Flow chart

Table A

Table B

Appendix 1

References


[posted as supplied by author]

 

Web table A Results of systemic review of randomised controlled trials of psychological interventions in children and adolescents with type 1 diabetes [posted as supplied by author]

First author, year, country, reference	Number recruited/at follow-up	Mean age(SD) (years)	Mean % (SD) GHb at baseline	Clinical subgroup; age range (years)	Mean(SD) duration diabetes (years)	Model and duration of intervention	Regimen in intervention group; specialty of therapist	Model and duration of control	Regimen in control group and specialty of therapist	Follow-up in months	Quality
Gross, 1985, USAw1	14/14	11.4 (NS)	13.5 (NS)	General; 9 to 13	4.8 (1 to 12)	Multi-family and group CBT for 8 weeks	8 parallel sessions of multi-family self-management training for parents and children; by psychologist	Group counselling for 8 weeks	8 sessions of multi-family discussion groups, separately for parents and children; by psychologist	6	C
Kaplan, 1985, USA,w2	21/14	14.5 (NS)	13.1 (NS)	General; 13 to 18	8.3 (NS)	Group CBT for 3 weeks at summer camp	Social skills training by psychologist; (number of sessions NS)	Group education at diabetes camp for 3 weeks	Intensive education from diabetes MDT (number of sessions NS)	4	C
Anderson, 1989, USAw3	70/60	12.7 (NS)	10.4 (2.1)	³ 1 year duration; 11 to 14	5 (3.3)	Multi-family CBT for 18 months	5 parallel problem-solving sessions for parents by psychologist and group education sessions for children by nurse educator	Usual care	Routine care from diabetes MDT	18	C
Satin, 1989, USA,w4	21/21	14.6 (2.6)	12.8 (1.1)	General; 12 to 19	5.9 (4.3)	Multi-family systems therapy for 6 weeks	6 sessions of problem-solving simulation by psychological social worker & diabetes nurse	Waiting list	NS	6	C
Delamater1990, USAw5	24/24	9.6 (3.3)	11.7 (2.5)	New onset; 3 to 16	NA	Family counselling for 12 months	9 sessions of supportive family therapy by social worker	Usual care	Standard 3 monthly diabetes MDT clinics	24	C
Daley, 1992, USA,w6	54/54	NS	NS	General; 12 to 16	NS	Individual counselling for 10 months	20 sessions of supportive adult team sponsorship, by trained befriender with diabetes	NS	NS	10	C
Boardway1993, USAw7	31/18	14.9 (1.5)	14.9 (3.2)	SOGC, ³ 1 year duration; 12 to 17	6.6 (4.4)	Group CBT for 6 months	13 sessions of a range of CBT strategies; specialty not specified	Usual care	Routine clinical care from diabetes MDT	9	C
Wolanski,1996, Canadaw8	41/39	NS	None	Poor diabetes skills; 8 to 16	NS	Individual counselling; duration NS	2 sessions of counselling addressing attitude towards self-monitoring of blood glucose in camp; specialty NS	Group education; duration NS	Traditional diabetes education in camp; specialty NS	NS	C
Olivares, 1997, Spainw9*	28/25	6.0 (NS)	None	³ 1 year duration; ³ age 8 years	2	Family CBT for 8 weeks	8 sessions of a range of CBT techniques for parents, by psychologist	Usual care	Routine diabetes clinic care	2	C
Méndez, 1997, Spainw10*	38/38	8.5 (3.0)	9.7 (1.7)	³ 2 years duration; 2 to 12	2.7 (1.3)	Family CBT for 6 weeks	6 sessions of stress management for parents; by psychologist.	Usual care	Routine care from diabetes MDT	2.5	C
Forsander, 1998, Swedenw11-13	38/38	8.2 (1.7)	9.6 (2.34)	New onset; 3 to 15	NA	Family systems therapy for 2 weeks	Family-orientated crisis therapy in a milieu therapeutic setting by family therapist; number of sessions NS	Usual care	Conventional treatment according to national guidelines from pediatric diabetes team	12	C
Grey, 1998, USAw14-15	75/75	14.4 (2.0)	9.2 (1.5)	SOGC; 12 to 20	8.9 (3.8)	Group CBT for 6 weeks	4 to 8 sessions of a range of CBT techniques by diabetes nurse with psychiatric skills	Intensive therapy	Based on DCCT protocol	12	C
Wysocki, 2000, USAw16-17	79/72	14.4 (1.3)	11.9 (3.2)	Parent-adolescent conflict; 12 to 16	5.3 (3.8)	Family systems therapy for 12 weeks	10 sessions of a range of CBT techniques, by psychologist	Usual care	At least 1 session of standard therapy, by diabetes MDT	12	B
Wysocki, 2003, USAw18	147/142	11.4 (2.7)	8.3 (1.1)	NS; 6 to 15	4.5 (2.8)	Multi-family and individual counselling for 18 months	Intensive education & medical therapy and monthly support groups, by diabetes MDT & psychologist	Usual care	4 monthly clinic visits & standard education, by diabetes care MDT	18	C
Howells, 2002, UKw19	91/79	16.8 (3.4)	8.8 (1.7)	NS; 12 to 25	7 (4.5)	Individual counselling for 12 months	Problem-solving (no of sessions NS), by psychologist and telephone support by dietician trained in counselling	Usual care	3 monthly clinic visits by diabetes MDT	12	A
Svoren, 2003, USAw20	301/298	11.87 (2.49)	8.66 (1.17)	General; 7 to 16	5.22 (2.94)	Family counselling	8 psychoeducation sessions with family discussion plus case management support, by college graduate	Usual care	Standard clinical care from diabetes MDT	24	B

