Psychosocial intervention for patients with type 2 diabetes mellitus and comorbid depression: a meta-analysis of randomized controlled trials.

Background: The efficacy of psychosocial intervention has been proven in treatment of diabetic patients with depression in some studies. This meta-analysis was conducted to explore the efficacy as well as additional effects of this method during diabetic management in patients with type 2 diabetes mellitus (T2DM) and comorbid depression. Methods: Electronic databases were searched from March 2000 to March 2017 for randomized controlled trials (RCTs) studying the effects of psychosocial intervention on T2DM patients with depression. There was no language limitation. Outcome measurements were symptoms of depression and anxiety, as well as glycemic control. A random effects model was conducted. Results: In total, 31 RCTs composed of 2,616 patients were eligible for this analysis. The psychosocial intervention was effective for depression symptoms with pooled standardized mean difference (SMD) of -1.50 (95% CI =-1.83, -1.18) and anxiety symptoms with SMD of -1.18 (95% CI =-1.50, -0.85). Meanwhile, the additional effects indicated a better improvement of glycemic control, including the fasting blood-glucose with SMD of -0.93 (95% CI =-1.15, -0.71), 2-hour postprandial plasma glucose with SMD of -0.84 (95% CI =-1.13, -0.56), and hemoglobin A1c with SMD of -0.81 (95% CI =-1.10, -0.53). Conclusion: These results demonstrate that the psychosocial intervention is very effective in treating T2DM patients with depression.