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

Diabetes Care. 2015 May;38(5):776-83. doi: 10.2337/dc14-1728. Epub 2015 Feb 20.


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.

Research design and 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.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Affect
  • Cell Phone*
  • Depressive Disorder / prevention & control*
  • Diabetes Mellitus, Type 1 / psychology*
  • Diabetes Mellitus, Type 2 / psychology*
  • Female
  • Health Behavior
  • Humans
  • Internet*
  • Male
  • Middle Aged
  • Patient Compliance
  • Patient Education as Topic / methods
  • Patient Satisfaction
  • Psychotherapy / methods*
  • Self Care / methods