The limited efficacy of psychological interventions for depression in people with Type 1 or Type 2 diabetes: An Individual Participant Data Meta-Analysis (IPD-MA)



Mather, Sarah, Fisher, Peter ORCID: 0000-0002-7388-720X, Nevitt, Sarah ORCID: 0000-0001-9988-2709, Cherry, Mary Gemma, Maturana, Camila, Warren, Jasmine G ORCID: 0000-0001-6676-2954 and Noble, Adam ORCID: 0000-0002-8070-4352
(2022) The limited efficacy of psychological interventions for depression in people with Type 1 or Type 2 diabetes: An Individual Participant Data Meta-Analysis (IPD-MA). JOURNAL OF AFFECTIVE DISORDERS, 310. pp. 25-31.

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Abstract

<h4>Background</h4>People with either Type 1/Type 2 diabetes experiencing anxiety or depression experience worse clinical and social outcomes. Efficacy of available psychological and pharmacological treatments for anxiety and depression is unclear. Aggregate data meta-analyses (AD-MAs) have failed to consider the clinical relevance of any change these treatments elicit. Thus, we sought to complete an individual participant data meta-analysis (IPD-MA) to evaluate this.<h4>Methods</h4>Eligible RCTs of psychological treatments (PTs) and pharmacological treatments (PhTs) were systematically identified and assessed using the Cochrane Risk of Bias Tool-2. IPD was requested and Jacobson's methodology was used to determine the clinical relevance of symptom-change. Traditional effect sizes were calculated to permit comparison of trials providing and not providing IPD and to compare with AD-MAs.<h4>Results</h4>Sufficient data was obtained to conduct an IPD-MA for PTs (12/25) but not PhTs (1/5). Across PT trials, rates of 'recovery' for depression post-intervention were low. Whilst significantly more treated patients did recover (17% [95% CI 0.10, 0.25]) than controls (9% [95% CI 0.03, 0.17]), the difference was small (6% [95% CI 0.02, 0.10]).<h4>Limitations</h4>Only 50% of eligible trials provided IPD; we were also only able to examine outcomes immediately following the end of an intervention.<h4>Conclusion</h4>Current psychological interventions offer limited benefit in treating anxiety and depression in people with Type 1 or Type 2 diabetes (83% remain depressed). More efficacious interventions are urgently needed.

Item Type: Article
Uncontrolled Keywords: Anxiety, Depression, Diabetes, Clinical significance, IPD-MA
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Population Health
Depositing User: Symplectic Admin
Date Deposited: 05 May 2022 08:32
Last Modified: 18 Jan 2023 21:04
DOI: 10.1016/j.jad.2022.04.132
Open Access URL: https://doi.org/10.1016/j.jad.2022.04.132
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URI: https://livrepository.liverpool.ac.uk/id/eprint/3154284