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Original Research
Cognitive Behavioral Therapy Versus Sertraline in Patients With Depression and Poorly Controlled Diabetes: The Diabetes and Depression (DAD) Study
Frank Petrak, Stephan Herpertz, Christian Albus, Norbert Hermanns, Christoph Hiemke, Wolfgang Hiller, Kai Kronfeld, Johannes Kruse, Bernd Kulzer, Christian Ruckes, Daniela Zahn, Matthias J. Müller
Diabetes Care 2015 Feb; dc141599. https://doi.org/10.2337/dc14-1599
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Abstract

OBJECTIVE This study compared the long-term efficacy of a diabetes-specific cognitive behavioral group therapy (CBT) with sertraline in patients with diabetes and depression who initially responded to short-term depression treatment.

RESEARCH DESIGN AND METHODS A randomized, controlled, single-blind trial was conducted in 70 secondary care centers across Germany comparing 12 weeks of CBT with sertraline in 251 patients with type 1 or 2 diabetes (mean HbA1c 9.3%, 78 mmol/mol) and major depression (Structured Clinical Interview for DSM-IV [SCID]). After 12 weeks, treatment responders (≥50% reduction Hamilton Depression Rating Scale [HAMD-17]) were included in the 1-year study phase where CBT patients were encouraged to use bibliotherapy and sertraline patients received continuous treatment. We analyzed differences for HbA1c (primary outcome) and reduction (HAMD-17) or remission (SCID) of depression from baseline to the 1-year follow-up using ANCOVA or logistic regression analysis.

RESULTS After 12 weeks, 45.8% of patients responded to antidepressant treatment and were included in the 1-year study phase. Adjusted HbA1c mean score changes from baseline to the end of the long-term phase (−0.27, 95% CI −0.62 to 0.08) revealed no significant difference between interventions. Depression improved in both groups, with a significant advantage for sertraline (HAMD-17 change: −2.59, 95% CI 1.15–4.04, P < 0.05).

CONCLUSIONS Depression improved under CBT and sertraline in patients with diabetes and depression, with a significant advantage for sertraline, but glycemic control remained unchanged. CBT and sertraline as single treatment are insufficient to treat secondary care diabetes patients with depression and poor glycemic control.

  • Received June 30, 2014.
  • Accepted January 11, 2015.
  • © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.
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Diabetes Care: 44 (4)

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April 2021
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Cognitive Behavioral Therapy Versus Sertraline in Patients With Depression and Poorly Controlled Diabetes: The Diabetes and Depression (DAD) Study
Frank Petrak, Stephan Herpertz, Christian Albus, Norbert Hermanns, Christoph Hiemke, Wolfgang Hiller, Kai Kronfeld, Johannes Kruse, Bernd Kulzer, Christian Ruckes, Daniela Zahn, Matthias J. Müller
Diabetes Care Feb 2015, dc141599; DOI: 10.2337/dc14-1599

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Cognitive Behavioral Therapy Versus Sertraline in Patients With Depression and Poorly Controlled Diabetes: The Diabetes and Depression (DAD) Study
Frank Petrak, Stephan Herpertz, Christian Albus, Norbert Hermanns, Christoph Hiemke, Wolfgang Hiller, Kai Kronfeld, Johannes Kruse, Bernd Kulzer, Christian Ruckes, Daniela Zahn, Matthias J. Müller
Diabetes Care Feb 2015, dc141599; DOI: 10.2337/dc14-1599
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