SOGC: suboptimal glycaemic control; NS: not specified; CBT: cognitive behaviour techniques; MDT: multidisciplinary diabetes team; NA: not applicable

*translated

 

 

 

Web table B Results of systemic review of randomised controlled trials of psychological interventions in adults with type 1 diabetes [posted as supplied by author]

First author, year, country	Number recruited/at follow-up	Mean age(SD) (years)	Mean % (SD) GHb at baseline	Clinical subgroup; age range (years)	Mean(SD) duration diabetes (years)	Model and duration of intervention	Regimen in intervention group; specialty of therapist	Model and duration of control	Regimen in control group and speciality of therapist	Follow-up in months	Quality
Feinglos, 1987, USAw21	20/20	37 (3.8)	12.9 (0.9)	SOGC	11 (2.5)	Individual & group CBT for 7 weeks	19 relaxation therapy sessions plus telephone support, specialty NS	Attention control	Inpatient with no intervention	1.75	C
Beléndez, 1991, Spainw22*	20/20	19.4 (NS)	NS	NS	7.7 (NS)	Group CBT for 12 weeks	8 relaxation training sessions, by psychologist	Usual care	Usual care, by diabetes MDT	3	C
McGrady, 1991, USAw23	19/18	42 (9.5)	NS	NS	NS	Individual CBT for 10 weeks	10 stress management & relaxation therapy sessions, by biofeedback therapist	Individual education for 10 weeks	10 education sessions, by diabetes nurse	3	C
Spiess, 1995, Austriaw24	23/23	24.6 (4.7)	10.3 (1.4)	New onset (<1 month)	NA	Individual and group psycho-dynamic therapy for 6 months	25 sessions of psychoanalytical therapy, by psychotherapist	Usual care	Standard intensive therapy, by diabetes MDT	15	A
Fosbury, 1997, UKw25	32/26	31.5 (8.9)	11.9 (1.7)	SOGC	16 (7.3)	Individual psycho-dynamic therapy for 17 weeks	16 sessions of psychotherapy, by cognitive analytic therapist	Intensive education for 35.5 weeks	16 sessions of individualized education, by diabetes nurse	13	B
Halford, 1997, Australiaw26	40/31	37.2	10.8 (NS)	NS	16.1 (NS)	Group CBT, duration of therapy NS	6 sessions of a range of CBT techniques, by psychologist	Usual care	Routine medical care, by diabetes MDT	3	C
Glasgow, 1996, USw27-28**	34/34	NS	NS	Combined T1/T2, ≥40 years	NS	Individual counselling duration of therapy NS	1 session of computer assessed barriers to dietary self-care, and follow-up phone calls, by research staff	Usual care	Medical care from diabetes physician, 3 monthly	12	C
