Eva Melin´s research

Psychological and biochemical factors in diabetes, and intervention with the Affect School and Body Awareness Therapy for patients with diabetes and impaired metabolic control

Background
Depression is common in patients with diabetes and is associated with impaired metabolic control. A negative self-image leads to impaired self-management. Affect School (AS) is an intervention that may reduce depression and alexithymia in patients with chronic benign pain. Basic Body Awareness Therapy (BBA) is a stress-reducing technique.
 
Purpose
To examine the relationship between psychological factors and biochemical markers in patients with diabetes and to evaluate AS and BBA in patients with diabetes and impaired metabolic control.

Method
A randomized controlled trial of 350 people with diabetes, 18-59 years, 56% men, 44% women. Base-line study: from medical records and the National Diabetes Registry - waist circumference, BMI, blood pressure, type and duration of diabetes, diabetes complications, other diseases, medications, exercise habits and smoking. Tests - HbA1c, blood lipids, cytokines, hormones, beta-cell antibodies, c-peptide, midnight cortisol (salivary). Self-report questionnaires of psychological variables: HAD, TAS-20, SASB. Intervention: patients with HbA1c ≥ 7 and anxiety (HAD ≥ 8), depression (HAD ≥ 8), negative self-image (SASB: AFF <284) or alexithymia (TAS-20 ≥ 61) are randomized to AS or BBA. AS: 8 group sessions followed by 10 individual sessions. Instructors are a general practitioner and a psychotherapist. BBA: 9 group meetings and six individual sessions. Instructor is a physiotherapist. Post intervention: questionnaires, HbA1c, cytokines, hormones, midnight cortisol.

Expected findings
Relationship between depression, alexithymia, negative self-image and diabetes with poor metabolic control. After AS-intervention: less alexithymia and depression, improved self-image and better metabolic control as measured by lower HbA1c.

Read Eva´s article in Biopsychosocial medicine:

http://www.bpsmedicine.com/content/4/1/5

Supervisor: Mona Landin-Olsson, Hans Thulesius