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Facilitated physical activity as a treatment for depressed adults: randomised controlled trial.

Chalder M, Wiles NJ, Campbell J, Hollinghurst SP, Haase AM, Taylor AH, Fox KR, Costelloe C, Searle A, Baxter H, Winder R, Wright C, Turner KM, Calnan M, Lawlor DA, Peters TJ, Sharp DJ, Montgomery AA, Lewis G - BMJ (2012)

Bottom Line: Secondary outcomes included use of antidepressants and physical activity at the four, eight, and 12 month follow-up points, and symptoms of depression at eight and 12 month follow-up.Similarly, there was no evidence that the intervention group reported a change in mood by the eight and 12 month follow-up points.The addition of a facilitated physical activity intervention to usual care did not improve depression outcome or reduce use of antidepressants compared with usual care alone.

View Article: PubMed Central - PubMed

Affiliation: School of Social and Community Medicine, University of Bristol, Bristol BS8 2BN, UK. melanie.chalder@bristol.ac.uk

ABSTRACT

Objective: To investigate the effectiveness of facilitated physical activity as an adjunctive treatment for adults with depression presenting in primary care.

Design: Pragmatic, multicentre, two arm parallel randomised controlled trial.

Setting: General practices in Bristol and Exeter.

Participants: 361 adults aged 18-69 who had recently consulted their general practitioner with symptoms of depression. All those randomised had a diagnosis of an episode of depression as assessed by the clinical interview schedule-revised and a Beck depression inventory score of 14 or more.

Interventions: In addition to usual care, intervention participants were offered up to three face to face sessions and 10 telephone calls with a trained physical activity facilitator over eight months. The intervention was based on theory and aimed to provide individually tailored support and encouragement to engage in physical activity.

Main outcome measures: The primary outcome was self reported symptoms of depression, assessed with the Beck depression inventory at four months post-randomisation. Secondary outcomes included use of antidepressants and physical activity at the four, eight, and 12 month follow-up points, and symptoms of depression at eight and 12 month follow-up.

Results: There was no evidence that participants offered the physical activity intervention reported improvement in mood by the four month follow-up point compared with those in the usual care group; adjusted between group difference in mean Beck depression inventory score -0.54 (95% confidence interval -3.06 to 1.99; P=0.68). Similarly, there was no evidence that the intervention group reported a change in mood by the eight and 12 month follow-up points. Nor was there evidence that the intervention reduced antidepressant use compared with usual care (adjusted odds ratio 0.63, 95% confidence interval 0.19 to 2.06; P=0.44) over the duration of the trial. However, participants allocated to the intervention group reported more physical activity during the follow-up period than those allocated to the usual care group (adjusted odds ratio 2.27, 95% confidence interval 1.32 to 3.89; P=0.003).

Conclusions: The addition of a facilitated physical activity intervention to usual care did not improve depression outcome or reduce use of antidepressants compared with usual care alone.

Trial registration: Current Controlled Trials ISRCTN16900744.

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Related in: MedlinePlus

Flow of participants through trial
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Related In: Results  -  Collection

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fig1: Flow of participants through trial

Mentions: Sixty five practices agreed to take part in the study, referring a total of 766 patients to the research team. Of 490 people assessed, 361 eligible and consenting participants were successfully randomised (figure). At baseline, 182 people were allocated to the intervention arm and 179 to the usual care arm. Eighty per cent of the participants provided data at the primary outcome follow-up point. Participants who provided follow-up information on the primary outcome were more likely at baseline to be older, own their own home, be educated to “A” level or beyond, be in receipt of counselling, smoke cigarettes, and drink alcohol less than weekly than those who did not provide such information. Fewer participants were lost to follow-up at the four and 12 month time points, where face to face data collection had taken place.


Facilitated physical activity as a treatment for depressed adults: randomised controlled trial.

Chalder M, Wiles NJ, Campbell J, Hollinghurst SP, Haase AM, Taylor AH, Fox KR, Costelloe C, Searle A, Baxter H, Winder R, Wright C, Turner KM, Calnan M, Lawlor DA, Peters TJ, Sharp DJ, Montgomery AA, Lewis G - BMJ (2012)

Flow of participants through trial
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3368484&req=5

fig1: Flow of participants through trial
Mentions: Sixty five practices agreed to take part in the study, referring a total of 766 patients to the research team. Of 490 people assessed, 361 eligible and consenting participants were successfully randomised (figure). At baseline, 182 people were allocated to the intervention arm and 179 to the usual care arm. Eighty per cent of the participants provided data at the primary outcome follow-up point. Participants who provided follow-up information on the primary outcome were more likely at baseline to be older, own their own home, be educated to “A” level or beyond, be in receipt of counselling, smoke cigarettes, and drink alcohol less than weekly than those who did not provide such information. Fewer participants were lost to follow-up at the four and 12 month time points, where face to face data collection had taken place.

Bottom Line: Secondary outcomes included use of antidepressants and physical activity at the four, eight, and 12 month follow-up points, and symptoms of depression at eight and 12 month follow-up.Similarly, there was no evidence that the intervention group reported a change in mood by the eight and 12 month follow-up points.The addition of a facilitated physical activity intervention to usual care did not improve depression outcome or reduce use of antidepressants compared with usual care alone.

View Article: PubMed Central - PubMed

Affiliation: School of Social and Community Medicine, University of Bristol, Bristol BS8 2BN, UK. melanie.chalder@bristol.ac.uk

ABSTRACT

Objective: To investigate the effectiveness of facilitated physical activity as an adjunctive treatment for adults with depression presenting in primary care.

Design: Pragmatic, multicentre, two arm parallel randomised controlled trial.

Setting: General practices in Bristol and Exeter.

Participants: 361 adults aged 18-69 who had recently consulted their general practitioner with symptoms of depression. All those randomised had a diagnosis of an episode of depression as assessed by the clinical interview schedule-revised and a Beck depression inventory score of 14 or more.

Interventions: In addition to usual care, intervention participants were offered up to three face to face sessions and 10 telephone calls with a trained physical activity facilitator over eight months. The intervention was based on theory and aimed to provide individually tailored support and encouragement to engage in physical activity.

Main outcome measures: The primary outcome was self reported symptoms of depression, assessed with the Beck depression inventory at four months post-randomisation. Secondary outcomes included use of antidepressants and physical activity at the four, eight, and 12 month follow-up points, and symptoms of depression at eight and 12 month follow-up.

Results: There was no evidence that participants offered the physical activity intervention reported improvement in mood by the four month follow-up point compared with those in the usual care group; adjusted between group difference in mean Beck depression inventory score -0.54 (95% confidence interval -3.06 to 1.99; P=0.68). Similarly, there was no evidence that the intervention group reported a change in mood by the eight and 12 month follow-up points. Nor was there evidence that the intervention reduced antidepressant use compared with usual care (adjusted odds ratio 0.63, 95% confidence interval 0.19 to 2.06; P=0.44) over the duration of the trial. However, participants allocated to the intervention group reported more physical activity during the follow-up period than those allocated to the usual care group (adjusted odds ratio 2.27, 95% confidence interval 1.32 to 3.89; P=0.003).

Conclusions: The addition of a facilitated physical activity intervention to usual care did not improve depression outcome or reduce use of antidepressants compared with usual care alone.

Trial registration: Current Controlled Trials ISRCTN16900744.

Show MeSH
Related in: MedlinePlus