Obesity and Depression Can Be Treated With Collaborative Care

MedicalResearch.com Interview with:

Jun Ma, MD, PhD, FAHA, FABMRProfessor and Associate Head of Research, Department of MedicineDirector, Center for Health Behavior ResearchThe University of Illinois at Chicago

Dr. Jun Ma

Jun Ma, MD, PhD, FAHA, FABMR
Professor and Associate Head of Research
Department of Medicine
Director, Center for Health Behavior Research
The University of Illinois at Chicago

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Obesity and depression are major public health problems. Obesity affects 40% of United States (US) adults. About 20% in US women and 13% in men experience major depressive disorder at some point in their lifetime and, additionally, many adults have elevated depressive symptoms that do not meet clinical diagnostic criteria but can nevertheless negatively affect their health and quality of life. Obesity and depression share common risk factors, such as poor diet and lack of exercise, and cause other health problems, such as diabetes and cardiovascular disease. People with obesity are at increased risk of being depressed and, likewise, people with depression are at increased risk of being obese. Consequently, obesity and depression often co-occur. To date, there has been no integrated therapy to effectively treat patients affected by both conditions at the same time.

The RAINBOW randomized clinical trial addressed this gap.

The main finding from the trial is that, among adult patients with obesity and depression, a collaborative care intervention integrating behavioral weight loss treatment, problem-solving therapy, and as-needed antidepressant medications significantly improve weight loss and depressive symptoms over one year compared with usual care, which patients received through their primary care physicians. 

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Cognitive Therapy May Be Safe and Effective For Chronic Insomnia

MedicalResearch.com Interview with:
Dr David Cunnington
Sleep Physician & Director
Melbourne Sleep Disorders Centre
East Melbourne Australia

Medical Research: What is the background for this study? What are the main findings?

Response: Insomnia is a very common problem with 15-20% of adults having chronic insomnia, that is, trouble getting to sleep or staying asleep most days for  3 months or more. The most commonly used treatment is sleeping pills or hypnotics, however, they don’t address the underlying disorder, and come with potential side effects. Also, sleeping tablets just mask the symptoms, and as soon as tablets are stopped, symptoms recur. People with chronic insomnia think and behave differently around sleep, which perpetuates their symptoms. The key to improving symptoms in the long run is addressing thoughts and behaviours around sleep, which is what cognitive behaviour therapy does.

Our study showed that cognitive behaviour therapy reduced the time taken to get to sleep by 20 minutes and reduced the amount of time spent awake after falling asleep by nearly 30 minutes. These effects were maintained out to 12 months after treatment. These reductions in time taken to get to sleep and time spent awake are similar to those reported in clinical trials of hypnotics.  Continue reading

Diabetes and Depression: Cognitive Therapy Improved Both

Steven A. Safren, Ph.D., ABPP Professor of Psychology, Harvard Medical School Director, Behavioral Medicine, Department of Psychiatry Massachusetts General Hospital, Boston, MA 02114MedicalResearch.com Interview with:
Steven A. Safren, Ph.D., ABPP
Professor of Psychology, Harvard Medical School
Director, Behavioral Medicine, Department of Psychiatry
Massachusetts General Hospital,
Boston, MA 02114

MedicalResearch.com: What are the main findings of the study?

Dr. Safren:  The main findings of the study are that, in patients with uncontrolled type 2 diabetes and depression, a type of psychological treatment, cognitive behavioral therapy (CBT) that addressed both self-care and depression, resulted in improvements in both depressed mood, self-care, and glucose control.  This was a randomized controlled trial, and this cognitive-behavioral treatment worked better than lifestyle adherence and nutrition counseling alone; and the effects were sustained over 8 months.

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