Practice Update
Research · June 04, 2014
TAKE-HOME MESSAGE
- This randomized, controlled trial of patients with diabetes and depression demonstrated that treatment with mindfulness-based cognitive therapy (MBCT) or individual cognitive behavior therapy (CBT) resulted in a significant decrease in depressive symptoms compared with a waiting-list control. The effect was similar among participants in the MBCT and CBT arms.
- Results showed a benefit in a range of psychological symptoms in patients with type 1 and type 2 diabetes when treated with MBCT or CBT.
ABSTRACT
OBJECTIVE
Depression is a common comorbidity of diabetes, undesirably affecting patients’ physical and mental functioning. Psychological interventions are effective treatments for depression in the general population as well as in patients with a chronic disease. The aim of this study was to assess the efficacy of individual mindfulness-based cognitive therapy (MBCT) and individual cognitive behavior therapy (CBT) in comparison with a waiting-list control condition for treating depressive symptoms in adults with type 1 or type 2 diabetes.
RESEARCH DESIGN AND METHODS
In this randomized controlled trial, 94 outpatients with diabetes and comorbid depressive symptoms (i.e., Beck Depression Inventory-II [BDI-II] ≥14) were randomized to MBCT (n = 31), CBT (n = 32), or waiting list (n = 31). All participants completed written questionnaires and interviews at pre- and postmeasurement (3 months later). Primary outcome measure was severity of depressive symptoms (BDI-II and Toronto Hamilton Depression Rating Scale). Anxiety (Generalized Anxiety Disorder 7), well-being (Well-Being Index), diabetes-related distress (Problem Areas In Diabetes), and HbA1c levels were assessed as secondary outcomes.
RESULTS
Results showed that participants receiving MBCT and CBT reported significantly greater reductions in depressive symptoms compared with patients in the waiting-list control condition (respectively, P = 0.004 and P < 0.001; d = 0.80 and 1.00; clinically relevant improvement 26% and 29% vs. 4%). Both interventions also had significant positive effects on anxiety, well-being, and diabetes-related distress. No significant effect was found on HbA1c values.
CONCLUSIONS
Both individual MBCT and CBT are effective in improving a range of psychological symptoms in individuals with type 1 and type 2 diabetes.
Diabetes Care
Individual Mindfulness-Based Cognitive Therapy (MBCT) and Cognitive Behavior Therapy (CBT) for Treating Depressive Symptoms in Patients With Diabetes: Results of a Randomized Controlled Trial
Diabetes Care 2014 Jun 04;[EPub Ahead of Print], KA Tovote, J Fleer, E Snippe, AC Peeters, PM Emmelkamp, R Sanderman, TP Links, MJ Schroevers