Abstract
This study examined whether patients’ expectations of treatment outcome predict treatment completion, homework compliance, and depressive symptom improvement in cognitive behavior therapy (CBT) and mindfulness-based cognitive therapy (MBCT). Study participants were patients with diabetes and comorbid depressive symptoms who were randomized to 8 sessions of either CBT (n = 45) or MBCT (n = 46), both individually delivered. The results showed that high outcome expectations were predictive of post-treatment depressive symptoms in CBT and MBCT, but not of early and mid-treatment symptoms. Patients’ outcome expectations predicted treatment completion in CBT and MBCT as well as homework compliance in MBCT. Homework compliance did not mediate the association between patients’ outcome expectations and post-treatment depressive symptom improvement. The findings do not support the hypothesis that patients’ expectations have an immediate impact on patients’ mental state and partially support the notion that patients are less involved in treatment when they hold low expectations for improvement.
Highlights
The prevalence of depressive symptoms in patients with diabetes is almost twice as high as in individuals without a chronic disease (Roy and Lloyd 2012)
This study examined whether patients’ expectations of treatment outcome predict treatment completion, homework compliance, and depressive symptom improvement in cognitive behavior therapy (CBT) and mindfulness-based cognitive therapy (MBCT)
The average number of performed exercises per week was lower in CBT than in MBCT since fewer homework exercises are assigned in CBT in comparison with MBCT
Summary
The prevalence of depressive symptoms in patients with diabetes is almost twice as high as in individuals without a chronic disease (Roy and Lloyd 2012). There are psychological interventions available that have been shown to be efficacious in reducing depressive symptoms in patients with diabetes, such as cognitive behavior therapy (CBT; Gonzalez et al 2010; Lamers et al 2010; Lustman et al 1998; Penckofer et al 2012; van Bastelaar et al 2011) and mindfulness-based cognitive therapy (MBCT; Schroevers et al 2013; van Son et al 2013). The role of patients’ outcome expectations is examined concerning homework compliance, drop out from treatment, and depressive symptom improvement in individually delivered CBT and MBCT for patients with diabetes and comorbid depressive symptoms
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