Facilitated physical activity as a treatment for depressed adults: randomised controlled trial - PubMed (original) (raw)
Randomized Controlled Trial
doi: 10.1136/bmj.e2758.
Nicola J Wiles, John Campbell, Sandra P Hollinghurst, Anne M Haase, Adrian H Taylor, Kenneth R Fox, Ceire Costelloe, Aidan Searle, Helen Baxter, Rachel Winder, Christine Wright, Katrina M Turner, Michael Calnan, Deborah A Lawlor, Tim J Peters, Deborah J Sharp, Alan A Montgomery, Glyn Lewis
Affiliations
- PMID: 22674921
- PMCID: PMC3368484
- DOI: 10.1136/bmj.e2758
Randomized Controlled Trial
Facilitated physical activity as a treatment for depressed adults: randomised controlled trial
Melanie Chalder et al. BMJ. 2012.
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.
Conflict of interest statement
Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi\_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; and no other relationships or activities that could appear to have influenced the submitted work.
Figures
Flow of participants through trial
Comment in
- Exercise to treat depression.
Daley A, Jolly K. Daley A, et al. BMJ. 2012 Jun 6;344:e3181. doi: 10.1136/bmj.e3181. BMJ. 2012. PMID: 22674923 No abstract available. - TREAD adds little to the evidence.
Pilling S, Anderson I. Pilling S, et al. BMJ. 2012 Jul 3;345:e4490; author reply e4500. doi: 10.1136/bmj.e4490. BMJ. 2012. PMID: 22761100 No abstract available. - Study's conclusion is misleading and ill considered.
Donnelly L. Donnelly L. BMJ. 2012 Jul 3;345:e4494; author reply e4500. doi: 10.1136/bmj.e4494. BMJ. 2012. PMID: 22761101 No abstract available. - Media reports fuelled by authors' claims.
Davies S, Larkin J, Loosemore M, Montgomery H. Davies S, et al. BMJ. 2012 Jul 3;345:e4495; author reply e4500. doi: 10.1136/bmj.e4495. BMJ. 2012. PMID: 22761102 No abstract available. - Adding facilitated physical activity to standard GP care for depression does not improve symptoms.
Wilbur J, Buchholz SW. Wilbur J, et al. Evid Based Ment Health. 2012 Nov;15(4):93. doi: 10.1136/eb-2012-100913. Epub 2012 Sep 6. Evid Based Ment Health. 2012. PMID: 22956482 No abstract available. - Physical activity as a treatment for depressed adults.
Mead GE. Mead GE. J R Coll Physicians Edinb. 2012;42(4):325. doi: 10.4997/JRCPE.2012.410. J R Coll Physicians Edinb. 2012. PMID: 23240120 No abstract available.
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