• Join over 1.2 million students every month
  • Accelerate your learning by 29%
  • Unlimited access from just £6.99 per month

Would cognitive behavioural therapy in conjunction with routine diabetic treatment be more efficient in managing depression in patients with Type 2 diabetes than routine treatment alone?

Extracts from this document...


Would cognitive behavioural therapy in conjunction with routine diabetic treatment be more efficient in managing depression in patients with Type 2 diabetes than routine treatment alone? Introduction The essay presented below is aimed at finding evidence-based answer to my question: "Would cognitive behavioural therapy (CBT) in conjunction with routine diabetic treatment be more efficient in managing depression in patients with Type 2 diabetes than routine treatment alone?" It also involves the critical appraisal of a study which has tried to answer the above question, followed by the systematic review of 5 articles closely related to the topic. The aim of this essay is to investigate whether psychological interventions in diabetic patients with depression are effective in improving clinical outcomes. When looking into the medical treatment given to diabetic patients nationwide in the UK, I came across several non-pharmacological therapies that could improve the patients' adherence and control over their condition. The efficacy and the cost effectiveness of such therapies combined with usual treatment appeared to be an interesting topic to investigate. I have narrowed down the available therapies and specified my systematic literature search on Cognitive Behaviour Therapy, as its use in the management of depression in diabetes has recently become more popular in the UK and in other countries. Diabetes is showing a steadily growing incidence globally, the occurrence of diabetes among adults was around 6.4% in 2010, reaching 7.7% by 2030. 9% of patients with diabetes also suffer from depressive disorders (Petrak et al. 2010), which in turn leads to poor treatment adherence and hyperglycaemia. The risk of developing cardiovascular disease and retinopathy is greater in patients who have depression. ...read more.


and a guided self-help intervention (SH). Treatment evaluations are conducted by blinded assessors. As clearly identifiable group interventions were compared to treatment as usual, further blinding is not possible. The randomisation process does not open to manipulation from the researchers or the participants thus reducing bias. The aim is to compare the efficacy of the 3 different treatments. Primary and secondary parameters are aiming to reduce depressive symptoms, prevent the occurrence of moderate/severe major depression and improve glycaemic control, mortality and cost effectiveness. The measures being used to determine the outcome of the trial are fitting for a quantitative study. Participants are randomised into groups as: 132 in CBT (diabetes-specific CBT in small groups of 4-8, delivered by psychologists), 132 in SH (guided self-help intervention "Successful ageing with Diabetes", delivered by trained moderators), and 51 in TAU (any treatment option may be applicable). Patients in all groups are having usual diabetic treatment for the first 12 weeks. Thereafter, the two group interventions are receiving one session per month for another year. At the one-year check-up, all groups are being examined as to the primary and secondary outcome variables. A 20% rate of loss to follow-up is expected, accounting for mortality in the sample. All sessions are videotaped and supervised by psychotherapists. Analyses are carried out by the intent-to-treat principle (ITT) including all participants in all groups. In case of any dropouts, the last observation carried forward method (LOCF) will be used in purpose of handling of missing data. The primary outcome variable is HRQoL as measured by the Short Form-36 Mental Component Summary. ...read more.


This study clearly suggests though, that CBT can be effectively applied for the treatment of depression in Type 2 diabetes patients. The evidence found in the above articles indicates that CBT can be successfully used for treatment of depression in Type 2 diabetes patients, and there is evidence that the application of CBT may reduce depressive symptoms and HbA1c. Nevertheless, future research should be done to provide sufficient statistical power and substantiate these preliminary findings. There is lack of clinical trials to support the statement that CBT in conjunction with routine diabetic care would be more efficient in treating depression in Type 2 diabetes than routine care alone. Conclusion The evidence gathered in the process of literature search and literature review backs up the theory that application of CBT when used in conjunction with routine diabetes care is useful in treatment of depression in patients with Type 2 diabetes. CBT seems to have relatively positive short-term results in improving both quality of life and glycaemic control of patients with Type 2 diabetes. However, there is still not enough evidence to state that CBT in conjunction with usual diabetic care would be more effective in treating depression in patients with Type 2 diabetes, which is due to limited research and few clinical trials conducted in the UK in this area. Further research is needed in order to work out the best approaches towards psychological counselling for patients with diabetes and depression. Nevertheless, the information found during the literature search process shows that CBT as additional care is obtaining popularity among patients and health professionals. A well-organised healthcare environment run by health-care professionals who are trained to provide CBT would be beneficial for patients with diabetes. ...read more.

