Depressive Symptoms in a Trial Behavioral Family Systems Therapy for Diabetes: A Post Hoc Analysis of Change.

Diabetes Care

Institute on Development & Disability, Division of Psychology, Department of Pediatrics, Oregon Health & Science University, Portland, OR Harold Schnitzer Diabetes Health Center, Portland, OR

Published: August 2015

Objective: The objective was to test whether Behavioral Family Systems Therapy for Diabetes (BFST-D), an evidence-based family therapy, produces individual changes in depressive symptoms for adolescents with type 1 diabetes in suboptimal glycemic control (HbA(1c) ≥9.0% [≥74.9 mmol/mol]).

Research Design And Methods: Data were from a randomized controlled trial (RCT) comparing two modes of BFST-D delivery: in clinic versus Internet videoconferencing. There were no significant differences between groups in the RCT, so groups were collapsed into a within-group prepost design for secondary analyses. A multiple regression analysis was performed to test for mediation of treatment outcomes by changes in family processes.

Results: Significant improvements in glycemic control, depressive symptoms, and family functioning were found from pre- to posttreatment. A multiple regression analysis for within-subject mediation indicated that improvements in depressive symptoms were partially mediated by improvements in parent-youth conflict; however, family process changes did not mediate diabetes health outcomes.

Conclusions: In addition to improving treatment adherence and glycemic control, BFST-D has collateral benefits on depressive symptoms.

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http://dx.doi.org/10.2337/dc14-2519DOI Listing

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