Treatment of Depression in Diabetes: an Update

Frank Petrak; Stephan Herpertz

Disclosures

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

In This Article

What Will we Learn From Ongoing Research on Depression Treatment in Diabetes?

According to the metaRegister of Controlled Trials and other sources, we can expect results within the next 3 years from at least 12 RCTs that cover the topic of depression and diabetes ( Table 2 ).[31,32,33•,34,35,36,37,38,39,40•,41]

Pharmacological Trials

The effects of fish oil added to antidepressants in patients with depression and diabetes are currently being assessed. Sertraline will be compared with placebo for underserved Hispanics and African-Americans who have diabetes and major depression.

Psychological Treatments

Five RCTs focus predominantly on minor-to-moderate depression. We can expect new knowledge about psychoeducation, web-based CBT, diabetes-specific CBT, CBT that focuses on adherence to treatment, and diabetes-specific CBT that is directed toward elderly patients in particular.

Mixed Interventions

Two more algorithm-based treatment trials are ongoing or completed; first, combined treatment with computer-based CBT and escitalopram vs. computer-based CBT and placebo; and second, diabetes-specific CBT compared with sertraline in patients who have both poorly controlled diabetes and major depression.

Hence, we can look forward to a significant increase in knowledge about psychological treatments regarding different subgroups of patients and specific interventions. We anticipate data concerning the question of whether antidepressant medication is superior to CBT in diabetes and major depression. Finally, we can expect answers to the question of whether combinations of antidepressants with CBT are more effective than CBT alone.

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