Abstract
Purpose: A number of studies, including systematic reviews, show beneficial effects of psychosocial interventions for people with diabetes mellitus; however, they have not been assessed using meta-analysis. The purpose of this meta-analysis of randomized controlled trials is to investigate the effects of psychosocial interventions on depressive and anxiety symptoms, quality of life and self-efficacy in individuals with diabetes mellitus.Methods: The databases Pubmed, MEDLINE, CINAHL, PsycINFO, Scopus, Web of Science and SocINDEX were searched with no year restriction. Eligible studies were randomized controlled trials published in English that included individuals diagnosed with diabetes mellitus, aged 18 years or above, who engaged in a psychosocial intervention, with outcome measures addressing depressive or anxiety symptomology, quality of life or self-efficacy. Eligible studies needed to compare the intervention to usual care. Study selection was completed using Covidence and meta-analysis was undertaken using Comprehensive Meta-Analysis software.Results: Seven studies were included in the meta-analysis. Five studies investigated the effects of psychosocial interventions and showed a medium to large benefit for depressive symptoms (SMD: −0.70; CI: −1.27, −0.13) which persisted at follow up (SMD: −1.54, CI: −2.97, −0.12). Similar results were not seen immediately post-intervention in the three studies that assessed anxiety symptoms (SMD: −0.30; CI: −0.69, 0.10); however, a medium beneficial effect was seen at follow up (SMD = −0.61, CI = −0.92 to −0.31). Small benefits were seen in the three studies assessing quality of life outcomes (SMD: 0.30, CI: 0.06, 0.55). No benefit was seen in the two studies assessing self-efficacy (SMD: 0.23, CI: −0.11, 0.57).Conclusions: The results of the current study provide preliminary evidence that psychosocial interventions, compared to usual care, reduce depressive symptoms, and may improve quality of life in individuals with diabetes. However, only a few studies were included and the clinical significance of these findings is unknown.
Highlights
The worldwide burden of diagnosed diabetes mellitus (DM) was approximately 422 million in 2014 (NCD-RisC, 2016)
In all but one study (Kuijer et al, 2007) participants were diagnosed with type II diabetes
56% of participants were diagnosed with DM and 44% with asthma; only data relating to individuals with DM have been included here (Kuijer et al, 2007)
Summary
The worldwide burden of diagnosed diabetes mellitus (DM) was approximately 422 million in 2014 (NCD-RisC, 2016). This number is expected to reach 592 million by 2035 (Guariguata et al, 2014) and an additional 174 million individuals are estimated to have undiagnosed DM (Beagley et al, 2014). Given the high prevalence of DM and associated impact on individuals and communities, it is important to understand the factors influencing wellbeing to achieve the best possible quality of life (QoL) for individuals with DM. Depressive and anxiety disorders are highly prevalent among individuals with chronic disease (Moussavi et al, 2007), including DM. The incorporation of psychological wellbeing in the management of DM is commonplace in national standards of care (Craig et al, 2011)
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