Treatment of Depression in Diabetes: an Update

Frank Petrak; Stephan Herpertz

Disclosures

Curr Opin Psychiatry. 2009;22(2):211-217. 

In This Article

What is the Best Treatment for Depression in Diabetes?

Because the ideal treatment for depression in diabetes would demonstrate positive effects on medical and psychological outcomes at the same time, this criterion of a combined effect was applied to evaluate the studies described in the following sections.

Psychological Interventions

The best results were observed for counseling[25] and CBT;[24] however, because of the limitations of these studies, more data are needed before the results can be generalized.

Pharmacological Interventions

With the exception of minor depression in elderly patients,[23•] various antidepressants seem to be effective for the treatment of depression in patients with diabetes;[20,21,22] however, regarding the medical outcome variables of diabetes, no benefit of pharmacological treatments has yet been demonstrated conclusively.

Mixed Interventions

Flexible algorithm-based care, including various psychological and psychopharmacological approaches, are the treatments that provide the best scientific evidence of the successful treatment of depression; moreover, there is some evidence that treatment of depression could reduce mortality.[30••] But no positive effect on glycemic control could be observed in the mixed interventions. Because of the combination of interventions in these mixed RCTs, it was not possible to identify the effective components of treatment or evaluate claims of the superiority of one new treatment in comparison with another.

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