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Br J Psychiatry. 2016 Nov;209(5):414-420. Epub 2016 Sep 8.

Exercise and internet-based cognitive-behavioural therapy for depression: multicentre randomised controlled trial with 12-month follow-up.

Author information

1
Mats Hallgren, PhD, Division of Epidemiology and Public Health Intervention Research (EPHIR), Department of Public Health Sciences, Karolinska Institute; Björg Helgadóttir, MSc, Department of Public Health Sciences, Karolinska Institute, Solna, Sweden; Matthew P. Herring, PhD, Department of Physical Education and Sport Sciences, and Health Research Institute, University of Limerick, Ireland; Zangin Zeebari, PhD, Department of Public Health Sciences, EPHIR, Karolinska Institute, Solna, Sweden; Nils Lindefors, MD, PhD, Viktor Kaldo, PhD, Department of Clinical Neuroscience, Karolinska Institute, Huddinge, Sweden; AgnetaÖjehagen, PhD, Department of Clinical Sciences, Psychiatry, Lund University, Lund, Sweden; Yvonne Forsell, MD, PhD, Department of Public Health Sciences, EPHIR, Karolinska Institute, Solna, Sweden Mats.hallgren@ki.se.
2
Mats Hallgren, PhD, Division of Epidemiology and Public Health Intervention Research (EPHIR), Department of Public Health Sciences, Karolinska Institute; Björg Helgadóttir, MSc, Department of Public Health Sciences, Karolinska Institute, Solna, Sweden; Matthew P. Herring, PhD, Department of Physical Education and Sport Sciences, and Health Research Institute, University of Limerick, Ireland; Zangin Zeebari, PhD, Department of Public Health Sciences, EPHIR, Karolinska Institute, Solna, Sweden; Nils Lindefors, MD, PhD, Viktor Kaldo, PhD, Department of Clinical Neuroscience, Karolinska Institute, Huddinge, Sweden; AgnetaÖjehagen, PhD, Department of Clinical Sciences, Psychiatry, Lund University, Lund, Sweden; Yvonne Forsell, MD, PhD, Department of Public Health Sciences, EPHIR, Karolinska Institute, Solna, Sweden.

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 (post-treatment) 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 × 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.

PMID:
27609813
DOI:
10.1192/bjp.bp.115.177576
[Indexed for MEDLINE]

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