Abstract
This meta-analysis was performed to evaluate the effect of cognitive behavioural therapy (CBT) in improving the depression symptoms of patients with diabetes. Literature search was conducted in PubMed and Embase up to October 2016 without the initial date. The pooled SMD (standard mean difference) and its 95% confidence interval (CI) were calculated by Revman 5.3. Subgroup analyses were performed by type of diabetes and evaluation criteria of depression. A total of five randomized control trials involving 834 patients with diabetes mellitus (including 417 patients in CBT group and 417 patients in control group) were included in this meta-analysis. The pooled estimates indicated significant improvement of depression by CBT compared with routine approaches in overall outcomes (SMD =–0.33, 95% CI =–0.46 to –0.21, P<0.00001), post-intervention outcomes (SMD =–0.43, 95% CI =–0.73 to –0.12, P=0.006) and outcomes after 12 months intervention (SMD =–0.38, 95% CI = –0.54 to –0.23, P<0.0001). Subgroup analyses showed that the results were not influenced by the type of diabetes. However, the effect of CBT on improving the depression symptoms disappeared when only using CES-D (Centre for Epidemiological Studies scale for Depression) to evaluate depression.
Highlights
Both diabetes and depression were highly prevalent health problems and there was interrelationship between diabetes and depression [1]
All included studies should meet the following criteria: (i) study type should be randomized control trial (RCT); (ii) participants were patients with diabetes mellitus aged older than 18 years; (iii) the effect of Cognitive behavioural therapy (CBT) (CBT group) on the depression symptoms was evaluated by comparing with usual care or other routine therapies in patients with diabetes mellitus; (iv) the outcomes of depression symptoms were evaluated
67 articles were removed by scanning the titles or abstracts: 17 non-original articles, 29 articles not about CBT, 6 articles on adolescents or children and 15 non-RCTs, according to the inclusion and exclusion criteria
Summary
Both diabetes and depression were highly prevalent health problems and there was interrelationship between diabetes and depression [1]. Some studies with high risk of attrition bias (which reported incomplete outcome data) were used and analyzed in that previous meta-analysis [20,21,22]. We performed this meta-analysis to further evaluate the effect of CBT on depression symptoms in patients with diabetes c 2017 The Author(s).
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