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- Danielsson, Louise, 1979, et al.
(author)
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Exercise in the treatment of major depression: A systematic review grading the quality of evidence
- 2013
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In: Physiotherapy Theory and Practice. - : Informa UK Limited. - 0959-3985 .- 1532-5040. ; 29:8, s. 573-585
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Journal article (peer-reviewed)abstract
- Objective: To examine the quality of evidence for exercise in the treatment of major depression, comparing specific study types; aerobic exercise vs. antidepressants, aerobic exercise vs. any physical activity, and aerobic exercise as augmentation therapy to treatment as usual vs. treatment as usual. Methods: Electronic searches for randomized controlled studies, reporting on treatment outcome in adults with major depression confirmed by a clinical interview. Quality of evidence was assessed using the Grading and Recommendations Assessment, Development and Evaluation and an additional risk of bias-protocol. Results: Fourteen eligible studies were retrieved, of which nine had low risk of bias. We found moderate quality of evidence that aerobic exercise has no significant effect compared to antidepressants. We found moderate quality of evidence that aerobic exercise at a moderate to high intensity has no significant effect compared to other forms of physical activity. We found low quality of evidence that exercise as augmentation to treatment as usual has a small effect - depression scores were on average 0.44 of a standard deviation lower - compared to treatment as usual. Conclusion: In general, exercise appears to be beneficial in the treatment of depression when used in combination with medication. A significant issue that is not well addressed in previous studies is the risks associated with exercise. Further, this review indicates that aerobic exercise is not more effective than other types of physical activity, pointing to a need to further investigate active components.
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- Danielsson, Louise, 1979, et al.
(author)
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Exercise or basic body awareness therapy as add-on treatment for major depression: A controlled study
- 2014
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In: Journal of Affective Disorders. - : Elsevier BV. - 0165-0327. ; 168, s. 98-106
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Journal article (peer-reviewed)abstract
- Background: While physical exercise as adjunctive treatment for major depression has received considerable attention in recent years, the evidence is conflicting. This study evaluates the effects of two different add-on treatments: exercise and basic body awareness therapy. Methods: Randomized controlled trial with two intervention groups and one control, including 62 adults on antidepressant medication, who fulfilled criteria for current major depression as determined by the Mini International Neuropsychiatric Interview. Interventions (10 weeks) were aerobic exercise or basic body awareness therapy (BBAT), compared to a single consultation with advice on physical activity. Primary outcome was depression severity, rated by a blinded assessor using the Montgomery Asberg Rating Scale (MADRS). Secondary outcomes were global function, cardiovascular fitness, self-rated depression, anxiety and body awareness. Results: Improvements in MADRS score (mean change= -10.3, 95% CI (-13.5 to -7.1), p=0.038) and cardiovascular fitness (mean change=2.4 ml oxygen/kg/min, 95% Cl (1.5 to 3.3), p=0.017) were observed in the exercise group. Per-protocol analysis confirmed the effects of exercise, and indicated that BBAT has an effect on self-rated depression. Limitations: The small sample size and the challenge of missing data. Participants' positive expectations regarding the exercise intervention need to be considered. Conclusions: Exercise in a physical therapy setting seems to have effect on depression severity and fitness, in major depression. Our findings suggest that physical therapy can be a viable clinical strategy to inspire and guide persons with major depression to exercise. More research is needed to clarify the effects of basic body awareness therapy.
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- Danielsson, Louise, 1979, et al.
(author)
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The lived body in depression
- 2013
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In: 21st International Conference on Health Promoting Hospitals and Health Services (HPH). May 22-24, 2013 Gothenburg, Sweden.
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Conference paper (other academic/artistic)abstract
- Depression is a common and complex health problem, increasing worldwide as a threat to public health. Research approaching lived experiences of depression are still sparse. The purpose was to study lived experiences of depression. Individual in-depth interviews were conducted with ten adults diagnosed major depression. A phenomenological hermeneutical analysis was used, drawing on phenomenological theories on the lived body and to the concept of attunement as a mode of being in the world. The preliminary analysis reveals that the participants experience a withdrawal and estrangement, which is experienced both in relation to the immediately lived, physical body and in relation to the world around them. the withdrawal from body and world involves personal ways of dealing both with an urge to distance oneself and to direct oneself toward connecting. The analysis will be further elaborated on during 2013.
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- Danielsson, Louise, 1979
(author)
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There is more to it than talking - physiotherapists' experiences of physiotherapy for patients with generalized anxiety
- 2012
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In: 4th International Conference Physiotherapy in Psychiatry and Mental Health IC-PPMH, Edinburgh, Scotland, 8-10 February 2012.
