Web-based Cognitive Behavioural Therapy (W-CBT) for Diabetes Patients with co-morbid Depression

Period: 2006-2010 
Funding: Dutch Diabetes research Foundation 
Contact person: K. van Bastelaar 
Trial registration: Current Controlled Trials ISRCTN24874457 

Depression is common among people with diabetes, negatively affecting quality of life, treatment adherence and diabetes outcomes. In routine clinical care, diabetes patients are not offered specialized mental health services. Depression therefore often remains untreated. Web-based therapy could potentially be an effective way to improve the reach of psychological care for diabetes patients, at relatively low costs. This study seeks to test the effectiveness of a web-based self-help depression program for people with diabetes and co-morbid depression. 
The effectiveness of a moderated web-based 8-week self-help course for adults with diabetes with co-morbid depression is tested in a randomised trial, using a wait-list controlled design. The intervention is a self-help course tailored to the needs of persons living with diabetes and is offered on an individual basis, with homework assignments and a moderated forum. We aim to include 286 patients (143/143), as power analyses showed that this number is needed to detect an effect size of 0.35, with measurements at baseline, directly after completing the web-based intervention and at 1, 3, 4 and 6 months follow-up. Patients in the control condition are placed on a waiting list, and follow the course 12 weeks after the experimental group. 
Primary outcomes are depressive symptoms and diabetes-specific emotional distress. Secondary outcomes are satisfaction with the course, perceived health status, self-care behaviours, glycaemic control, and days in bed/absence from work. Questionnaires are administered via the Internet. 
The intervention is expected to help improve mood and reduce diabetes-specific emotional distress in diabetes patients with depression, with subsequent beneficial effects on diabetes self-care and glycaemic outcomes. When proven efficacious, the intervention could be disseminated to reach large groups of patients with diabetes and concurrent depressive symptoms. 

SugarBlues or Happinezz?

Websurvey on the prevalence of depressive symptoms in teens with diabetes

Period: 2008-2009 
Funding: Dutch Diabetes Research Foundation
Research Institute: EMGO
Contact: Dr. M. de Wit

Websurvey on the prevalence of depressive symptoms and (un)met mental health needs of youth with diabetes 
BACKGROUND: Among youth with type 1 diabetes depressive symptoms have been found to be common, negatively impacting relationships, school performance and quality of life (QoL) and associated with recurrent hospitalizations and poor metabolic control. Screening for and treatment of depression in youth with diabetes has been advocated (16, 17), yet depression appears often to be missed and under treated. The extent to which depression is under recognized and under treated in youth with diabetes is unknown. 
AIM: With this study we aimed to study rates of depressive symptoms and (un)met mental health needs in Dutch youth with type 1 diabetes.
METHODS: The study was conducted in collaboration with the Dutch Society of Pediatricians and Dutch Working group of Pediatric Diabetes Nurses. Letters were e-mailed or handed out by care providers in outpatient clinics to youth with type 1 diabetes (9-19 years) with information on the survey they were invited to complete on the internet. The site was advertised as a survey on well-being (" The survey consisted of questions about demographic and diabetes related variables, the Children's Depression Survey (CDI), items of the DQOL-Youth and questions about received or wished psychological care. 
Data have been analyzed and a paper has been submitted for publication.