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Individual Mindfulness-Based Cognitive Therapy (MBCT) and Cognitive Behavior Therapy (CBT) Improve Depressive Symptoms in Patients with Diabetes

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. 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 HbA1clevels were assessed as secondary outcomes. 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.

Tovote, K. A., Fleer, J., Snippe, E., Peeters, A. C. T. M., Emmelkamp, P. M. G., Sanderman, R., … Schroevers, M. J. (2014). 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, doi: 10.2337/dc13-2918 1935-5548.

CBT Improves Adherence and Depression in Patients with Uncontrolled Type 2 Diabetes

According to a new study published in Diabetes Care, cognitive behavior therapy (CBT) may be an effective intervention for medication adherence, depressive symptoms, and glycemic control in adults with type 2 diabetes and depression.  In the current study, 87 adults with unipolar depression and uncontrolled type 2 diabetes were randomized to receive either enhanced treatment as usual (ETAU) (medication adherence, self-monitoring of blood glucose, and lifestyle counseling) or ETAU plus 9 to 11 sessions of CBT for adherence and depression (CBT-AD). At four months, immediately following treatment, the CBT-AD group showed greater improvements in medication adherence, depressive symptoms, and glycemic control than the ETAU group.  At 8- and 12-month follow ups, CBT-AD remained superior to ETAU on adherence and glycemic control. There was no between group difference on depression, though some evidence of continued improvement was noted for both groups. These findings suggest that CBT is an effective intervention for medication adherence, glycemic control, and depression with lasting benefits for self-management and control among patients with type 2 diabetes and depression.

Safren, S. A., Gonzalez, J. S., Wexler, D. J., Psaros, C., Delahanty, L. M., Blashill, A. J., Margolina, A. I., … Cagliero, E. (January 01, 2014). A Randomized Controlled Trial of Cognitive Behavioral Therapy for Adherence and Depression (CBT-AD) in Patients With Uncontrolled Type 2 Diabetes. Diabetes Care, 37, 3, 625-33.