Internet-delivered cognitive behaviour therapy for depression in people with diabetes: study protocol for a randomised controlled trial

Robins, Lisa; Newby, Jill M.; Wilhelm, Kay; Smith, Jessica; Fletcher, Therese; Ma, Trevor; Finch, Adam; Campbell, Lesley V.; Andrews, Gavin

doi:10.1136/bmjdrc-2015-000144

Cited by 12 publications

(17 citation statements)

References 53 publications

(55 reference statements)

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“…Diabetes-specific cognitive behavioral group therapy for people with diabetes and subclinical depression [34] and webbased guided CBT for people with T1DM or T2DM and mild to moderate depression [35] have also reported significant reductions in both depression and diabetes distress. Further trials utilizing Internet and mobile technologies for the mental health of people with diabetes are currently being conducted [36], including our own study using a local iCBT study for depression in people with diabetes [37]. A recent report of an online diabetes self-management program, of the sort which could compliment depression resources reported 'small but significant' benefits as a stand-alone program [38] but points to the need for a mixture of face-to-face and online resources targeted to individual needs.…”

Section: Discussionmentioning

confidence: 99%

The Importance of Screening for Mild Depression in Adults with Diabetes

Wilhelm¹,

Reddy²,

Crawford³

et al. 2017

Transl Biomed

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Aim: While the impact of major depression on diabetes has gained increasing attention, the role of minor depression is less well investigated. This observational study compared three groups of adults with Type 1 (T1DM) or Type 2 (T2DM) diabetes mellitus: with me) no depressive symptoms (NODEP), ii) mild depressive symptoms (MILD) and iii) moderate-to-severe symptoms (MOD/SEVERE)-on diabetes distress, psychological distress, anxiety and somatic symptoms, quality of life and HbA1c levels.Methods: 245 outpatients attending two hospital diabetes services (27% with T1DM; 73% with T2DM) completed self-report measures including patient health questionnaire (PHQ), problem areas in diabetes (PAID) scale and short form health survey (SF12). Participants were interviewed by a psychiatrist and HbA1c levels recorded.Results: Half the sample reported depressive symptoms on the PHQ-9 (29% in the MILD group, 21% in MOD/ SEVERE and the remaining 50% in the NODEP group). Compared to the NODEP group, MILD group participants had significantly higher levels of diabetes distress, psychological distress, anxiety and somatic symptoms and significantly lower mental-health related quality of life. Participants in the MOD/SEVERE group had significantly higher levels of diabetes distress, psychological distress, anxiety, and somatic symptoms than either of the other two groups, and significantly lower quality of life. The groups did not differ significantly on HbA1c.Conclusions: Mild symptoms of depression in patients with diabetes are common and are associated with higher levels of diabetes distress, psychological distress, anxiety and somatic symptoms and lower quality of life.Addressing mild depression provides a potential avenue for preventing clinical depression in patients with diabetes.

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Section: Discussionmentioning

confidence: 99%

The Importance of Screening for Mild Depression in Adults with Diabetes

Wilhelm¹,

Reddy²,

Crawford³

et al. 2017

Transl Biomed

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“…Web-based interventions have also been used as an add-on support to in-person treatment. A recent RCT found that the addition of a web-based intervention focused on skills for achieving and maintaining abstinence resulted in an increase in abstinence compared to treatment-as usual (75). This effect was more pronounced in individuals with a positive breath alcohol at study entry (75).…”

Section: Psychosocial Treatmentmentioning

confidence: 99%

State-of-the-art behavioral and pharmacological treatments for alcohol use disorder

Ray

Bujarski

Grodin

et al. 2018

The American Journal of Drug and Alcohol Abuse

108

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Background: Alcohol use disorder (AUD) and its associated consequences remain significant public health concerns. Given that AUD represents a spectrum of severity, treatment options represent a continuum of care, ranging from single-session brief interventions to more intensive, prolonged, and specialized treatment modalities. Objective: This qualitative literature review seeks to describe the best practices for AUD by placing a particular emphasis on identifying those practices which have received the most empirical support. Method: This review summarizes psychological and pharmacological intervention options for AUD treatment, with a focus on the relapse prevention phase of recovery. Psychological and pharmacological treatments are summarized in terms of the empirical evidence favoring each approach and the level of AUD severity for which they are most indicated. Scientific Significance: One of the broad assertions from this review is that while AUD is highly prevalent, seeking treatment for AUD is not. There are a myriad of behavioral and pharmacological treatments that have shown compelling evidence of efficacy for the treatment of AUD. In the behavioral treatment literature, Cognitive Behavioral Therapy (CBT) has received the most consistent support. Opioid antagonism (via naltrexone) has been the most widely studied pharmacotherapy and has produced moderate effect sizes. While none of the treatments reviewed herein represents a so called “silver bullet” for AUD, they each have the potential to significantly improve the odds of recovery. Precision medicine, or the identification of best treatment matches for individual patients, looms as an important overarching goal for the field; although specific matches are not yet sufficiently reliable in their empirical evidence to warrant clinical dissemination.

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“…Four of them used homework assignments to encourage patients to apply the learned skills in daily practice [21,31,32,52]. Two added mood, thought, behavior and/or diabetes selfmanagement reporting [30,31].…”

Section: Therapeutic Approachmentioning

confidence: 99%

“…Three addressed no logging to the web site or no homework received by e-mail (mainly standardized) or in last instant by phone call from the clinician when e-mail had no response [21,32,52]. Cohn and cols [31] intervention used payment as a motivation strategy, they paid $1 for each daily report completed, $20 for completing the final questionnaires and phone interview, and $20 if they completed the study within 75 days with reports on at least 75% of all days.…”

Section: Adherence Managementmentioning

confidence: 99%