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Facilitated physical activity as a treatment for depressed adults: randomised controlled trial
Melanie Chalder1, Nicola J Wiles, John Campbell
1School of Social and Community Medicine, University of Bristol, Bristol BS8 2BN, UK. melanie.chalder@bristol.ac.uk
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.