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Conference paper (other academic/artistic)abstract
- The purpose of this study was to describe experiences of physiotherapy for patients with generalized anxiety, from the physiotherapists’ perspective. Since patients with generalized anxiety often suffer from physical discomfort, they frequently seek help from physiotherapists. Research has shown that physiotherapists often find it challenging to treat this group of patients. Hence, it is important for physiotherapists to reflect upon why and how they may contribute to improved health. On an educational level, this study may serve as an inspiration to discuss central issues within the professional paradigm. Ten physiotherapists working in psychiatry or primary care were recruited by local physiotherapy coordinators. The strategic selection was aiming at varied ages, work experiences and work locations among the participants. Nine women and one man accepted the invitation to participate. They were between 31 and 51 years of age and had been working as physiotherapists between 7 and 20 years. Five worked in psychiatric out-patient clinics, two in psychiatric in-patient clinics and three worked in primary care. A qualitative, phenomenographic approach was used. Data for this study was collected from semi-structured individual interviews, recorded and transcribed verbatim. The interviews started with an open question “What comes to mind when you think about physiotherapy for patients with generalized anxiety?” Follow-up questions were used to deepen descriptions relevant to the phenomenon. Nine interviews were conducted at the physiotherapist’s workplace, one in the home of the physiotherapist. The interviews lasted 29-48 minutes. Ethical viewpoints were considered according to the principles of The World Medical Association Declaration of Helsinki. Data was analyzed by a systematic seven-step model; 1) Familiarization; 2) Condensation; 3) Comparison; 4) Grouping; 5) Articulation; 6) Labeling and 7) Contrasting. The analysis ended in seven categories of description of which one was interpreted as more complex; overarching the remaining six categories. A central, overarching category was labeled “Physiotherapy affects anxiety and thereby everyday life”. The following categories were: “Physiotherapy suggests lifestyle guidelines”, “Physiotherapy helps the patient to stand secure”, “Physiotherapy affects physiological processes”, “Physiotherapy increases body awareness”, “Physiotherapy changes the view on body sensations” and “Physiotherapy helps to see that you are and you have your body”. The physiotherapists described different aspects of how physiotherapy is important for patients with generalized anxiety, reducing the impact of symptoms by more nuanced body experiences. They consider the shifting back and forth between; a) doing and reflecting and b) the subjective and objective body; as unique and beneficial features in their profession. The results of this study articulate some of the tacit knowledge embedded in psychiatric physiotherapy and may inspire to professional reflection and discussion among clinical physiotherapists and students.
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- Danielsson, Louise, 1979, et al.
(author)
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To sense and make sense of anxiety: Physiotherapists' perceptions of their treatment for patients with generalized anxiety.
- 2013
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In: Physiotherapy theory and practice. - : Informa UK Limited. - 1532-5040 .- 0959-3985. ; 29:8, s. 604-615
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Journal article (peer-reviewed)abstract
- The generalized anxiety is characterized by long-term psychological and physiological discomfort. Pharmacological and psychotherapeutic interventions have been extensively examined, whereas knowledge is scant regarding other professional perspectives. This article focuses on the physiotherapeutic perspective on anxiety, exploring physiotherapists' perceptions of their treatment for patients with generalized anxiety. Semi-structured interviews were conducted with 10 physiotherapists working in psychiatry or primary health care. Data were analysed using qualitative content analysis, resulting in one main category and five subcategories. The main category "To sense and make sense of one's anxiety" reflects the idea that physiotherapy works through immediate, tangible bodily experiences to help a person understand and handle his or her anxiety better. Five subcategories reflected different aspects of this main category: (1) the body is the arena of anxiety, (2) to get in touch with oneself, (3) to get down-to-earth with oneself, (4) to make sense of bodily sensations, and (5) to gain trust in one's capability to handle anxiety. In conclusion, the gradual bodily awareness of sensations, to sense and make sense of anxiety in physiotherapy treatment, becomes an opportunity to find ways to withstand and to manage symptoms of anxiety, encouraging an embodied self-trust. The emphasis on the immediately lived body involves the potential to learn how to endure anxiety instead of running away from it, to discern and to understand different sensations, leading to an integration of anxiety as being part of oneself rather than overflowing oneself.
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- Lopez-Valladares, Gloria, 1963-, et al.
(author)
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Human isolates of Listeria monocytogenes in Sweden during half a century (1958-2010)
- 2014
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In: Epidemiology and Infection. - 0950-2688 .- 1469-4409. ; 142, s. 2251-2260
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Journal article (peer-reviewed)abstract
- Isolates of Listeria monocytogenes (n=932) isolated in Sweden during 1958–2010 from human patients with invasive listeriosis were characterized by serotyping and pulsed-field gel electrophoresis (PFGE) (AscI). Of the 932 isolates, 183 different PFGE types were identified, of which 83 were each represented by only one isolate. In all, 483 serovar 1/2a isolates were distributed over 114 PFGE types; 90 serovar 1/2b isolates gave 32 PFGE types; 21 serovar 1/2c isolates gave nine PFGE types; three serovar 3b isolates gave one PFGE type; and, 335 serovar 4b isolates gave 31 PFGE types. During the 1980s in Sweden, several serovar 4b cases were associated with the consumption of European raw soft cheese. However, as cheese-production hygiene has improved, the number of 4b cases has decreased. Since 1996, serovar 1/2a has been the dominant L. monocytogenes serovar in human listeriosis in Sweden. Therefore, based on current serovars and PFGE types, an association between human cases of listeriosis and the consumption of vacuum-packed gravad and cold-smoked salmon is suggested.
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