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Psychotherapeutic Interventions to Improve Psychological Adjustment in Type 1 Diabetes: A Systematic Review.

ABSTRACT: Background: International clinical practice guidelines highlight the importance of improving the psychological and mental health care of patients with Type 1 diabetes mellitus (T1DM). Psychological interventions can promote adherence to the demands of diabetes self-care, promoting high quality of life and wellbeing. Methods: A systematic review was carried out to determine whether psychological treatments with a specific focus on emotional management have an impact on glycemic control and variables related to psychological adjustment. Comprehensive literature searches of PubMed Medline, Psycinfo, Cochrane Database, Web of Science, and Open Grey Repository databases were conducted, from inception to November 2019 and were last updated in December 2020. Finally, eight articles met inclusion criteria. Results: Results showed that the management of emotions was effective in improving the psychological adjustment of patients with T1DM when carried out by psychologists. However, the evidence regarding the improvement of glycemic control was not entirely clear. When comparing adolescent and adult populations, findings yielded slightly better results in adolescents. Conclusions: More rigorous studies are needed to establish what emotional interventions might increase glycemic control in this population.

SUBMITTER: Resurreccion DM

PROVIDER: S-EPMC8535719 | biostudies-literature | 2021 Oct

REPOSITORIES: biostudies-literature

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Psychotherapeutic Interventions to Improve Psychological Adjustment in Type 1 Diabetes: A Systematic Review.

Resurrección Davinia M DM Navas-Campaña Desirée D Gutiérrez-Colosía Mencía R MR Ibáñez-Alfonso Joaquín A JA Ruiz-Aranda Desireé D

International journal of environmental research and public health 20211018 20

<i>Background</i>: International clinical practice guidelines highlight the importance of improving the psychological and mental health care of patients with Type 1 diabetes mellitus (T1DM). Psychological interventions can promote adherence to the demands of diabetes self-care, promoting high quality of life and wellbeing. <i>Methods</i>: A systematic review was carried out to determine whether psychological treatments with a specific focus on emotional management have an impact on glycemic cont ...[more]

PMID: 34682687

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Project description:ObjectiveTo determine whether psychological interventions have any effect on glycaemic control in people with type 1 diabetes.DesignSystematic review and meta-analysis of psychological therapies to assess their effectiveness in improving glycaemic control in type 1 diabetes.Data sourcesMedline, PsycINFO, Embase, and Cochrane central register of controlled trials searched to September 2004.Review methodsAll included studies were randomised controlled trials in children (including adolescents) or adults with type 1 diabetes that evaluated the effect of a psychological therapy (counselling, cognitive behaviour therapy, family systems therapy, and psychodynamic therapy) on control of diabetes. Data were extracted on sample size, age, duration of diabetes, type of psychological therapy, its mode of delivery, and type of intervention in control group.Main outcome measuresGlycaemic control measured by percentage of glycated haemoglobin and psychological distress. Pooled standardised effect sizes were calculated.Results29 trials were eligible for the systematic review and 21 trials for the meta-analysis. In the 10 studies of children and adolescents included in the meta-analysis, the mean percentage of glycated haemoglobin was significantly reduced in those who had received a psychological intervention compared with those in the control group (pooled standardised mean difference -0.35 (95% confidence interval -0.66 to -0.04), equivalent to a 0.48% (0.05% to 0.91%) absolute reduction in glycated haemoglobin. In the 11 studies in adults the pooled standardised mean difference was -0.17 (-0.45 to 0.10), equivalent to 0.22% (-0.13% to 0.56%) absolute reduction in glycated haemoglobin. Psychological distress was significantly lower in the intervention groups in children and adolescents (pooled standardised effect size -0.46, -0.83 to -0.10) but not in adults (-0.25, -0.51 to 0.01).ConclusionPsychological treatments can slightly improve glycaemic control in children and adolescents with diabetes but have no effect in adults.

