subjects and 157 Zambian patients with diabetes completed the Major Depression Inventory and a list of demographic indicators. Results Compared with control subjects (mean  SD Major Depression Inventory score 15.10  9.19), depressive symptoms were significantly more common in patients with diabetes (mean  sd Major Depression Inventory score 19.12  8.95; P < 0.001). ANCOVA showed that having diabetes [F(1,698) = 16.50, P < 0.001], being female [F(1,698) = 7.35, P < 0.01] and having low socio-economic status (F(1,698) = 13.35, P < 0.001) were positive predictors of depression. Conclusions Contrary to the WHO study, we found that depression was a common comorbid health problem among Zambian people with diabetes. Clinicians should consider patients’ health status, sex and socio-economic status as potential factors predicting depression. Diabet. Med.00: 000–000 (2014) Introduction Abundant evidence suggests that the prevalence and inci- dence of depression is elevated in people with Type 1 or Type 2 diabetes [1–4]. Depression in diabetes is not only associ- ated with impaired quality of life [5], but prospective studies have also shown that depression is associated with poor glycaemic control, an increased risk of developing microvas- cular and macrovascular complications and higher mortality rates [6,7]. Only a few studies on diabetes and depression have been conducted on the African continent. In a Nigerian study, in 83 people with diabetes, 25% had an elevated depression score on the Hospital Anxiety Depression Scale [8]. Further two Nigerian studies used a diagnostic psychiatric interview [9,10]. The first was conducted among 200 outpatients with Type 1 or Type 2 diabetes: 30% had a depressive disorder, compared with 9.5% in a control group without diabetes [9]. Agbir et al. [10] found that the prevalence of major depressive disorder was 19.4% in an outpatient diabetes clinic. In another global study, diabetes was associated with a twofold increase in the prevalence of depressive symptoms except in Africa [11]. Little is known about the prevalence of depression in people with diabetes in Zambia. The aim of the present study, therefore, was to address two questions: (1) Do Zambian people with diabetes mellitus have more depressive symptoms than control subjects without diabetes? and (2) Which sociodemographic and clinical variables are associ- ated with depression in patients with diabetes? Subjects and methods Study population Patients with diabetes were recruited from four central hospitals. Healthy adolescent control subjects were recruited from secondary schools and healthy adult control subjects were recruited from various public places within Lusaka. Healthy adolescents gave consent and the head teachers of their schools also gave permission. A total of 930 subjects were included, of whom 773 were healthy subjects and 157 Correspondence to: Given Hapunda. E-mail: given.hapunda@unza.zm © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK 1 DIABETICMedicine DOI: 10.1111/dme.12645