Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Diabet Med. 2022 Nov;39(11):e14948. doi: 10.1111/dme.14948. Epub 2022 Sep 16.
Diabetes-related distress is common in diabetes and has implications for well-being. Cognitive behavioural therapy (CBT) and third-wave CBT hold promise as treatments for diabetes-related distress, although previous findings are inconclusive. We aimed to conduct a systematic review with meta-analysis to understand the efficacy of these interventions in treating diabetes-related distress, while also assessing the associative benefits of these interventions on depression, anxiety and glycaemic control. We also aimed to conduct a narrative synthesis, and subgroup analyses to identify intervention components most useful in treating diabetes-related distress.
We searched seven electronic databases from inception to April 2021. Data extraction was independently performed by two reviewers. Methodological quality was assessed. The protocol was registered with the Prospective Register Of Systematic Reviews (PROSPERO): CRD42021240628.
We included 22 randomised controlled trials investigating the efficacy of CBT and third-wave CBT interventions on diabetes-related distress. CBT for diabetes-related distress significantly reduced distress (SMD = -0.278, p = 0.010) and depression (SMD = -0.604, p = 0.016). Third-wave CBT for diabetes-related distress significantly reduced anxiety (SMD = -0.451, p = 0.034). No significant effect of either intervention on glycated haemoglobin was observed. CBT interventions that included a digital component, were delivered by a psychological practitioner, and included behavioural activation bolstered the effects on diabetes-related distress.
CBT aiming to target diabetes-related distress is beneficial for distress and depression. Third-wave CBT for diabetes-related distress is beneficial for anxiety. More work is needed to optimise interventions to improve both mental and physical health outcomes in people with diabetes.
糖尿病相关困扰在糖尿病患者中很常见，对幸福感有影响。认知行为疗法（CBT）和第三波认知行为疗法有望成为治疗糖尿病相关困扰的方法，但之前的研究结果并不一致。我们旨在进行系统评价和荟萃分析，以了解这些干预措施治疗糖尿病相关困扰的疗效，同时评估这些干预措施对抑郁、焦虑和血糖控制的关联益处。我们还旨在进行叙述性综合分析，并进行亚组分析，以确定治疗糖尿病相关困扰最有用的干预措施组成部分。
我们从创建到 2021 年 4 月搜索了七个电子数据库。两名评审员独立进行数据提取。评估方法学质量。该方案已在系统评价前瞻性注册库（PROSPERO）中注册：CRD42021240628。
我们纳入了 22 项随机对照试验，研究了 CBT 和第三波 CBT 干预措施对糖尿病相关困扰的疗效。CBT 治疗糖尿病相关困扰可显著降低困扰（SMD=-0.278，p=0.010）和抑郁（SMD=-0.604，p=0.016）。第三波 CBT 治疗糖尿病相关困扰可显著降低焦虑（SMD=-0.451，p=0.034）。两种干预措施对糖化血红蛋白均无显著影响。包含数字组件、由心理从业者提供、包含行为激活的 CBT 干预措施可增强对糖尿病相关困扰的疗效。
旨在针对糖尿病相关困扰的 CBT 对困扰和抑郁有益。第三波 CBT 治疗糖尿病相关困扰对焦虑有益。需要进一步努力优化干预措施，以改善糖尿病患者的身心健康结局。
