Recruitment, retention rates and engagement with the ESI were assessed. The intervention included up to six sessions supported by pharmacy staff (‘ESI facilitators’) trained to deliver the ESI within the community pharmacy setting. Adults with subthreshold depression and a minimum of one LTC were recruited from community pharmacies/local general practices and offered a brief psychological support intervention (‘Enhanced Support Intervention’ (ESI)), based on behavioural activation within a Collaborative Care framework. The Community Pharmacies Mood Intervention Study (CHEMIST) explored whether community pharmacies represent a suitable setting to offer brief psychological support to people with LTCs and comorbid subthreshold depression.Ī feasibility intervention study with a nested mixed methods evaluation was employed. Subthreshold depression may go undetected and/or untreated. Therefore, the association between ASD and diabetes is likely confounded by demographic and clinical factors that should be systematically investigated in future studies.Īdults with long-term health conditions (LTCs) are more likely to experience depressive symptoms which can worsen health outcomes and quality of life, and increase healthcare costs. No significant prospective association was found (n=2) on diabetes predicting ASD (HR: 1.232, 0.826-11.837). There was a significant association, albeit characterized by significant heterogeneity, when pooling unadjusted OR (1.535, 95%CI = 1.109-2.126), which remained significant when restricting the analysis to children and type 2 diabetes, but became non-significant when considering adjusted ORs (OR: 1.528, 95%CI = 0.954-2.448).
We included 24 studies (total: 3,427,773 individuals 237,529 with ASD and 92,832 with diabetes) in the systematic review and 20 in the meta-analysis (mean stars number on the NOS: 5.89/10). We assessed study quality using the Newcastle-Ottawa Scale (NOS). Based on a pre-registered protocol (PROSPERO: CRD42021261114), we searched Pubmed, Ovid, and Web of Science databases up to 6 December 2021, with no language/type of document restrictions. We conducted the first systematic review/meta-analysis on their association. There is mixed evidence on the link between autism spectrum disorder (ASD) and diabetes.
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