A Psychoeducational Intervention (SWEEP) for Depressed Women with Diabetes

Abstract

Background Clinically significant depression is present in 25 % of individuals with type 2 diabetes, its risk being doubled in women. Purpose To examine the effectiveness of the Study of Women's Emotions and Evaluation of a Psychoeducational (SWEEP), a group therapy for depression treatment based on cognitive behavioral therapy principles that was developed for women with type 2 diabetes was conducted. Methods Women with significantly elevated depression symptoms (Center for Epidemiologic Studies Depression Scale ≥16) were randomized to SWEEP (n=38) or usual care (UC, n=36). Results Multilevel modeling indicated that SWEEP was more effective than UC in reducing depression (mean difference of –15 vs. –7, p<.01), decreasing trait anxiety (mean difference of –15 vs. –5, p<.01), and improving anger expression (mean difference of –12 vs. –5, p<.05). Although SWEEP and UC had improvements in fasting glucose (mean difference of –24 vs. –1 mg/dl) and HbA1c (mean difference of –0.4 vs. –0.1 %), there were no statistically significant differences between groups. Conclusions SWEEP was more effective than UC for treating depressed women with type 2 diabetes. Addition of group therapy for depression meaningfully expands the armamentarium of evidence-based treatment options for women with diabetes.

Individual Mindfulness-Based Cognitive Therapy and Cognitive Behavior Therapy for Treating Depressive Symptoms in Patients With Diabetes: Results of a Randomized Controlled Trial

“…It is clinically relevant to observe that both MBCT and CBT significantly increase well-being and reduce anxiety and diabetes-related distress. These findings are consistent with previous research showing that psychological interventions focusing on depressive symptoms can also improve anxiety and quality of life (10,20). Results are also in line with previous studies in patients with diabetes investigating either MBCT or CBT, also showing reductions in diabetes-related distress (14,19).…”

“…CBT has been related to significant improvements in psychological symptoms in patients with a diversity of somatic diseases, especially when delivered individually (18). Regarding CBT in patients with diabetes and comorbid depression, five RCTs have investigated and demonstrated its efficacy (19)(20)(21)(22)(23). Thus, CBT is characterized as the gold standard against which to assess the efficacy of a relatively new and promising intervention like MBCT.…”

Psychosocial interventions for people with diabetes and co-morbid depression. A systematic review

“…Mental health resources are grossly inadequate globally and there is a stark gap between service users and service providers (Saraceno & Saxena, 2002;WHO, 2013c). The success of nurses administering the interventions was reported in the various included studies (Penckofer et al, 2012;Piette et al, 2011;Rungreangkulkij et al, 2011). In psychosocial interventions, the therapeutic alliance that a therapist has with the individual is one of the pivotal factors in Page 26 of 53 A c c e p t e d M a n u s c r i p t 26 determining a successful treatment (Feller & Cottone., 2003).…”

“…There were also predominantly more female than male participants in this review despite diabetes having similar prevalence rates in men and women (IDF, 2013a), and one study (Penckofer et al, 2012) focused its intervention solely on women. Research has shown that women were more likely to seek help and get diagnosed for their depression than men (Branney & White, 2008;Ogrodniczuk & Oliffe, 2010).…”

“…These were the RCTs byLustman et al (1998), Pibernik-Okanovic et al (2009), and van Bastelaar et al (2011. SMD was calculated for the three RCTs with two studies having a small effect of -0.42(Piette et al, 2011) and - 0.24 (Simson et al, 2008), while the other one having a large effect of -0.81(Penckofer et al, 2012). SMD for quasi-experimental trial forRungreangkulkij et al (2011) was -1.74.. SMGS was calculated for the three NRS and the effect sizes were mostly large with -0.91 for de Groot (2012), -1.22 forGeorgiades et al (2007), and -0.55, -1.87, and-1.94 forGonzalez et al (2010) with the respective depression scales.…”