Manning 1994, UKw29**	19/19	NS	7.7 (1.8)	Combined T1/T2, BMI 28 to 45	NS	Group CBT for 12 months	10 sessions of group behaviour therapy, by clinical psychologist, physiotherapist and dietician	Intensive education over 12 months	7 individual sessions with a dietician	12	C
Weinger, 2002, USAw30	74/60	31.2 (8.1)	9.8 (1.7)	SOGC	11.2 (4.7)	Group CBT for 8 weeks	Range of CBT techniques (number of sessions NS), by psychologist	Attention control	Cholesterol education, program NS	6	B
Didjurgeit 2002, Germanyw31	46/44	38.5 (9.5)	8.9 (1.9)	Micro-vascular complications	24 (9.5)	Individual CBT for 14 weeks	14 sessions of a range of CBT techniques, by psychotherapist	Waiting list	Routine care by diabetes MDT	6	B
Pouwer, 2001, Nether-landsw32**	166/132	40.8 (14.3)	7.9 (1.4)	Combined T1/T2	20.4 (11.9)	Individual counselling for 12 months	3 sessions of counselling and computer feedback of well-being, by diabetes nurses trained by psychologists	Usual care	3 to 4 sessions of standard care from diabetes MDT	12	B
Der Ven, 2005, Nether-landsw33**	107/88	37.6 (10.3)	9.1 (1.3)	SOGC	18.0 (10.3)	Group CBT for 6 weeks	6 sessions of range of CBT techniques, by psychologist and diabetes nurse	Intensive education for 6 weeks	6 sessions of blood glucose awareness training, by diabetes nurse and psychologist	3	B
Stenstrom, 2003, Swedenw34	36/31	40.8 (12.4)	7.3 (1.4)	NS	16.7 (10.5)	Group CBT for 14 weeks	14 sessions of stress management using a range of CBT techniques, specialty NS	NS	NS	3.5	C

SOGC: suboptimal glycaemic control; NS: not specified; CBT: cognitive behaviour therapy; MDT: multidisciplinary diabetes team; NA: not applicable;

*translated; **included unpublished data for type 1 diabetes from authors

 

 

Appendix 1: Electronic search strategy using Ovid [posted as supplied by author]

1 exp Diabetes mellitus, insulin-dependent/

2 exp Diabetic ketoacidosis/

3 DKA.mp

4 IDDM.mp

5 insulin depend$.mp

6 insulindepend$.mp

7 (Typ$ adj ("1" or II) adj (diabet$ or dm)).mp

8 ((juvenil$ or child$ or keto$ or labil$ or brittl$ or (earl$ adj onset)) adj (diabet$ or dm)).mp

9 (((keto$ adj prone) or autoimmun$ or (sudden adj onset)) adj (diabet$ or dm)).mp

10 (insulin defic$ adj absolut$).mp

11 1 or 2 or 3 or 4 or 5 or 6 or 7 or 8 or 9 or 10

12 exp Diabetes mellitus, non-insulin-dependent/

13 exp Insulin resistance/

14 ((insulin resistanc$ or slow onset or stabl$) adj (diabet$ or dm)).mp

16 (obes$ adj5 diabet$).mp

17 MODY.mp

18 NIDDM.mp

19 (non insulin depend$ or noninsulin depend$ or noninsulindepend$ or non insulin depend$).mp

