Effect Of Combined Cognitive Behavioural Therapy and Dhikr Therapy on Depression And Glycaemic Control Among Patients with Type II Diabetes Mellitus: A Quasi-Experimental Study in Bulukumba, Indonesia

Abstract

Background: Depression is a common comorbidity in Diabetes Mellitus (DM) and is associated with poor glycaemic control. Although pharmacotherapy can reduce depressive symptoms, nearly half of DM patients remain severely depressed, highlighting the need for effective non-pharmacological interventions. Cognitive Behavioural Therapy (CBT) combined with dhikr therapy offers a potential approach that integrates psychological and spiritual healing. Objective: This study aimed to determine the effect of CBT combined with dhikr therapy on depression levels and glycaemic control among Type II DM patients. Methods: A quasi-experimental pretest–posttest control group design was conducted over four weeks at Tanete and Bontobangun Health Centres, Bulukumba Regency, Indonesia. Eighty-four Type II DM patients with depression were recruited through purposive sampling, comprising 44 participants in the intervention group and 40 in the control group. The intervention group received structured CBT sessions integrated with dhikr once weekly for four weeks, while the control group received standard care. Depression levels were measured using the DASS-21 instrument, and blood glucose levels were assessed with a glucometer. Data were analyzed using the Wilcoxon test in SPSS. Results: CBT combined with dhikr therapy significantly reduced depression scores and blood glucose levels in the intervention group (p < 0.05), whereas the control group showed no significant changes. Conclusion: The integration of CBT and dhikr therapy effectively improves psychological well-being and glycaemic control in Type II DM patients. This combined therapy provides an evidence-based, non-pharmacological approach that supports holistic diabetes management. Further studies should explore optimal duration and frequency for sustained outcomes.