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Exercise and internet-based cognitive-behavioural therapy for depression: Multicentre randomized controlled trial with 12-month follow-up
Division of Epidemiology and Public Health Intervention Research (EPHIR), Department of Public Health Sciences, Karolinska Institute, Solna, Sweden.
Division of Epidemiology and Public Health Intervention Research (EPHIR), Department of Public Health Sciences, Karolinska Institute, Solna, Sweden.
Department of Physical Education and Sport Sciences, Health Research Institute, University of Limerick, Ireland.
Division of Epidemiology and Public Health Intervention Research (EPHIR), Department of Public Health Sciences, Karolinska Institute, Solna, Sweden.ORCID iD: 0000-0003-2733-4441
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2016 (English)In: British Journal of Psychiatry, ISSN 0007-1250, E-ISSN 1472-1465, Vol. 209, no 5, p. 414-420Article in journal (Refereed) Published
Abstract [en]

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. 

Place, publisher, year, edition, pages
Cambridge University Press, 2016. Vol. 209, no 5, p. 414-420
Keywords [en]
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)
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:hj:diva-39965DOI: 10.1192/bjp.bp.115.177576ISI: 000387934500009PubMedID: 27609813Scopus ID: 2-s2.0-84996560150OAI: oai:DiVA.org:hj-39965DiVA, id: diva2:1214917
Available from: 2018-06-07 Created: 2018-06-07 Last updated: 2018-06-07Bibliographically approved

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