Insulin dependent diabetes mellitus (IDDM) is a serious and complicated medical condition that requires a strict and burdensome regimen for its control. Statistical data suggests that IDDM is more prevalent in Latino populations, particularly in Puerto Ricans. Also, higher rates of complications, hospitalizations and mortality have been registered for Latinos. This population has been traditionally underrepresented in medical and psychological research. Depression symptomatology has been identified in approximately 32.4% of diabetic patients making it a frequent co-morbid condition. Although several studies have demonstrated good outcomes in the treatment of depression in adult diabetes, this has not been tested for youth with IDDM, much less for Latino youth. The main objective of this proposal is to develop and test a culturally appropriate group CBT intervention for depression in Puerto Rican youth with IDDM.
The specific aims are to: (1) Develop, adapt, manualize, and refine an empirically based CBT group intervention for the treatment of depression in Puerto Rican adolescents with IDDM and depressive symptoms; (2) To pilot test the CBT for adolescents with IDDM (CBT-IDDM) to assess primary (depression, adherence, and metabolic control) and secondary (cognitions, self-esteem, coping strategies, quality of life, social support, and functionality) outcomes; (3) To evaluate the feasibility and acceptability of the procedures for implementation of CBT-G-IDDM and measures. Data will be collected to estimate intervention parameters such as effect size, attrition and response rate; recruitment of participants and therapists; sample definitions; outcome measures; protocol adherence; therapist competency; and patient acceptance of treatment and measures. Forty Puerto Rican adolescents with IDDM and depression symptomatology will be randomly assigned to one of two conditions: CBT-G-IDDM or a minimal contact (MC) group with close monitoring of symptoms. Multiple measures will be completed by multiple raters (adolescent, parent, and interviewer) at pre, midline and post. The impact of the intervention will be evaluated on primary and secondary outcome targets. Results from this study will permit a large randomized controlled clinical trial to further study efficacy and effectiveness issues. The treatment manual and procedures could benefit other Latino and minority youth with IDDM.
| Cumba-Avilés, Eduardo; Sáez-Santiago, Emily (2016) Research Program on Type 1 Diabetes and Youth Depression in Puerto Rico. Rev Puertorriquena Psicol 27:44-60 |
