Format

Send to

Choose Destination
See comment in PubMed Commons below
Ann Intern Med. 1998 Oct 15;129(8):613-21.

Cognitive behavior therapy for depression in type 2 diabetes mellitus. A randomized, controlled trial.

Author information

1
Washington University School of Medicine and the Veterans Affairs Medical Center, St. Louis, Missouri 63110, USA.

Abstract

BACKGROUND:

Psychotherapy is the principal nonpharmacologic method for the management of depression, but its usefulness for depressed patients with diabetes remains unknown.

OBJECTIVE:

To assess the efficacy of cognitive behavior therapy (CBT) for depression in patients with diabetes.

DESIGN:

Randomized, controlled trial.

SETTING:

Referral-based academic medical center.

PATIENTS:

51 patients with type 2 diabetes and major depression.

INTERVENTION:

Patients were assigned either to a group that received 10 weeks of individual CBT or to a control group that received no specific antidepressant treatment. All patients participated in a diabetes education program to control for the effects of supportive attention and the possible influence of enhanced diabetes control on mood.

MEASUREMENTS:

Degree of depression was measured by using the Beck Depression Inventory; glycemic control was measured by using glycosylated hemoglobin levels. Outcomes were assessed immediately after treatment and 6 months after treatment.

RESULTS:

The percentage of patients achieving remission of depression (Beck Depression Inventory score < or = 9) was greater in the CBT group than in the control group: posttreatment, 85.0% of patients in the CBT group (17 of 20) compared with 27.3% of controls (6 of 22) achieved remission (difference, 57.7 percentage points [95% CI, 33 to 82 percentage points]) (P < 0.001); at follow-up, 70.0% of patients in the CBT group (14 of 20) compared with 33.3% of controls (7 of 21) achieved remission (difference, 36.7 percentage points [CI, 9 to 65 percentage points]) (P = 0.03). Post-treatment glycosylated hemoglobin levels were not different in the two groups, but follow-up mean glycosylated hemoglobin levels were significantly better in the CBT group than in the control group (9.5% compared with 10.9%; P = 0.03).

CONCLUSIONS:

The combination of CBT and supportive diabetes education is an effective nonpharmacologic treatment for major depression in patients with type 2 diabetes. It may also be associated with improved glycemic control.

PMID:
9786808
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Silverchair Information Systems
    Loading ...
    Support Center