Is type of depressive symptoms related to need for psychological treatment and efficacy of treatment?

Abstract

Background: As part of a RCT on the efficacy of psychological treatment in diabetic patients, Beck Depression Inventory (BDI-II) was used for screening on depressive symptoms. BDI can be divided into domains cognitive/affective versus somatic. We investigate whether among diabetics with depressive symptoms (BDI ≥14), those with high levels on the cognitive/affective domain are more likely to express a need for care and be interested in participating in the RCT, compared to individuals low on this domain. No effect on the somatic domain is expected. Additionally, we hypothesized the greatest improvement in the cognitive/affective domain, whereas no improvement in the somatic domain is expected. Methods: 619 depressed diabetics are divided into groups based on their needs (e.g. unmet need, no need). We use ANCOVAs for detecting differences between these groups in levels of cognitive/affective and somatic symptoms. Regarding recovery, ANCOVAs will be used to investigate whether the greatest improvement (measured by Reliable Change Index) is found for the high cognitive/affective domain individuals. Expected results: Preliminary results suggest that individuals with high levels on the cognitive/affective domain, are more likely to express a need for care. No effect was found for the somatic domain. Current stage of work: Only preliminary analyses regarding need for care have been executed so far. Discussion: Insight in need for care and recovery may contribute to more effective screening methods.