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Cited by 20Digital Mental Health InterventionsDiabetes Management and EducationAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Web-Based Interventions for Depression in Individuals with Diabetes: Review and Discussion

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Franco, Pamela, Gallardo, Ana María, Urtubey, Xavier·2018·JMIR Diabetes
DOI 10.2196/diabetes.9694PMC PMC6238863

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Abstract

BACKGROUND: Depression is twice as common in people with diabetes, and this comorbidity worsens the course of both pathologies. In clinical practice guidelines, screening and treatment of depression in patients with diabetes are highly recommended. However, depression is still both underrecognized and undertreated. To find ways to enhance their reach, psychological treatments have taken advantage of benefits of internet and technological devices as delivery formats, providing interventions that require considerably less (or even no) interaction time with therapists. Web-based treatments hold promise for effective interventions at low cost with positive results. OBJECTIVE: The objectives of this review were to describe Web-based interventions for depression in individuals with diabetes and to discuss these studies' procedures and findings in light of evidence from a wider range of interventions for depression and diabetes. METHODS: A comprehensive literature search was conducted in PsycINFO and MEDLINE electronic databases. Studies were included when they met the following selection criteria: the study was available in a peer-reviewed journal mainly publishing studies written in either English or Spanish; the studied sample comprised individuals with diabetes; the intervention targeted depression symptomatology; the intervention was accessible via the internet; and the intervention was accessible via the internet with little or no clinician support. RESULTS: Overall, 5 research studies were identified in the review. All studies were randomized controlled trials, and most used a wait list as a control; 4 studies reported treatment dropout, rates of which varied from 13% to 42%. Studies supported the notion that the Web-based format is a suitable psychology service delivery option for diabetic individuals with depression (effect size range for completers 0.7-0.89). Interventions varied in their characteristics but most were clinical-assisted, had a cognitive behavioral therapy approach, used diabetes-specific topics, had a weekly modular display, used homework assignments, and had some adherence management strategy. These characteristics are consistent with the intervention features associated with positive results in the literature. CONCLUSIONS: The analyzed studies' findings and procedures are discussed in light of evidence drawn from a wider range of reviews on Web-based interventions for depression and diabetes. Consistent with previous research on depression treatment, Web-based interventions for depression among individuals with diabetes have shown positive results. Future research should contribute new evidence as to why these interventions are effective, for whom, and which particular aspects can increase patients' adherence.

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  • Evidence regarding potential beneficial effects of the implementation of peer support in IMI targeting depression in chronic medical conditions is still very limited (Franco et al., 2018).

    “Also, evidence regarding potential beneficial effects of the implementation of peer support in IMI targeting depression in chronic medical conditions is still very limited (Franco et al., 2018).”

    From Involving patients' perspective in the development of an internet- and mobile-based CBT intervention for adolescents with chronic medical conditions: Findings from a qualitative study (2021) · cites this paper as Franco et al., 2018

    The Discussion (Main Results and Comparisons with Previous Work; page unavailable) says only one reviewed intervention incorporated peer support and that evidence for peer support in depression interventions is limited and inconsistent. The review concerns people with diabetes, however, so it does not establish the same conclusion across chronic medical conditions generally. (LLM, conf=0.86)

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Authors
Franco, P., Gallardo, A. M., & Urtubey, X.
Affiliations
  • Universidad del Desarrollo (CL)
  • Pontificia Universidad Católica de Chile (CL)
Corresponding author
Franco, Pamela
ORCID
Venue
JMIR Diabetes
Publisher
JMIR Publications Inc.
Published
2018-09-14
Volume
3
Issue
3
Pages
e13
ISSN
2371-4379 (ISSN-L)
DOI
10.2196/diabetes.9694
PMC
PMC6238863
OpenAlex
W2807819410
Cited by
20
References
77
Citations by year
2026: 1 · 2024: 4 · 2023: 2 · 2022: 3 · 2021: 4 · 2020: 4 · 2019: 2
FWCI
0.34
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • JMIR Diabetes (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
depression, diabetes mellitus, online intervention, cognitive behavioral therapy, medication adherence, treatment discontinuation, digital mental health

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