Effect of a collaborative care model on anxiety symptoms among patients with depression and diabetes in India: the INDEPENDENT randomized clinical trial
Open accessAbstract
Objective We assessed the impact of a collaborative care intervention on anxiety symptoms among participants in India with comorbid depression, poorly controlled diabetes, and moderate to severe anxiety symptoms.Method We analyzed data from a randomized controlled trial conducted at four diabetes clinics in India. Participants received either collaborative care or usual care. We included only participants who scored ⩾10 on the Generalized Anxiety Disorder-7 (GAD-7) at baseline. We estimated the effect of the intervention on clinically significant reduction in anxiety symptoms; we considered several potential baseline moderators and mediation by anti-depressant use.Results One hundred and seventy-two participants scored 10 or above on the GAD-7 at baseline. Collaborative care participants were more likely than control participants to achieve a clinically significant reduction in anxiety symptoms at 6 and 12 months (65.7% vs. 41.4% at 12 months, p = 0.002); these differences were not sustained at 18 or 24 months. There was little evidence of moderation by participant characteristics at baseline, and effects were not mediated by anti-depressant use.Conclusions Collaborative care for the treatment of depression and type 2 diabetes can lead to clinically significant reductions in anxiety symptoms among patients with anxiety. Effects were notable during the active intervention period but not over the year post-intervention.
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In adults with type 2 diabetes and elevated depressive symptoms, collaborative care demonstrated benefits on anxiety symptoms for up to 1 year.
“Among adults with type 2 diabetes and elevated depressive symptoms, an RCT of collaborative care demonstrated benefits on anxiety symptoms for up to 1 year (380).”
From 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes:<i>Standards of Care in Diabetes—2023</i> (2023) · cites this paper as [380]
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- Authors
- Kemp, C. G., Johnson, L. C. M., Sagar, R., Poongothai, S., Tandon, N., Anjana, R. M., Aravind, S., Sridhar, G. R., Patel, S. A., Emmert-Fees, K., Rao, D., Narayan, K. M. V., Mohan, V., Ali, M. K., & Chwastiak, L. A.
- Affiliations
- Johns Hopkins University (US)
- Emory University (US)
- All India Institute of Medical Sciences (IN)
- Madras Diabetes Research Foundation (IN)
- Diacon Hospital (IN)
- Helmholtz Munich (DE)
- University of Washington (US)
- Corresponding author
- Chwastiak, Lydia A.
- ORCID
- Venue
- General Hospital Psychiatry
- Publisher
- Elsevier BV
- Published
- 2022-01
- Volume
- 74
- Pages
- 39-45
- ISSN
- 0163-8343 (ISSN-L)
- PMC
- PMC8934572
- OpenAlex
- W3215720698
- Cited by
- 21
- References
- 45
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 6 · 2023: 6 · 2022: 7
- FWCI
- 3.55
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- General Hospital Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- mediaTUM – the media and publications repository of the Technical University Munich (Technical University Munich) (submittedVersion, cc-by-nc-nd)
- Site cant be reached (submittedVersion, other-oa)
- PuSH - Publication Server of Helmholtz Zentrum München (submittedVersion)
- Funders
- National Institute of Mental Health (R01MH100390)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- collaborative care, anxiety symptoms, depression, type 2 diabetes, comorbidities, generalized anxiety disorder, antidepressant use, diabetes clinic, India, mediation
- MeSH terms
- Anxiety, Depression, Diabetes Mellitus, Type 2, Humans, India, Primary Health Care
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