Abstract
Subthreshold depression is common in people with type 2 diabetes and is an important risk factor for poor health. Collaborative care is the suggested approach for people with long term conditions and persistent subthreshold depression, with a high-intensity psychological intervention being the recommended treatment. However, there is little evidence that a high-intensity psychological intervention improves subthreshold depression in people with type 2 diabetes. Additionally, its use as a treatment in day to day practice can be difficult and expensive to organise even when a collaborative care approach is utilised. Behavioural activation delivered by the patients? usual diabetes care giver as a treatment for subthreshold depression could be an effective alternative.
Highlights
Type 2 diabetes is a prevalent long term condition
Subthreshold depression and diabetes: People with subthreshold depression will have experienced more than two and less than five depressive symptoms which are present most or all of the time, for at least 2 weeks in duration, and be associated with evidence of social dysfunction [8]. These symptoms are the same as those identified by the criteria as defined by DSM-V for major depression where at least five out of nine depression symptoms need to be present [9]. It is thought around eight percent of people with subthreshold depression progress to major depression within two years of developing symptoms [10,11] carried out a meta-analysis of 42 published studies that included 21,351 adults with diabetes
A randomized controlled trial published since the Cochrane review [27], tested a psychological intervention (CBT) in people with diabetes and subthreshold depression
Summary
Type 2 diabetes is a prevalent long term condition. To control their condition well, people with diabetes need to learn how to self-manage their lifestyle behaviours [1]. It is thought around eight percent of people with subthreshold depression progress to major depression within two years of developing symptoms [10,11] carried out a meta-analysis of 42 published studies that included 21,351 adults with diabetes They found the prevalence of mild or subthreshold depression was 20% compared to nine percent of those without diabetes. A randomized controlled trial published since the Cochrane review [27], tested a psychological intervention (CBT) in people with diabetes and subthreshold depression. They found significant improvement in depressive symptoms and the risk of incident major depression was reduced. When the person is deliberating, the therapist seeks to activate alternative healthy behaviours [35] plan to conduct a systematic review to clarify and further develop theoretical underpinnings for the use of BA interventions in depressed individuals with chronic physical illnesses, and to identify adaptations that have been made to BA interventions for this population
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