A systematic review and meta-analysis of randomized controlled trials of cognitive behavior therapy for patients with diabetes and depression

Li, Chen; Xu, Dongmei; Hu, Mingyue; Tan, Yongfei; Zhang, Ping; Li, Guichen; Chen, Li

doi:10.1016/j.jpsychores.2017.02.006

Cited by 74 publications

(53 citation statements)

References 57 publications

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“…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).…”

Section: Introductionmentioning

confidence: 99%

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

Pan

Wang²,

Xia

et al. 2020

Front. Psychiatry

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Introduction: This study evaluated a cognitive behavioral-based self-care intervention program on diabetes management in individuals with type 2 diabetes in Jiangsu Province, China. People with type 2 diabetes were recruited to a 6-month, prospective, intervention study. Methods: The intervention group (n = 296) received an intensive cognitive behavioralbased self-care intervention, including group activities, frequent blood glucose monitoring, nutritional counseling, diabetes-specific meal and a weekly progress report. The control group (n = 110) received diabetes education, including diet and physical activity instruction only. Assessment data was obtained at baseline, and after 12 and/or 24 weeks of intervention. The intention to treat method was used to assess the effectiveness of the intervention program. Results: The intervention group showed improved fasting blood glucose, HbA1c, systolic and diastolic blood pressures compared to the control group. The intervention group also had significantly improved knowledge and self-care behavior, and general health. Conclusion: This study demonstrates that significant improvement in glycemic control and markers of cardiovascular health can occur in Chinese people with type 2 diabetes following a CBT-based intervention program that includes diabetes education, frequent blood glucose monitoring and daily use of a diabetes-specific meal plan, suggesting CBT is beneficial to improve health outcome in patients with type 2 diabetes.

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Section: Introductionmentioning

confidence: 99%

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

Pan

Wang²,

Xia

et al. 2020

Front. Psychiatry

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“…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).…”

Section: Introductionmentioning

confidence: 99%

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

Yang

Sun

2020

Front. Psychiatry

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Background: Patients with diabetes mellitus (DM) have a high risk of secondary physiological and psychological complications. Some interventions based on cognitive behavioral therapy (CBT) have been used to control glucose levels and improve negative emotions of patients with DM. This study was undertaken to provide an overview of the effectiveness of CBT-based interventions for improving glycaemic control, psychological, and physiological outcomes in adult patients with DM. Methods: Randomized controlled trials (RCTs) published in English and Chinese during 2007 and April 2019 were searched through various electronic databases including PubMed, Cochrane Library, Scopus, Embase, ProQuest Dissertations and Theses, and the Chinese databases (WanFang data and China National Knowledge Infrastructure). The primary outcome variables included glycated haemoglobin (HbA1c), fasting plasma glucose (FPG), depression, and anxiety symptoms. The secondary outcomes were weight and cholesterol. Effect sizes were pooled by random-effects modelling using Comprehensive Meta-Analysis software. Physiotherapy Evidence Database tool was used to assess the quality of all included studies. Results: Twenty-three RCTs comprising 2,619 patients with DM (type 1 and type 2) were included in at least one meta-analysis. The results of the main analysis showed that CBTbased interventions had a better effect on reduced HbA1c (−0.275%, 95% CI: −0.443 to −0.107; p < 0.01) with Hedge's g of 0.466 (95% CI: 0.710-0.189), reduced depression symptoms with average reduction of −2.788 (95% CI: −4.450 to −1.207; p < 0.01) and Hedge's g of 0.966 (95% CI: 1.507-0.426). Twenty-three RCTs comprising 2,619 patients with DM (type 1 and type 2) were included in this meta-analysis. Several mediators of the effect were found through subgroup analysis for HbA1c and

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“…A variety of psychological interventions, such as progressive relaxation techniques (Perfect & Elkins, 2010), cognitive‐behavioral therapy (Clarke et al, 2019), family systems therapy (Shao, Liang, Shi, Wan, & Yu, 2017), and mindfulness‐based interventions (Kabat‐Zinn & Hanh, 2009) have been implemented to improve mental health. Clinical research and systematic reviews have shown the benefits of these psychological interventions in people with diabetes (Cherkin et al, 2016; Li et al, 2017). Mindfulness, in particular, is considered a promising intervention strategy for psychosocial issue (Burgess, Beach, & Saha, 2017) and has become increasingly popular and available globally (Cherkin et al, 2016) in recent years.…”

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confidence: 99%

Effects of Mindfulness‐Based Stress Reduction and Mindfulness‐Based Cognitive Therapy in People With Diabetes: A Systematic Review and Meta‐Analysis

2020

J of Nursing Scholarship

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Purpose The purpose of this study was to determine the effectiveness of mindfulness‐based stress reduction (MBSR) and mindfulness‐based cognitive therapy (MBCT) on depression, quality of life (QoL), and glycosylated hemoglobin (HbA1c) in people with diabetes. Design A systematic literature review and meta‐analysis was conducted. Methods Eight databases (PubMed, Embase, the Cumulative Index to Nursing and Allied Health Literature [CINAHL], Cochrane, PsycINFO, and three Chinese databases) were searched for relevant studies from inception to December 2019. Only randomized controlled trials (RCTs) of MBSR and MBCT interventions for people with type 1 and type 2 diabetes were included. Findings Nine studies described in 11 articles were included in the review. Meta‐analysis showed a significant effect favoring MBSR and MBCT on depression (standardized mean difference ‐0.84; 95% confidence interval [CI] ‐1.16 to ‐0.51; p < .0001), the mental health composite score of QoL (mean difference [MD] 7.06; 95% CI 5.09 to 9.03; p < .00001), and HbA1c (MD ‐0.28; 95% CI ‐0.47 to ‐0.09; p = .004). However, effects on the physical health composite score of QoL have not been found. Conclusions MBSR and MBCT are beneficial in improving depression, the mental health composite score of QoL, and HbA1c in people with diabetes. More well‐designed trials using longer follow‐up measurements are needed. Clinical Relevance MBSR and MBCT could be considered as effective complementary treatment alternatives for people with diabetes.

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A systematic review and meta-analysis of randomized controlled trials of cognitive behavior therapy for patients with diabetes and depression

Cited by 74 publications

References 57 publications

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

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

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

Effects of Mindfulness‐Based Stress Reduction and Mindfulness‐Based Cognitive Therapy in People With Diabetes: A Systematic Review and Meta‐Analysis

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