Do Nonsuicidal Severely Depressed Individuals with Diabetes Profit from Internet-Based Guided Self-Help? Secondary Analyses of a Pragmatic Randomized Trial

Research output: Journal contributionsJournal articlesResearchpeer-review

Authors

  • Sandra Schlicker
  • Kiona K. Weisel
  • Claudia Buntrock
  • Matthias Berking
  • Stephanie Nobis
  • Dirk Lehr
  • Harald Baumeister
  • Frank J. Snoek
  • Heleen Riper
  • David D. Ebert

Introduction. Diabetes mellitus type 1 and type 2 are linked to higher prevalence and occurrences of depression. Internet-based depression- and diabetes-specific cognitive behavioral therapies (CBT) can be effective in reducing depressive symptom severity and diabetes-related emotional distress. The aim of the study was to test whether disease-specific severity indicators moderate the treatment outcome in a 6-week minimally guided web-based self-help intervention on depression and diabetes (GET.ON Mood Enhancer Diabetes (GET.ON M.E.D.)) and to determine its effectiveness in a nonsuicidal severely depressed subgroup. Methods. Randomized controlled trial- (RCT-) based data (N = 253) comparing GET.ON M.E.D. to an online psychoeducation control group was used to test disease-specific severity indicators as predictors/moderators of a treatment outcome. Changes in depressive symptom severity and treatment response were examined in a nonsuicidal severely depressed subgroup (CES - D>40; N = 40). Results. Major depressive disorder diagnosis at the baseline (pprf6 = 0 01), higher levels of depression (Beck Depression Inventory II; pprpo = 0 00; pprf6 = 0 00), and lower HbA1c (pprpo = 0 04) predicted changes in depressive symptoms. No severity indicator moderated the treatment outcome. Severely depressed participants in the intervention group showed a significantly greater reduction in depressive symptom severity (dprpo = 2 17, 95% Confidence Interval (CI): 1.39-2.96) than the control condition (dprpo = 0 92; 95% CI: 0.001-1.83), with a between-group effect size of dprpo = 1 05 (95% CI: 0.11-1.98). Treatment response was seen in significantly more participants in the intervention (4/20; 20%) compared to the control group (0/20, 0%; χ 2 2 N = 40 = 4 44; p < 0 02). At the 6-month follow-up, effects were maintained for depressive symptom reduction (dpr6f = 0 71; 95% CI: 0.19-1.61) but not treatment response. Conclusion. Disease-specific severity indicators were not related to a differential effectiveness of guided self-help for depression and diabetes. Clinical meaningful effects were observed in nonsuicidal severely depressed individuals, who do not need to be excluded from web-based guided self-help. However, participants should be closely monitored and referred to other treatment modalities in case of nonresponse.

Original languageEnglish
Article number2634094
JournalJournal of Diabetes Research
Volume2019
Number of pages11
ISSN2314-6745
DOIs
Publication statusPublished - 14.05.2019

Bibliographical note

Funding Information:
We acknowledge support by Deutsche Forschungsge-meinschaft and Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) within the funding programme Open Access Publishing. We also acknowledge the ethics board of the University of Marburg and thank Patrícia Kessler, who helped with dataset preparation as part of her master thesis. The study on which the analyses presented in this paper were based was funded by the European Union (EU ERDF: ZW6-80119999 and CCI 2007DE161PR001) and BARMER.

Publisher Copyright:
© 2019 Sandra Schlicker et al.

Documents

DOI

Recently viewed

Publications

  1. Art 159: Composition, procedure and voting
  2. The positive facet of self-compassion predicts self-reported use of and attitudes toward desirable difficulties in learning
  3. Paradoxe Kritik
  4. Reconceptualizing Plural Sourcing
  5. Unified Generation of Conformations, Conformers, and Stereoisomers
  6. Deconstructing a 2-year long transdisciplinary sustainability project in Northern universities
  7. Dimensionierung von Sicherheitsbeständen
  8. How health message framing and targets affect distancing during the Covid-19 pandemic
  9. Sustainable digitalization – fostering the twin transformation in a transdisciplinary way
  10. Handelsgesetzbuch
  11. Experts of thoroughness and fanatics of planning?
  12. Through the eye of a butterfly
  13. Schematism, Imagination, and Pure Intuition in Kant
  14. Ungleich mächtig
  15. Innovation bazaar
  16. Ernst Cassirer (1874-1945)
  17. Zur Regulierungsdynamik des Prüfungsausschusses
  18. Wertermittlung von Mauerwerksbauten nach Vergleichswert, Sachwert und Ertragswert
  19. Aufsätze im SMS-Stil?
  20. Innovation by forming technology
  21. Cooperative Internationalization of SMEs: Self-commitment as a Success Factor for International Entrepreneurship
  22. Influence of Solution Heat Treatment on the Microstructure, Hardness and Stress Corrosion Behavior of Extruded Resoloy®
  23. Das Itinerar der Dinge – Objekte und ihre Ordnung
  24. Digitalisierung – Musik – Unterricht
  25. Einführende Überlegungen zur Allfinanz-Entwicklung
  26. Of housewives and feminists
  27. Advances in recovery research
  28. Zur Beschäftigungsentwicklung in der Region Hannover
  29. Nachhaltige Unternehmensstrategie
  30. Kooperation mit Migranteneltern
  31. The fantasy of the organizational One
  32. Emotional intelligence
  33. Zum Politischen der Kleinen Formen
  34. German multiple-product, multiple-destination exporters
  35. Inszenierung
  36. Entgrenzung des künstlerischen Feldes durch Globalisierung ?