Exercise and internet-based cognitive-behavioural therapy for depression : Multicentre randomized controlled trial with 12-month follow-up

• Background Evidence-based treatment of depression continues to grow, but successful treatment and maintenance of treatment response remains limited.Aims To compare the effectiveness of exercise, internet-based cognitive-behavioural therapy (ICBT) and usual care for depression.Method A multicentre, three-group parallel, randomised controlled trial was conducted with assessment at 3 months (posttreatment) and 12 months (primary end-point). Outcome assessors were masked to group allocation. Computer-generated allocation was performed externally in blocks of 36 and the ratio of participants per group was 1:1:1. In total, 945 adults with mild to moderate depression aged 18-71 years were recruited from primary healthcare centres located throughout Sweden. Participants were randomly assigned to one of three 12-week interventions: supervised group exercise, clinician-supported ICBT or usual care by a physician. The primary outcome was depression severity assessed by the Montgomery-Åsberg Depression Rating Scale (MADRS).Results The response rate at 12-month follow-up was 84%. Depression severity reduced significantly in all three treatment groups in a quadratic trend over time. Mean differences in MADRS score at 12 months were 12.1 (ICBT), 11.4 (exercise) and 9.7 (usual care). At the primary end-point the group x time interaction was significant for both exercise and ICBT. Effect sizes for both interventions were small to moderate.Conclusions The long-term treatment effects reported here suggest that prescribed exercise and clinician-supported ICBT should be considered for the treatment of mild to moderate depression in adults. 

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Psykiatri (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Psychiatry (hsv//eng)

SAMHÄLLSVETENSKAP  -- Psykologi -- Tillämpad psykologi (hsv//swe)

SOCIAL SCIENCES  -- Psychology -- Applied Psychology (hsv//eng)

Nyckelord

adult

clinical trial

cognitive behavioral therapy

controlled clinical trial

controlled study

effect size

exercise

follow up

human

Internet

major clinical study

Montgomery Asberg Depression Rating Scale

multicenter study

physician

primary health care

randomized controlled trial

Sweden

young adult

adolescent

aged

cognitive therapy

comparative study

depression

female

kinesiotherapy

male

middle aged

outcome assessment

procedures

severity of illness index

Exercise Therapy

Follow-Up Studies

Humans

Outcome Assessment (Health Care)

Psychology

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)