Cognitive Behavior Therapy for Diabetes Distress, Depression, Health Anxiety, Quality of life and Treatment Adherence among patients with Type- II Diabetes Mellitus: A Randomized Control Trial

Objective: Diabetes distress typically causes depression common comorbidity of diabetes unpleasantly affects patients' medical and mental functions. Psychotherapeutic interventions are effective treatments to treat depressive disorders and improve the quality of life in chronic diseases as well as in patients with diabetes. The present study aimed to investigate the efficacy of cognitive behavior therapy (CBT) with experimental and waitlist control conditions to treat depression in patients with type 2 diabetes mellitus (T2DM). Materials and Methods A total of 130 outpatients with diabetes and depression were assessed in this randomized control trial and 90 patients were randomized to CBT with experimental (n = 45) and waitlist control (n = 45) conditions. All the patients completed clinical interviews and assessment measures at pre-and post-assessment 16 weeks intervals. Diabetes Distress Scale (DDS) and Patient Health Questionnaire (PHQ) were used to assess primary outcomes. Short Health Anxiety Inventory (SHAI), Revised Version of Diabetes Quality of Life Questionnaire (DQLQ), and General Medication Adherence Scale (GMAS) were used to investigate secondary outcomes. Results The findings indicated that patients received CBT significantly decreased the level of diabetes distress F(1,60) = 222.710, P  < 0.001, η 2  = .788), depression F(1,60) = 94.436, P  < 0.001, η 2  = .611), health anxiety F(1,60) = 201.915, P < . 0.001, η 2  = 771) as compared to waitlist control condition. Moreover, participants received CBT significantly improved the quality of life F(1,60) = 83.352, P <  0.001, η 2  = .581), treatment adherence F(1,60) = 67.579, P <  0.001, η 2  = .566) and physical activity schedule F(1,60) = 164.245, P < .0.001, η 2  = .736 as compared to a waitlist control condition. Conclusion It is concluded that cognitive behavior therapy is an effective and promising intervention for depressive symptoms, diabetes distress, and health anxiety which also help the person to promote quality of life, treatment adherence and physical activity.