Depression Clinical Trial
Official title:
Psychological Impact, Metabolic Control, Biological Stress Markers in Diabetes: Intervention With Affect School and Basal Body Awareness
The investigators want to try the psycho educational method "The Affect School with Script Analysis and the physiotherapeutic mind-body therapy "Basal Body Awareness Therapy in patients with diabetes, high HbA1c and psychological symptoms, in order to improve psychological health- with the primary outcome reduced depression. Secondary outcomes are improved improved glycemic control and self-image, and reduced alexithymia and anxiety.
Background:
Depression is common in patients with diabetes and is associated with impaired glycemic
control and elevated cortisol levels. Alexithymia has been associated with depression,
anxiety, stress related disorders and diabetes mellitus. Affect School (AS) is an
intervention that may reduce depression and alexithymia according to previous research. Basic
Body Awareness Therapy (BBAT) is a stress-reducing technique and is used in psychiatric care
in Scandinavia in order to improve psychiatric health.
Purpose:
The aims are to: 1. Analyze the prevalence of depression and anxiety and the personality
variables alexithymia and self image in diabetes patients at baseline. 2. Explore
correlations between these variables and risk factors, including biochemical markers for
diabetic complications. 3. To evaluate an intervention with Affect School with Script
Analysis and Basal Body Awareness Therapy in patients with diabetes that scored high in
psychometric self-report tests and at the same time showed impaired metabolic control.
Method:
A randomized controlled trial in two steps. First step started in 2009 and consists of 350
people with diabetes, 90% with type 1 diabetes, 18-59 years, 56% men, 44% women. Base-line
study: from medical records and the National Diabetes Registry - waist circumference, BMI,
blood pressure, type and duration of diabetes, diabetes complications, other diseases,
medications, exercise habits and smoking. Tests - A1c, blood lipids, cytokines, hormones,
beta-cell antibodies, c-peptide, midnight cortisol (salivary). Self-report tests of
psychological and personality variables: HAD, TAS-20, SASB. Intervention: patients with HbA1c
>70 mmol/mol (A1c ≥ 8 %) and anxiety (HAD ≥ 8), depression (HAD ≥ 8), negative self-image
(SASB: Affinity dimension <284) or alexithymia (TAS-20 ≥ 61) were randomized to AS or BBA.
AS: 8 group sessions followed by 10 individual sessions. Instructors were a primary care
physician and a psychotherapist. BBA: 10 group meetings and 5individual sessions with a
physiotherapist as instructor. Post intervention: Self report tests, A1c, cortisol.
Second step will start in 2015: Recruitment of 350 people from primary care with type 2
diabetes with high A1c and either depression, alexithymia, negative self image or anxiety.
Randomization procedures and patient characteristics will be assessed in the same way as
above.
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