20 (typ$ adj ("2" or II) adj (diabet$ or dm)).mp

21 (((keto$ adj resistant) or nonketo$ or (non adj keto$) or (adult$ adj onset) or (matur$ adj onset) or (late$ adj onset)) adj (diabet$ or dm)).mp

22 (insulin defic$ adj relativ$).mp

23 12 or 13 or 14 or 15 or 16 or 17 or 18 or 19 or 20 or 21 or 22

24 11 or 23

25 exp Psychotherapy/

26 exp Mood disorders/

27 exp Depression/

28 psycho$.mp

29 counsel$.mp

30 depression.mp

31 depressive.mp

32 (interpersonal adj5 therap$).mp

33 art therap$.mp

34 aversion therap$.mp

35 balint.mp

36 behavior therap$.mp

37 behavior modific$.mp

38 behavior therap$.mp

39 behavior modific$.mp

40 color therap$.mp

41 colour therap$.mp

42 (cognitive adj5 therap$).mp

43 crisis intervention.mp

44 dance therap$.mp

45 gestalt therap$.mp

46 music therap$.mp

47 music therap$.mp

48 milieu therap$.mp

49 (assert$ adj5 training).mp

50 nondirective therap$.mp

51 (problem solving adj5 therap$).mp

52 (self control adj5 therap$).mp

53 person cent$.mp

54 client cent$.mp

55 psychodrama$.mp

56 paradoxical technique$.mp

57 play therap$.mp

58 rational emotive.mp

59 reality therap$.mp

60 role play$.mp

61 (relax$ adj5 training).mp

62 sociotherap$.mp

63 socioenvironmental.mp

64 supportive therap$.mp

65 transactional.mp

66 25 or 26 or 27 or 28 or 29 or 30 or 31 or 32 or 33 or 34 or 35 or 36 or 37 or 38 or 39 or 40 or 41 or 42 or 43 or 44 or 45 or 46 or 47 or 48 or 49 or 50 or 51 or 52 or 53 or 54 or 55 or 56 or 57 or 58 or 59 or 60 or 61 or 62 or 63 or 64 or 65

67 randomized-controlled-trial.pt

68 controlled clinical trial.pt

69 randomized controlled trials.sh

70 random allocation.sh

71 double blind method.sh

72 single blind method.sh

73 clinical trial.pt

74 exp Clinical trials/

75 (clin$ adj25 trial$).ti,ab

76 ((singl$ or doubl$ or tripl$ or trebl$) adj25 (blind$ or mask$ or dummy$)).mp

77 placebos.sh

78 placebo$.ti,ab

79 random$.ti,ab

80 research design.sh

81 comparative study.sh

82 exp evaluation studies/

83 follow up studies.sh

84 prospective studies.sh

85 (control$ or prospectiv$ or volunteer$).ti,ab

86 67 or 68 or 69 or 70 or 71 or 72 or 73 or 74 or 75 or 76 or 77 or 78 or 79 or 80 or 81 or 82 or 83 or 84 or 85

87 (animal not human).sh

88 86 not 87

89 24 and 66 and 88

Key

Exp=explode

mp=[mp=title, abstract, case registry/ec number word, mesh subject heading]

$=any character(s)

adj5 or adj25= within 5 or 25 words

ti=in title

ab= in abstract

sh=subject heading

pt= publication type

 

  

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w3 Anderson B, Wolf F, Burkhart M, Cornell R, Bacon G. Effects of peer-group intervention on metabolic control of adolescents with IDDM: randomized outpatient study. Diabetes Care 1989;12:179-83.

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w5 Delameter A, Bubb J, Davis S, Smith J, Schmidt L, White N et al. Randomized prospective study of self management training with newly diagnosed diabetic children. Diabetes Care 1990;13:492-8.

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w29 Manning R, Jung R, Leese G, Newton R. The comparison of four weight reduction strategies aimed at overweight diabetic patients. Diabet Med 1994;12:409-15.

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