Poster Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2014

Online depression treatment for people living with diabetes: protocol and preliminary findings (#386)

Lisa Robins 1 2 , Jill Newby 3 , Kay Wilhelm 1 2 4 , Therese Fletcher 2 , Jessica Smith 3 , Trevor Ma 1 , Inika Gillis 2 , Adam Finch 1 , Lesley Campbell 5 , Jerry Greenfield 5 , Gavin Andrews 3
  1. Consultation Liaison Psychiatry, St Vincent's Hospital, Sydney, NSW, Australia
  2. Faces in the Street, St Vincent's Hospital, Sydney, NSW, Australia
  3. Clinical Research Unit for Anxiety and Depression (CRUfaD), St Vincent's Hospital , Sydney, NSW, Australia
  4. School of Psychiatry, University of New South Wales, Randwick, NSW, Australia
  5. Diabetes Centre, St Vincent's Hospital, Sydney, NSW, Australia

Background: depression treatment for people with comorbid diabetes and Major Depressive Disorder (MDD) is of critical importance for both improving quality of life and disease self-management. Depression is under-treated in this population; there is a clear need to develop and evaluate cost—effective and accessible forms of depression treatment.

Aims: to explore the outcomes of the clinician assisted internet Cognitive Behaviour Therapy (iCBT) program for people with comorbid MDD and diabetes compared to those who remain under usual care. We hypothesis that compared to the control group, the treatment group will show: (1) a significant improvement on disorder specific measures (Patient Health Questionnaire; PHQ-9) relative to those in the control group; (2 a decrease in diabetes-related distress. This study will also examine: (1) the effect of iCBT for MDD on disability (as measured by the SF-12 and SDS), general distress (as measured by the K10), (2) the feasibility of these treatments in terms of patient acceptability (as measured by the Credibility/Expectancy Questionnaire; CEQ). We hypothesise that associated disability, and general distress will reduce, and that the program will be acceptable.

Method: recruit 100 people with MDD comorbid with diabetes (either Type 1 or Type 2), and randomly allocated to the: (1) clinician assisted iCBT group (6 fully automated online lessons over 10 weeks) or (2) treatment as usual control group. Measures outlined under aims will be completed at baseline, mid-point, conclusion of treatment, and at 3- and 6-month follow-up. Self-reported HbA1c levels will also be obtained pre- and post intervention. 

Results: preliminary results comparing MDD symptom levels, anxiety, diabetes-specific distress, distress, disability, HbA1c levels, lifestyle factors, adherence to the lessons, homework downloads, satisfaction with the clinician's input and with the treatment will be presented.

Conclusion: if found to be efficacious, iCBT will provide an accessible and cost-effective treatment for people with comorbid depression and diabetes.