The Impact of Cognitive Behavioral Therapy on Depressive Symptoms in Patients with Type 2 Diabetes Mellitus

Abstract

Background: Diabetes and depression are major issues globally, with CBT identified as the most effective treatment for depression. Self-help CBT in Pakistan has shown positive results for depression treatment. A study has found that CBT leads to a higher remission rate for depression in Type 2 diabetes patients, highlighting the need for proper treatment of diabetes-related depression to improve health outcomes.Methods: In a randomized controlled trial a total of 32 patients with diabetes and depression were allocated to CBT therapy (n=16) and controls without CBT therapy (n=16). The study was conducted at the Department of Psychiatry, and diabetic’s clinic of Department of General Medicine, Pakistan Institute of Medical Sciences, Islamabad, in a period of 2 months. Known cases of Type 2 Diabetes fulfilling the diagnostic criteria of Depression and anxiety using DSM –V research criteria, and who lived within the catchment area were approached. Formal approval from hospital ethical committee and written informed consent from participants were obtained. Those persons, who agreed to enter the study, were assessed 2 weeks after the first screening, to fill in the baseline measures when they attended their first appointment. These persons were asked to attend further appointments and were assessed every two weeks till end of the study final assessment were made. Results: The mean age of patients was 50.9 + 7.5 years in group A (CBT) and 45.4 + 10.1 years in group B (without CBT). Male and female cases were equally selected in both groups respectively. The mean HADS was found similar at baseline in both study groups while post intervention phases in group A, greater improvement was observed (8.8 + 2.6) compared to (10.3 + 2.9) in group B. The WHO quality of life scale was almost similar in both groups at baseline, however, greater improvement in quality of life was observed in group A (90.7 + 9.0) compared to group B (82.1 + 13.9) and the difference in mean WHOQOL was found statistically significant (p-value = 0.04). Conclusions: The CBT intervention has a clear role in the management of depression in diabetic patients. In this study it has shown significant improvement in the health and depression scales and also in the overall quality of life according to WHO scale.