Efficacy of a Web-Based Intervention With Mobile Phone Support in Treating Depressive Symptoms in Adults With Type 1 and Type 2 Diabetes: A Randomized Controlled Trial

  • Stephanie Nobis
    Division of Online Health Training, Innovation Incubator, Leuphana University Lüneburg, Lüneburg, Germany
  • Dirk Lehr
    Division of Online Health Training, Innovation Incubator, Leuphana University Lüneburg, Lüneburg, Germany
  • David Daniel Ebert
    Division of Online Health Training, Innovation Incubator, Leuphana University Lüneburg, Lüneburg, Germany
  • Harald Baumeister
    Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, Albert-Ludwigs-University Freiburg, Freiburg, Germany
  • Frank Snoek
    Institute for Health and Care Research (EMGO), VU University Medical Centre, Amsterdam, the Netherlands
  • Heleen Riper
    Division of Online Health Training, Innovation Incubator, Leuphana University Lüneburg, Lüneburg, Germany
  • Matthias Berking
    Division of Online Health Training, Innovation Incubator, Leuphana University Lüneburg, Lüneburg, Germany

Abstract

<jats:sec> <jats:title>OBJECTIVE</jats:title> <jats:p>Depression is common in diabetes and linked to adverse health outcomes. This study evaluated the efficacy of a guided web-based intervention in reducing depression in adults with type 1 and type 2 diabetes.</jats:p> </jats:sec> <jats:sec> <jats:title>RESEARCH DESIGN AND METHODS</jats:title> <jats:p>A total of 260 participants with diabetes and elevated depressive symptoms (Center for Epidemiologic Studies Depression Scale [CES-D ≥23]) were randomly assigned to the GET.ON Mood Enhancer Diabetes (a guided self-help intervention, n = 130) or a brief online unguided psychoeducation program for depression (n = 130). The primary outcome was depressive symptoms severity (CES-D). The secondary outcomes included diabetes-specific emotional distress (Problem Areas in Diabetes [PAID] scale) and participant satisfaction (adaption CSQ-8). Data were collected at baseline and 2 months after randomization. To identify differences in outcome between the groups, we used analyses of covariance with the baseline CES-D score as covariate on both intent-to-treat (ITT) and per-protocol (PP) basis.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>Compared with the control group, the intervention group showed significantly less depressive symptom severity at posttreatment based on ITT (d = 0.89) and PP analyses (d = 1.00). The intervention participants displayed a significantly larger reduction in diabetes-specific emotional distress (d = 0.58, ITT). The intervention appeared to be acceptable to the participants; 95% (n = 121) would recommend the training to a friend with diabetes in need of psychological help.</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSIONS</jats:title> <jats:p>A guided, web-based intervention to reduce depression in adults with type 1 and type 2 diabetes is effective in reducing both depressive symptoms and diabetes-specific emotional distress.</jats:p> </jats:sec>

Journal

  • Diabetes Care

    Diabetes Care 38 (5), 776-783, 2015-02-20

    American Diabetes Association

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