As a regional leader in mindfulness-based cognitive therapy (MBCT), The Ohio State University Wexner Medical Center is actively recruiting type 2 diabetes patients with symptoms of depression to study the therapy’s impact on both mental health and disease outcomes.

MBCT is an empirically supported, group-based intervention designed to facilitate recovery from depression and prevent future depressive relapses. The treatment has also proven helpful for people with anxiety.

“MBCT helps individuals develop the capacity to be fully present in the moment, rather than fixated on the past or worried about the future,” says Ohio State psychologist and study lead Sophie Lazarus, PhD. “Through the cultivation of mindfulness and greater awareness of unhelpful habitual responses to negative thoughts and emotions, patients are better equipped to avoid downward spirals in mood that may allow depression to take hold. This ultimately gives patients a new way of relating to their experiences and taking care of themselves.”

The relationship between depression and type 2 diabetes

Though the psychological burden of diabetes may contribute to depression, this explanation does not fully explain the relationship between these two conditions. Both conditions may be driven by shared underlying biological and behavioral mechanisms, such as hypothalamic-pituitary-adrenal axis activation, inflammation, sleep disturbance, inactive lifestyle, poor dietary habits, and environmental and cultural risk factors.

“Data already indicate that MBCT may be equally effective as medication for reducing symptoms of depression and depressive relapse,” Dr. Lazarus, who is an assistant professor  clinical at the College of Medicine, says. “Our question now is whether addressing depression in this way can also impact lifestyle choices, which can improve disease outcomes for those with type 2 diabetes.”

Potential impact on best practices

To better understand the sequential connections among type 2 diabetes management, outcomes and depression, Dr. Lazarus, who is a qualified teacher of MBCT with the nationally recognized University of California San Diego Center for Mindfulness, has collaborated with Ohio State endocrinologist Joshua Joseph, MD, to establish an improved screening and referral process for type 2 diabetes patients. 

Patients who eventually enroll in the study will undergo an eight-week MBCT program that addresses both their depression and diabetes. Researchers will track changes in mental health and diabetes-related distress, as well as physical measurements such as blood sugar and lipids.

“One out of two patients seen in our diabetes center has comorbid mood disorder along with diabetes,” Dr. Joseph says, “so the impact of this collaborative, interdisciplinary study has tremendous potential to change best practices — and could even lead to a more holistic treatment approach for other diseases.”

Efforts beyond research

In addition to this active multidisciplinary study, Dr. Lazarus facilitates collaboration between departments by sharing information about MBCT at diabetes education sessions and with providers in endocrinology and internal medicine.

“In the end, I want to help providers understand the transactional nature of physical and psychological factors in these diseases,” she says. “Although endocrinologists treat the physical aspects of diabetes, once they grasp the role of mental health in any prognosis, they have tremendous opportunity to affect change. Their close interaction with patients makes them one of our best front-line defenses against depression.”

If you would like more information about this MBCT/type 2 diabetes study, or if you would like to refer a patient — recruitment extends to include patients beyond Ohio State — please send an email to Dr. Lazarus at Sophie.Lazarus@osumc.edu.

 

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