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Web-Based Cognitive Behavior Therapy for Depression in People With Diabetes Mellitus: A Randomized Controlled Trial.

Jill Newby^1,2, Lisa Robins^3,4,5, Kay Wilhelm^3,4

¹School of Psychology, The University of New South Wales, Randwick, Australia.

Journal of Medical Internet Research

|May 17, 2017

Summary

Internet-based cognitive behavioral therapy (iCBT) effectively treats depression in individuals with diabetes mellitus (DM). This accessible online therapy improved mental health and reduced distress, offering a viable option for this population.

Keywords:

cognitive behavior therapy computer-assisted therapy depression diabetes mellitus diabetes-related distress

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Area of Science:

Mental Health
Endocrinology
Digital Therapeutics

Background:

Depression is twice as common in diabetes mellitus (DM) patients compared to the general population.
Access to evidence-based depression therapies like cognitive behavioral therapy (CBT) is limited in routine diabetes care.
Internet-based CBT (iCBT) is effective for depression but unstudied in comorbid DM and depression.

Purpose of the Study:

To examine the efficacy of a 6-lesson, 10-week generic internet-based cognitive behavioral therapy (iCBT) program.
To evaluate iCBT in individuals with major depressive disorder (MDD) and comorbid type 1 or type 2 diabetes mellitus (DM).

Main Methods:

Online recruitment and randomization of participants with MDD and DM into iCBT with therapist support or treatment as usual (TAU).
Web-based self-report questionnaires assessed depression (PHQ-9), diabetes distress (PAID), glycemic control (HbA1c), anxiety (GAD-7), and distress (K-10, SF-12).
Outcomes were assessed at post-treatment and 3-month follow-up for the iCBT group.

Main Results:

iCBT significantly outperformed TAU in reducing depression (PHQ-9), diabetes distress (PAID), general distress (K-10), anxiety (GAD-7), and improving mental well-being (SF-12).
No significant differences were observed in glycemic control (HbA1c) or physical well-being (SF-12).
Depression symptom reduction was maintained at 3-month follow-up, with 87% no longer meeting MDD criteria.

Conclusions:

Internet-based cognitive behavioral therapy (iCBT) is an effective and accessible treatment for depression in people with diabetes.
Future research should explore tailoring iCBT programs to improve adherence and evaluate long-term outcomes.