Project description:BackgroundPerinatal loss is a traumatic and complex experience that contributes to negative maternal psychological states and adverse outcomes impacting fetal development, maternal-fetal/infant bonding, marital/partner relationships, and child cognitive, emotional, and behavioral development. These outcomes present preventable disease burden and financial liability to individuals, families, and the healthcare system. Psychological interventions have the potential to improve outcomes for women and their families after perinatal loss. A few studies have explored the effectiveness of individual psychotherapeutic interventions in reducing maternal psychological distress after perinatal loss; however, a systematic review to compare these interventions has not been conducted. The primary objective of this systematic review is to determine the effectiveness of psychotherapeutic intervention on psychological distress and perception, coping, and adjustment in women who have experienced perinatal loss. The secondary objective of this review is to examine the content and delivery methods of effective psychotherapeutic interventions.MethodsWe endeavor to search electronic databases (PsycINFO, MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, CINAHL, Social Work Abstracts, Family and Society Studies Worldwide, Family Studies Abstracts, Academic Search Premier), gray literature databases (Proquest Dissertation and Theses Global, Web of Science Conference Proceedings Citation Index, OAIster, Open-Grey, Canadian Electronic Library, Canadian Research Index), and relevant organizational websites and conduct forward and backward citation searches of included studies. Inclusion criteria will consider studies that (1) are randomized controlled trials (RCTs), quasi-experimental (e.g., before-after design), and observational (prospective cohort); (2) include women affected by perinatal loss accessing psychotherapeutic intervention or support; and (3) evaluate a mental health or related outcome. Two authors will independently screen all citations, full-text articles, and abstract data. The study methodological quality (or bias) will be appraised using an appropriate tool. The primary outcome(s) will be measurements on the severity of depressive, anxiety, grief, and post-traumatic stress symptoms. Secondary outcomes will include measurements on difficulties in perception, coping, social, or dyadic adjustment. Conducting a narrative synthesis will identify relationships within study findings, and if appropriate, a random effects meta-analysis will be performed.DiscussionThis systematic review will summarize the effectiveness of psychological interventions, including their content and delivery method, in reducing psychological distress and improving outcomes for women affected by perinatal loss. The evidence generated from this review can inform researchers and policymakers in expanding on related research and developing customized interventions or programs.Systematic review registrationPROSPERO CRD42019126456.

Project description:BackgroundExpanding technologies of early detection of Alzheimer's disease allow to identify individuals at risk of dementia in early and asymptomatic disease stages. Neuropsychiatric symptoms, such as anxiety and depression, are common in the course of AD and may be clinically observed many years before the onset of significant cognitive symptoms. To date, therapeutic interventions for AD focus on pharmacological and life style modification-based strategies. However, despite good evidence for psychotherapy in late-life depression, evidence for such therapeutic approaches to improve cognitive and emotional well-being and thereby reduce psychological risk factors in the course of AD are sparse.MethodsA systematic review was conducted in PUBMED, PsycINFO, Web of Science, and Clinical Trials to summarize the state of evidence on psychotherapeutic and psychoeducational interventions for individuals at risk for Alzheimer's dementia. Eligible articles needed to apply a manualized and standardized psychotherapeutic or psychoeducational content administered by trained professionals for individuals with subjective cognitive decline or mild cognitive impairment and measure mental health, quality of life or well-being.ResultsThe literature search yielded 32 studies that were included in this narrative summary. The data illustrates heterogeneous therapeutic approaches with mostly small sample sizes and short follow-up monitoring. Strength of evidence from randomized-controlled studies for interventions that may improve mood and well-being is scarce. Qualitative data suggests positive impact on cognitive restructuring, and disease acceptance, including positive effects on quality of life. Specific therapeutic determinants of efficacy have not been identified to date.ConclusionsThis review underlines the need of specific psychotherapeutic and psychoeducational approaches for individuals at risk of Alzheimer's dementia, particularly in terms of an early intervention aiming at improving mental health and well-being. One challenge is the modification of psychotherapeutic techniques according to the different stages of cognitive decline in the course of AD, which is needed to be sensitive to the individual needs.

Project description:BackgroundPoor diabetes self-care can have a negative impact on psychological well-being and quality of life. Given the scarcity of traditional psychological support and the barriers to uptake of and attendance at face-to-face education programs, Web-based interventions are becoming a popular approach to provide an additional platform for psychological support in long-term conditions. However, there is limited evidence to assess the effect of Web-based psychological support in people with type 2 diabetes.ObjectiveThis systematic review is the first review to critically appraise and quantify the evidence on the effect of Web-based interventions that aim to improve well-being in people with type 2 diabetes.MethodsSearches were carried out in the following electronic databases: MEDLINE, EMBASE, CINAHL, PsycINFO, and Cochrane Library. Reference lists were hand-searched. A meta-analysis was conducted for depression and distress outcomes.ResultsA total of 16 randomized controlled studies met the inclusion criteria for the systematic review and 9 were included in the meta-analyses. Theories were applied to the majority of the interventions. The most common behavior change techniques were "General information" and "Tracking/monitoring." Interventions with a duration of 2-6 months providing professional-led support with asynchronous and synchronous communication appeared to be associated with significant well-being outcomes. The pooled mean (95% confidence interval) difference between the intervention and control arms at follow-up on depression score was -0.31 (-0.73 to 0.11). The pooled mean difference on distress scores at follow-up was -0.11 (-0.38 to 0.16). No significant improvements in depression (P=.15) or distress (P=.43) were found following meta-analyses.ConclusionsWhile the meta-analyses demonstrated nonsignificant results for depression and distress scores, this review has shown that there is a potential for Web-based interventions to improve well-being outcomes in type 2 diabetes. Further research is required to confirm the findings of this review.

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Psychotherapeutic Interventions to Improve Psychological Adjustment in Type 1 Diabetes: A Systematic Review.

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Psychotherapeutic Interventions to Improve Psychological Adjustment in Type 1 Diabetes: A Systematic Review.

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