The 6-month effectiveness of Internet-based guided self-help for depression in adults with Type 1 and 2 diabetes mellitus

Research output: Journal contributionsJournal articlesResearchpeer-review

Authors

  • David Daniel Ebert
  • Stephanie Nobis
  • Dirk Lehr
  • Harald Baumeister
  • Heleen Riper
  • Randy P. Auerbach
  • Frank Jan Snoek
  • Pim Cuijpers
  • Matthias Berking

Aim: The aim of this research is to examine the 6-month effects of an Internet-based guided self-help intervention for comorbid depressive symptoms in people with diabetes. Methods: Participants (n = 260) with Type 1 or 2 diabetes and elevated depressive symptoms [Center for Epidemiological Studies Depression Scale (CES-D) ≥ 23] were randomly assigned to a guided Internet-based self-help intervention or a control condition (treatment as usual + online psychoeducation about depression). The primary outcome was a change in depressive symptom severity (CES-D) from baseline to 6-month follow-up. The secondary outcomes included numbers of people achieving treatment response (reliable change of depressive symptoms) and remission (CES-D ≤ 16), as well as the effects on glycaemic control, diabetes-related emotional distress and diabetes acceptance. Repeated measures analysis of variance examined between-group differences using intent-to-treat principles. Results: Both conditions showed improvements in depression severity: intervention condition, d = 1.48 [95% confidence interval (95% CI): 1.21 to 1.76]; control condition d = 0.55 (95% CI: 0.30 to 0.80). Changes were significantly greater in the intervention condition with a large between-group effect size (d = 0.83, 95% CI: 0.57 to 1.08). Accordingly, effects on response [relative risk (RR) = 2.60 (95% CI: 2.01 to 3.36), P < 0.001] and remission [RR = 3.36 (95% CI: 2.98 to 5.44), P < 0.001] were in favour of the intervention group, as were differences in change in diabetes emotional distress (d = 0.50, 95% CI: 0.04 to 0.54), and physical and mental functioning [Short Form Health Survey (SF-12) Physical d = 0.27 (95% CI: 0.01 to 0.51) and SF-12 Mental d = 0.68 (95% CI: 0.11 to 0.40)]. The intervention group was not superior with regard to glycaemic control, diabetes self-management and diabetes acceptance. Conclusions: The trial indicates that Internet-based guided self-help treatments for depression in people with diabetes can have sustained effects on depressive symptoms, well-being and emotional distress associated with diabetes.

Original languageEnglish
JournalDiabetic Medicine
Volume34
Issue number1
Pages (from-to)99–107
Number of pages9
ISSN0742-3071
DOIs
Publication statusPublished - 01.01.2017

DOI

Recently viewed

Publications

  1. Direct production of lactic acid based on simultaneous saccharification and fermentation of mixed restaurant food waste
  2. The impact of digitisation and big data analysis on the sustainable development of tourism and its environmental impact
  3. Modellierungen außerinstitutioneller Aneignungsprozesse digital-materieller Interfaces und (musik-)pädagogische Anschlüsse
  4. Exploring the Capacity of Water Framework Directive Indices to Assess Ecosystem Services in Fluvial and Riparian Systems
  5. Social-ecological factors influencing tourist satisfaction in three ecotourism lodges in the southeastern Peruvian Amazon
  6. Fostering collective climate action and leadership: Insights from a pilot experiment involving mindfulness and compassion
  7. Prüfung der nichtfinanziellen Erklärung und der Erklärung zur Unternehmensführung durch Aufsichtsrat und Abschlussprüfer
  8. W-RENA: Eine web-basierte Rehabilitationsnachsorge zur Transferförderung nach stationärer psychosomatischer Rehabilitation
  9. Call for Papers Special issue of International Journal of Human Resource Management: Danger and risk as challenges for HRM
  10. Wissenskommunikation als Möglichkeitsraum umweltpolitischer Verständigung – ein Blick auf die individuelle Handlungsebene
  11. Understanding drivers of human tolerance towards mammals in a mixed-use transfrontier conservation area in southern Africa
  12. Wirkt sich geschlechtliche Vielfalt im Verwaltungsrat auf die Klimaberichterstattung aus? Ergebnisse internationaler Studien
  13. Do investors value the inclusion in sustainability indices? - Evidence from an event study based on the FTSE4Good Europe Index