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Group therapy helps depressed women with diabetes

Wednesday October 10, 2012
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Gender-specific group therapy is effective for treating depressed women with type 2 diabetes, according to a study.

The researchers explored an alternative treatment to antidepressants, which may disrupt glucose control and can be associated with increased weight gain. "Using antidepressants to treat depression, although important, can be associated with side effects that make compliance an issue for people with diabetes or those at risk for diabetes," Sue Penckofer, RN, PhD, a study co-author and professor and faculty scholar at Loyola University Chicago Marcella Niehoff School of Nursing, said in a news release.

"This makes other options, such as cognitive-behavior therapy, increasingly important for diabetics with depression."

Depression is present in 25% of people with type 2 diabetes and occurs twice as often in women as in men with the disease. The researchers evaluated women with significantly elevated depressive symptoms.

About half the study participants received a nurse-delivered group therapy program called SWEEP (Study of Women’s Emotions and Evaluation of a Psychoeducational), a form of group therapy based on cognitive-behavior principles developed for women with type 2 diabetes, with the other half receiving routine care. Regular contact with a physician and clinic staff also was available to both groups.

The researchers said SWEEP is the first cognitive-behavior therapy to treat symptoms in depressed women in a group setting and to demonstrate an improvement in depression and other emotions.

Those who participated in the group therapy learned how blood sugar affects the symptoms of depression, anxiety and anger. They also were taught how to recognize signs of stress and how to think differently and identify other methods to decrease negative thoughts, improve self-care behaviors and communicate effectively.

Multilevel modeling indicated that SWEEP was more effective than usual care in reducing depression, decreasing trait anxiety and improving anger expression, the researchers reported. Although SWEEP and UC had improvements in fasting glucose and HbA1c, there were no statistically significant differences between groups.

"Additional work needs to be done to develop treatment options that address the emotional needs of people with type 2 diabetes," Penckofer said. "The next step would be to explore other tailored group cognitive-therapy programs for depression based on gender, race or disease. This is particularly important since depression is associated with relapse, and use of cognitive therapy is associated with a lower relapse rate."

The study, funded by the National Institute of Nursing Research, appears in the October issue of the Annals of Behavioral Medicine. The study abstract is available at www.springerlink.com/content/u625514101482388/.

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