title: Efficacy of a web-based intervention with mobile phone support in treating depressive symptoms in adults with type 1 and type 2 diabetes: a randomized controlled trial.
abstract: OBJECTIVE
  Depression is common in diabetes and linked to adverse health outcomes. This study evaluated the efficacy of a guided web-based intervention in reducing depression in adults with type 1 and type 2 diabetes.
  
  
  METHODS
  A total of 260 participants with diabetes and elevated depressive symptoms (Center for Epidemiologic Studies Depression Scale [CES-D ≥23]) were randomly assigned to the GET.ON Mood Enhancer Diabetes (a guided self-help intervention, n = 130) or a brief online unguided psychoeducation program for depression (n = 130). The primary outcome was depressive symptoms severity (CES-D). The secondary outcomes included diabetes-specific emotional distress (Problem Areas in Diabetes [PAID] scale) and participant satisfaction (adaption CSQ-8). Data were collected at baseline and 2 months after randomization. To identify differences in outcome between the groups, we used analyses of covariance with the baseline CES-D score as covariate on both intent-to-treat (ITT) and per-protocol (PP) basis.
  
  
  RESULTS
  Compared with the control group, the intervention group showed significantly less depressive symptom severity at posttreatment based on ITT (d = 0.89) and PP analyses (d = 1.00). The intervention participants displayed a significantly larger reduction in diabetes-specific emotional distress (d = 0.58, ITT). The intervention appeared to be acceptable to the participants; 95% (n = 121) would recommend the training to a friend with diabetes in need of psychological help.
  
  
  CONCLUSIONS
  A guided, web-based intervention to reduce depression in adults with type 1 and type 2 diabetes is effective in reducing both depressive symptoms and diabetes-specific emotional distress.
authors.affiliation: Division of Online Health Training, Innovation Incubator, Leuphana University Lüneburg, Lüneburg, Germany nobis@inkubator.leuphana.de.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Nobis
authors.affiliation: Division of Online Health Training, Innovation Incubator, Leuphana University Lüneburg, Lüneburg, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Lehr
authors.affiliation: Division of Online Health Training, Innovation Incubator, Leuphana University Lüneburg, Lüneburg, Germany Department of Health Care Policy, Harvard University, Boston, MA Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.
authors.forename: David Daniel
authors.initials: DD
authors.lastname: Ebert
authors.affiliation: Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, Albert-Ludwigs-University Freiburg, Freiburg, Germany.
authors.forename: Harald
authors.initials: H
authors.lastname: Baumeister
authors.affiliation: Institute for Health and Care Research (EMGO), VU University Medical Centre, Amsterdam, the Netherlands Department of Medical Psychology, VU University Medical Centre and Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Frank
authors.initials: F
authors.lastname: Snoek
authors.affiliation: Division of Online Health Training, Innovation Incubator, Leuphana University Lüneburg, Lüneburg, Germany Institute for Health and Care Research (EMGO), VU University Medical Centre, Amsterdam, the Netherlands Department of Clinical Psychology, VU University, Amsterdam, the Netherlands Institute of Telepsychiatry, University of Southern Denmark, Odense, Denmark.
authors.forename: Heleen
authors.initials: H
authors.lastname: Riper
authors.affiliation: Division of Online Health Training, Innovation Incubator, Leuphana University Lüneburg, Lüneburg, Germany Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Berking
mesh_terms: D000328:Adult; D000339:Affect; D040421:Cell Phone; D003866:Depressive Disorder / Q000517:prevention & control*; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods; D017060:Patient Satisfaction; D011613:Psychotherapy / Q000379:methods*; D012648:Self Care / Q000379:methods