Cognitive Behavior Therapy for Depression in Type 2 Diabetes Mellitus: A Randomized, Controlled Trial

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Psychotherapy is the principal nonpharmacologic method for the management of depression, but its usefulness for depressed patients with diabetes remains unknown.


To assess the efficacy of cognitive behavior therapy (CBT) for depression in patients with diabetes.


Randomized, controlled trial.


Referral-based academic medical center.


51 patients with type 2 diabetes and major depression.


Patients were assigned either to a group that received 10 weeks of individual CBT or to a control group that received no specific antidepressant treatment. All patients participated in a diabetes education program to control for the effects of supportive attention and the possible influence of enhanced diabetes control on mood.


Degree of depression was measured by using the Beck Depression Inventory; glycemic control was measured by using glycosylated hemoglobin levels. Outcomes were assessed immediately after treatment and 6 months after treatment.


The percentage of patients achieving remission of depression (Beck Depression Inventory score Conclusions

The combination of CBT and supportive diabetes education is an effective nonpharmacologic treatment for major depression in patients with type 2 diabetes. It may also be associated with improved glycemic control.

Ann Intern Med.1998;129:613-621.

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