Cited by 562Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesDiabetes Management and EducationPsychological Treatments and Assessments

The DOI matches its Crossref record; 47 of the 47 references it cites were found in a registry or an index.

Cognitive Behavior Therapy for Depression in Type 2 Diabetes Mellitus: A Randomized, Controlled Trial

Lustman, Patrick J., Griffith, Linda S., Freedland, Kenneth E., Kissel, Sarah S., Clouse, Ray E.·1998·Annals of Internal Medicine

Abstract

BACKGROUND: Psychotherapy is the principal nonpharmacologic method for the management of depression, but its usefulness for depressed patients with diabetes remains unknown. OBJECTIVE: To assess the efficacy of cognitive behavior therapy (CBT) for depression in patients with diabetes. DESIGN: Randomized, controlled trial. SETTING: Referral-based academic medical center. PATIENTS: 51 patients with type 2 diabetes and major depression. INTERVENTION: Patients were assigned either to a group that received 10 weeks of individual CBT or to a control group that received no specific antidepressant treatment. All patients participated in a diabetes education program to control for the effects of supportive attention and the possible influence of enhanced diabetes control on mood. MEASUREMENTS: Degree of depression was measured by using the Beck Depression Inventory; glycemic control was measured by using glycosylated hemoglobin levels. Outcomes were assessed immediately after treatment and 6 months after treatment. RESULTS: The percentage of patients achieving remission of depression (Beck Depression Inventory score < or = 9) was greater in the CBT group than in the control group: posttreatment, 85.0% of patients in the CBT group (17 of 20) compared with 27.3% of controls (6 of 22) achieved remission (difference, 57.7 percentage points [95% CI, 33 to 82 percentage points]) (P < 0.001); at follow-up, 70.0% of patients in the CBT group (14 of 20) compared with 33.3% of controls (7 of 21) achieved remission (difference, 36.7 percentage points [CI, 9 to 65 percentage points]) (P = 0.03). Post-treatment glycosylated hemoglobin levels were not different in the two groups, but follow-up mean glycosylated hemoglobin levels were significantly better in the CBT group than in the control group (9.5% compared with 10.9%; P = 0.03). CONCLUSIONS: The combination of CBT and supportive diabetes education is an effective nonpharmacologic treatment for major depression in patients with type 2 diabetes. It may also be associated with improved glycemic control.

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Crossref · 10.7326/0003-4819-129-8-199810150-00005

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Metadata

Authors
Lustman, P. J., Griffith, L. S., Freedland, K. E., Kissel, S. S., & Clouse, R. E.
Affiliations
Washington University in St. Louis (US)
Corresponding author
Lustman, Patrick J.
Venue
Annals of Internal Medicine
Published
1998-10-15
Volume
129
Issue
8
Pages
613-621
ISSN
  • 0003-4819 (ISSN-L)
  • 1539-3704
OpenAlex
W1966243965
Cited by
562
References
47
Citations by year
2026: 5 · 2025: 3 · 2024: 8 · 2023: 10 · 2022: 9 · 2021: 7 · 2020: 11 · 2019: 16 · 2018: 16 · 2017: 17 · 2016: 24 · 2015: 20 · 2014: 20 · 2013: 21 · 2012: 28
FWCI
18.00
Type
journal article
Language
en
Open access
closed
Locations
  • Annals of Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Mental Health (R21MH52629, R21MH052629)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
Keywords
cognitive behavioral therapy, depression, type 2 diabetes, major depressive disorder, glycemic control, HbA1c, diabetes education, non-pharmacological treatment, depression remission
MeSH terms
Adult, Aged, Analysis of Variance, Blood Glucose, Depression, Diabetes Mellitus, Type 2, Female, Humans, Male, Middle Aged, Patient Compliance, Patient Education as Topic, Blood Glucose Self-Monitoring, Cognitive Behavioral Therapy

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