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

Hallgren, Mats; Helgadóttir, Björg; Herring, Matthew P.; Zeebari, Zangin; Lindefors, Nils; Kaldo, Viktor; Öjehagen, Agneta LU and Forsell, Yvonne (2016) In British Journal of Psychiatry 209(5). p.414-420
Abstract

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. Computergenerated 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... (More)

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. Computergenerated 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-Å sberg 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 group6time 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. Declaration of interest None.

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organization
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type
Contribution to journal
publication status
published
subject
in
British Journal of Psychiatry
volume
209
issue
5
pages
7 pages
publisher
Royal College of Psychiatrists
external identifiers
  • scopus:84996560150
  • wos:000387934500009
ISSN
0007-1250
DOI
10.1192/bjp.bp.115.177576
language
English
LU publication?
yes
id
3d25b3e0-1e48-4cf3-87e1-4e56b48b26f6
date added to LUP
2016-12-12 11:16:28
date last changed
2017-10-29 04:55:26
@article{3d25b3e0-1e48-4cf3-87e1-4e56b48b26f6,
  abstract     = {<p>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. Computergenerated 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-Å sberg 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 group6time 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. Declaration of interest None.</p>},
  author       = {Hallgren, Mats and Helgadóttir, Björg and Herring, Matthew P. and Zeebari, Zangin and Lindefors, Nils and Kaldo, Viktor and Öjehagen, Agneta and Forsell, Yvonne},
  issn         = {0007-1250},
  language     = {eng},
  month        = {11},
  number       = {5},
  pages        = {414--420},
  publisher    = {Royal College of Psychiatrists},
  series       = {British Journal of Psychiatry},
  title        = {Exercise and internet-based cognitive-behavioural therapy for depression : Multicentre randomized controlled trial with 12-month follow-up},
  url          = {http://dx.doi.org/10.1192/bjp.bp.115.177576},
  volume       = {209},
  year         = {2016},
}