NCT01527981

Brief Summary

This study is a pilot behavioral intervention trial, designed to initially examine cognitive behavioral therapy for medical adherence and depression (CBT-AD) in patients with depression and poorly controlled type 1 diabetes.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
9

participants targeted

Target at below P25 for phase_2 depression

Timeline
Completed

Started Mar 2008

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

March 1, 2008

Completed
2.7 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

November 1, 2010

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

November 1, 2010

Completed
1.2 years until next milestone

First Submitted

Initial submission to the registry

January 31, 2012

Completed
7 days until next milestone

First Posted

Study publicly available on registry

February 7, 2012

Completed
Last Updated

February 7, 2012

Status Verified

February 1, 2012

Enrollment Period

2.7 years

First QC Date

January 31, 2012

Last Update Submit

February 3, 2012

Conditions

Keywords

DepressionDiabetesAdherenceMedicationGlucoseInsulin

Outcome Measures

Primary Outcomes (3)

  • Changes in glucose monitoring

    We used electronic glucometers to measure participants' adherence to prescribed glucose self-monitoring, which record each time glucose was measured and the glucose level of each measurement.

    Baseline assessment; 4, 8, and 12 months post-intervention assessments

  • Changes in insulin adherence

    We assessed adherence to participants' self-administered insulin through a self-report questionnaire.

    Baseline assessment; 4, 8, and 12 months post-intervention assessments

  • Changes in depression severity

    Participants' depression severity was measured by clinician-administered measures (Montgomery-Asberg Depression Rating Scale) and self-report measures (Center for Epidemiological Studies Depression Scale). Clinician-delivered measures were administered at baseline and follow-up assessments by assessors blinded to participants' randomization status.

    Baseline assessment; 4, 8, and 12 months post-intervention assessments

Secondary Outcomes (2)

  • Changes in hemoglobin A1C

    Baseline assessment; 4, 8, and 12 months post-intervention assessment

  • Changes in glucose levels

    Baseline assessment; 4, 8, and 12 months post-intervention assessment

Study Arms (1)

CBT-AD

EXPERIMENTAL

Participants received weekly one-hour CBT-AD sessions focusing on diabetes self-care and depression for approximately 10 sessions. Participants also had meetings with a registered dietitian and a nurse educator, focusing on nutritional management of diabetes and diabetes self-care education, respectively.

Behavioral: Cognitive behavioral therapy for adherence and depression

Interventions

Cognitive-behavioral therapy for adherence and depression (CBT-AD) is a weekly, psychosocial treatment focusing on depression and patients' adherence to diabetes self-care. Treatment consists of weekly one-hour sessions for approximately 10 sessions.

Also known as: CBT-AD
CBT-AD

Eligibility Criteria

Age18 Years - 80 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Diagnosis of type 1 diabetes that is poorly controlled (HbA1C greater than or equal to 8.0%) despite treatment with insulin.
  • Diagnosis of major depression and/or dysthymia, or current subclinical symptoms of depression in spite of being treated with antidepressants.
  • Age 18-80.
  • If on an antidepressant, stable for two months. Oral hypoglycemic medications stable for 2 months, and insulin prescription stable for 2 months (if prescribed).

You may not qualify if:

  • Active or untreated major mental illness that would interfere with participation (e.g., untreated psychosis), untreated/unstable bipolar disorder, eating disorder, mental retardation, dementia, or active suicidality.
  • Unable or unwilling to provide informed consent.
  • History of or current CBT for depression.
  • Currently on dialysis.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Massachusetts General Hospital

Boston, Massachusetts, 02114, United States

Location

Related Publications (1)

  • Markowitz SM, Carper MM, Gonzalez JS, Delahanty LM, Safren SA. Cognitive-behavioral therapy for the treatment of depression and adherence in patients with type 1 diabetes: pilot data and feasibility. Prim Care Companion CNS Disord. 2012;14(2):PCC.11m01220. doi: 10.4088/PCC.11m01220. Epub 2012 Mar 15.

MeSH Terms

Conditions

DepressionDiabetes Mellitus, Type 1Diabetes MellitusInsulin Resistance

Interventions

Cognitive Behavioral Therapy

Condition Hierarchy (Ancestors)

Behavioral SymptomsBehaviorGlucose Metabolism DisordersMetabolic DiseasesNutritional and Metabolic DiseasesEndocrine System DiseasesAutoimmune DiseasesImmune System DiseasesHyperinsulinism

Intervention Hierarchy (Ancestors)

Behavior TherapyPsychotherapyBehavioral Disciplines and Activities

Study Officials

  • Steven A Safren, Ph.D.

    Massachusetts General Hospital

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
phase 2
Allocation
NA
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
SINGLE GROUP
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Director, Behavioral Medicine

Study Record Dates

First Submitted

January 31, 2012

First Posted

February 7, 2012

Study Start

March 1, 2008

Primary Completion

November 1, 2010

Study Completion

November 1, 2010

Last Updated

February 7, 2012

Record last verified: 2012-02

Locations