Table 2.
Psychosocial interventions
| Reference | Study Design | Depression Entry Criteria | M(SD) Baseline HbA1c levels | Enrolled/Completed | Treatment modality/Duration/Type | Depression Measures | Significant Depression Outcomes | Significant Health/Glucose Outcomes | Methodological Characteristics |
|---|---|---|---|---|---|---|---|---|---|
| Lustman et al., 1998 | RCT of CBT w/education, education only | DIS diagnosis of MDD, BDI>13 | 10.2 (3.6)% for patients in the intervention group, 10.4 (3.1)% in the control group | 51/42 | CBT, 10 weeks, individual | BDI | ITT: 70.8% CBT achieved remission (BDI<9) v. 22.2% education (p<.001) and 66.6% CBT achieved clinical improvement v. 29.6% education (p=.01). At 6-mo f/u, 58.3% CBT in remission v. 25.9% education (p=.03) and 58.3% CBT achieved clinical improvement v. 29.6% education (p=.01). | No difference in HbA1c levels at post-treatment. At 6-mo f/u, CBT = 9.5% and education-only = 10.9% (p=.03) | RCT w/education-only comparison & 6-month follow-up interval, ITT analyses, age 21-70, type 2 only, MDD criterion, HbA1c as primary outcome measure |
| Lamers et al., 2006 | RCT of MPI, TAU | MINI diagnosis of Major or Minor Depression, HDRS > 18 | TBA | Goal of 180 | CBT, up to 10 visits over 3 mos., individual at-home nurse-delivered | BDI | TBA | N/A | RCT w/ TAU comparison and 9 month follow-up interval, planned ITT analyses, age 60 and over, type 2, Major and Minor Depressive Disorder, HbA1c not an outcome |
| Van Bastelaar et al., 2008 | RCT of web-based CBT, wait-list control | CES-D > 16 | TBA | Goal of 286 | CBT, 8 weeks, web-based | CES-D | TBA | TBA | RCT design w/waitlist control and 6 month follow-up, planned ITT analyses, age 18 or over, type 1 or 2, elevated depressive symptoms, HbA1c a secondary outcome measure |
| Simson et al., 2008 | RCT of supportive psychotherapy, TAU | HADS > 7 | 8.1 (1.9)% | 30/30 Hospitalized for diabetic foot syndrome | Supportive psychotherapy, weekly (avg. 5) sessions, individual | HADS | HADS depression change SP: -1.6 TAU: 0.3, p=.02 HADS anxiety change SP: -0.5 TAU: 1.6, p=.02 PAID change SP: -5.5 TAU: 2.1, p=.008 | N/A | RCT design w/TAU comparison and limited follow-up, pre-post completer analyses, age <= 75 years, type 1 or 2, elevated depressive symptoms, HbA1c not an outcome measure |
| Georgiades et al., 2007 | Open-label of group CBT | BDI>=10 | 7.6 (1.6)% | 90/65 | CBT, 16 sessions over 14 weeks for 90 minutes, group | BDI, HDRS | BDI decreased significantly from baseline to 12-month follow-up (p<.001). HDRS decreased significantly from baseline to 3-month follow-up (p<.001) | No significant change on HbA1c. Within subjects changes on BDI had no significant effect on HbA1c | Single-group open-label quasi-experimental design with 12-month follow-up, pre-post completer analyses, 18 and over, type 1 and 2, depressive symptoms, HbA1c outcome measure |
| Rossello & Himenez-Chafey, 2006 | Open-label pilot study of group CBT | Depressive symptoms on CDI | 9.3% (1.9)% | 16/11 | CBT, 12 weeks for 2 hours, group | CDI | Pre CDI=19.4 and post CDI=9.9, p<.05. No difference in glycemic control or diabetes self-care | N/A | Open-label pilot without randomization, control group or follow-up, pre-post completer analyses, age 13-17, type 1, elevated depressive symptoms, HbA1c outcome measure |