The above preview is unformatted text

This student written piece of work is one of many that can be found in our University Degree Nursing section.

Found what you're looking for?

  • Start learning 29% faster today
  • 150,000+ documents available
  • Just £6.99 a month

Not the one? Search for your essay title...
  • Join over 1.2 million students every month
  • Accelerate your learning by 29%
  • Unlimited access from just £6.99 per month

See related essaysSee related essays

Related University Degree Nursing essays

  1. Community Profile

    This ward makes up around 10% of the lone parent population of the entire city. Education The Black report (1980) acknowledged that the academic success or failure of a person at school ultimately has an effect on their long term health, as it has direct correlations to the type of job they will do.

  2. The purpose of this assignment is to look at psychosocial factors which have influenced ...

    People with internal LoC tend to be more prone to making changes and taking control of their lives. Conner et al (1995). They believe that their health-related outcomes are for the most part determined by their own choices and behaviours and are more likely to make positive changes to their health.

  1. Discussing a patient with type 2 Diabetes Mellitus.

    Obese people have an increased resistance to insulin action and an impaired suppression of glucose production, (Porth, 2002). The signs and symptoms of diabetes appear more rapidly in type 1; type 2 may go undiagnosed for some time due to the slow onset, (Diabetes UK, 2000).

  2. a critique of qualitative study regarding diabetes treatment

    CRITICAL APPRAISAL For analysing the article, the Critical Appraisal Skills Programme (CASP) framework has been chosen. This framework has 10 questions which enables the critiquer to understand qualitative research and therefore allows them to continue to analyse their chosen article.

  1. Stress in the clinical setting - A concept analysis

    Currently, the children are learning how to pronounce words by using flashcards. Mrs. Taylor shows the class the flash card Cinderella and puts the phonetic stress on "sin" when she pronounces the word to her students. This illegitimate case shows the concept of stress out of the normal context in this paper.

  2. Reflective Essay

    There also appeared to be some confusion regarding sexuality and what it meant amongst nursing staff. Reading through assessments carried out by staff had shown that many regarded this as an assessment of patient's marital status. Carter and Green (2002)

  1. HOSPITAL CASE ANALYSIS. This case study takes place at a hospital and is based ...

    - " when ward was being observed, 3 instances of postoperative fever." - "...error was not corrected for 5 hours." Assumptions: We only see perspectives from the students side of them learning. Maybe they don't know it now, but they might be being taught in a good manner.

  2. Case Study. This essay will examine the nursing process involved in managing chronic venous ...

    308-314. Available at: http://www.internurse.com/cgi-bin/go.pl/library/article.cgi?uid=84283;article=PN_22_6_308_314 [Accessed 16 November 2012]. Crumley, C. 2011, ?Post-thrombotic Syndrome Patient Education Based on the Health Belief Model: Self-reported Intention to Comply With Recommendations?, Journal Of Wound, Ostomy & Continence Nursing, Vol.38, No.6, pp. 648-654. Available at: http://gcal.summon.serialssolutions.com/search?s.q=Post-thrombotic+Syndrome+Patient+Education+Based+on+the+Health+Belief+Model%3A+Self-reported+Intention+to+Comply+With+Recommendations [Accessed 28 November 2012]. Cutting, K. 2010, ?Addressing the challenge of wound cleansing in the modern era?, British Journal of Nursing, Vol.

  • Over 160,000 pieces
    of student written work
  • Annotated by
    experienced teachers
  • Ideas and feedback to
    improve your own work