Comparison of integrated behavioral health treatment for internalizing psychiatric disorders in patients with and without Type 2 diabetes.
BACKGROUND
Type 2 diabetes is often comorbid with internalizing mental health disorders and associated with greater psychiatric treatment resistance. Integrating psychotherapy into primary care can help treat internalizing disorders generally. We explored whether such treatment had comparable effectiveness in patients with and without Type 2 diabetes.


METHODS
Participants were 468 consecutive adults (23% male; 62% Hispanic, Mage = 41.46 years) referred by medical staff for psychotherapy appointments to address internalizing symptoms (e.g., depression). After each visit, patients completed a self-report measure and clinicians assessed patient symptom severity. These data and demographics extracted from electronic medical records were analyzed using descriptive and multilevel modeling analyses.


RESULTS
Patients with and without diabetes were similar in types of internalizing disorders experienced and baseline clinician- and self-reported symptomology. Multilevel modeling suggested improvements in self-reported symptomology was comparable across patient groups; however, only patients without diabetes significantly improved according to clinician reports.


CONCLUSIONS
Although findings suggested integrated psychotherapy resulted in comparable patient-reported reductions of internalizing symptoms, these effects were not evident in clinician reports of diabetic patients. Possible reasons for this discrepancy (e.g., reporting biases) are discussed. Integrated psychotherapy for internalizing disorders may be effective for Type 2 diabetic patients, though caution is warranted. (PsycINFO Database Record
National Crime Victims Research and Treatment Center, Medical University of South Carolina.
Arthur R
AR
Andrews
Department of Psychological Science, University of Arkansas.
Debbie
D
Gomez
Department of Psychological Science, University of Arkansas.
Austin
A
Larey
Department of Psychological Science, University of Arkansas.
Hayden
H
Pacl
Department of Psychological Science, University of Arkansas.
Dennis
D
Burchette
Department of Psychological Science, University of Arkansas.
Juventino
J
Hernandez Rodriguez
Department of Psychological Science, University of Arkansas.
Freddie A
FA
Pastrana
Department of Psychological Science, University of Arkansas.
Ana J
AJ
Bridges
D000328:Adult; D001521:Behavior Therapy; D001524:Behavioral Medicine / Q000379:methods*; D019033:Delivery of Health Care, Integrated / Q000145:classification / Q000592:standards*; D003863:Depression / Q000175:diagnosis / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged
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