Cognitive behavioural therapy on improving the depression symptoms in patients with diabetes: a meta-analysis of randomized control trials

Abstract

This meta-analysis was performed to evaluate the effect of cognitive behavioural therapy (CBT) in improving the depression symptoms of patients with diabetes. Literature search was conducted in PubMed and Embase up to October 2016 without the initial date. The pooled SMD (standard mean difference) and its 95% confidence interval (CI) were calculated by Revman 5.3. Subgroup analyses were performed by type of diabetes and evaluation criteria of depression. A total of five randomized control trials involving 834 patients with diabetes mellitus (including 417 patients in CBT group and 417 patients in control group) were included in this meta-analysis. The pooled estimates indicated significant improvement of depression by CBT compared with routine approaches in overall outcomes (SMD =–0.33, 95% CI =–0.46 to –0.21, P<0.00001), post-intervention outcomes (SMD =–0.43, 95% CI =–0.73 to –0.12, P=0.006) and outcomes after 12 months intervention (SMD =–0.38, 95% CI = –0.54 to –0.23, P<0.0001). Subgroup analyses showed that the results were not influenced by the type of diabetes. However, the effect of CBT on improving the depression symptoms disappeared when only using CES-D (Centre for Epidemiological Studies scale for Depression) to evaluate depression.

A Group-Based Community Reinforcement Approach of Cognitive Behavioral Therapy Program to Improve Self-Care Behavior of Patients With Type 2 Diabetes

“…Evidence to date suggests this is the case (8). A meta-analysis found beneficial effects of CBT on depression symptoms in patients with T1DM or T2DM (9). In addition, Li and colleagues further found CBT was effective in reducing depression symptoms, fasting glucose and improving quality of life and anxiety in patients with diabetes in comorbid with depression (10).…”

Effects of Cognitive Behavioral Therapy–Based Intervention on Improving Glycaemic, Psychological, and Physiological Outcomes in Adult Patients With Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trials

“…They analyzed nine randomized controlled trials (RCTs) using single CBT as the intervention and found that CBT had short-term and medium-term benefits in improving glycaemic control, and short-term, medium-term, and long-term benefits for depression ( 12 ). Another meta-analysis reviewed five studies on the effect of CBT on depression symptoms in patients with T1DM or T2DM, and demonstrated that CBT can improve depressive mood effectively regardless of the type of diabetes ( 13 ). Li and colleagues conducted a review and meta-analysis including 10 RCTs to explore the effect of CBT for diabetic patients comorbid with depression and found CBT was effective in reducing depression symptoms, fasting glucose and improving quality of life and anxiety in patients with diabetes in comorbid with depression ( 14 ).…”

Group cognitive behavioural therapy and weight regain after diet in type 2 diabetes: results from the randomised controlled POWER trial

“…A recent meta-analysis showed that (group)-CBT reduces depressive symptoms in people with diabetes [ 40 ]. We found no effect of group-CBT on the HADS depression scale.…”