Systematic review and meta‐analysis of psychological interventions in people with diabetes and elevated diabetes‐distress |
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| Authors: | C B Schmidt B J Potter van Loon A C M Vergouwen F J Snoek A Honig |
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| Institution: | 1. Departments of Psychiatry, Amsterdam, The Netherlands;2. Departments of Amsterdam Public Health Research Institute, Amsterdam, The Netherlands;3. Departments of Internal Medicine, OLVG, Amsterdam, The Netherlands;4. Department of Medical Psychology, Academic Medical Centre (AMC), Amsterdam, The 5. Netherlands;6. Departments of Medical Psychology, Amsterdam, The Netherlands;7. Departments of Psychiatry, VU Medical Centre, Amsterdam, The |
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| Abstract: | Aims The clinical relevance of diabetes‐distress is increasingly recognized, but little is known about the efficacy of interventions specifically targeted to treat elevated diabetes‐distress. Therefore, this systematic review sought to determine the efficacy of psychological interventions aimed at treating elevated diabetes‐distress in people with Type 1 or Type 2 diabetes. Methods We systematically searched literature from five databases. Randomized controlled trials (RCTs) with an English abstract, describing the results of a psychological intervention in adults with diabetes were included. Articles were eligible for inclusion if the primary outcome was diabetes‐distress measured by the Problem Areas in Diabetes Scale (PAID‐5/PAID‐20) or the Diabetes Distress Scale (DDS‐17). Only mean group diabetes‐distress values above cut‐off at baseline or the results of a subgroup above cut‐off (PAID‐5 ≥ 8, PAID‐20 ≥ 40 or DDS‐17 ≥ 3) were included. Results The search yielded 8907 articles. After removing 2800 duplicates, 6107 articles remained. Titles and abstracts were screened, leaving 394 potential articles of interest, nine of which were RCTs. In a random‐effects meta‐analysis, the pooled effect size for diabetes‐distress was 0.48 (Cohen's d), Z = 3.91, P < 0.0001. Statistical heterogeneity was I² = 46.67% (confidence intervals 45.06% to 48.28%). Diabetes‐tailored psychological interventions reduced HbA1c (Cohen's d = 0.57), whereas mindfulness‐based interventions did not (Cohen's d = 0.11). Conclusions This systematic review shows that specifically diabetes‐tailored psychological interventions are effective in reducing elevated diabetes‐distress and HbA1c. More rigorous studies are warranted to establish the full potential of these interventions. PROSPERO database registration ID: CRD42017075290. |
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