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Physical exercise and internet-based cognitive-behavioural therapy in the treatment of depression: randomised
Mats Hallgren1, Martin Kraepelien2, Agneta Öjehagen2
1Mats Hallgren, PhD, Department of Public Health Sciences, Section for Epidemiology and Public Health Intervention Research (EPHIR), Karolinska Institutet, Stockholm; Martin Kraepelien, MSc, Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm; AgnetaÖjehagen, PhD, Department of Clinical Science, Lund, Division of Psychiatry, Lund University, Lund; Nils Lindefors, MD, PhD, Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm; Zangin Zeebari, PhD, Department of Public Health Sciences, Section for Epidemiology and Public Health Intervention Research (EPHIR), Karolinska Institutet, Stockholm; Viktor Kaldo, PhD, Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm; Yvonne Forsell, MD, PhD, Department of Public Health Sciences, Section for Epidemiology and Public Health Intervention Research (EPHIR), Karolinska Institutet, Stockholm, Sweden mats.hallgren@ki.se.
Background:
Depression is common and tends to be recurrent. Alternative treatments are needed that are non-stigmatising, accessible and can be prescribed by general medical practitioners.
Aims:
To compare the effectiveness of three interventions for depression: physical exercise, internet-based cognitive-behavioural therapy (ICBT) and treatment as usual (TAU). A secondary aim was to assess changes in self-rated work capacity.
Method:
A total of 946 patients diagnosed with mild to moderate depression were recruited through primary healthcare centres across Sweden and randomly assigned to one of three 12-week interventions (trail registry: KCTR study ID: KT20110063). Patients were reassessed at 3 months (response rate 78%).
Results:
Patients in the exercise and ICBT groups reported larger improvements in depressive symptoms compared with TAU. Work capacity improved over time in all three groups (no significant differences).
Conclusions:
Exercise and ICBT were more effective than TAU by a general medical practitioner, and both represent promising non-stigmatising treatment alternatives for patients with mild to moderate depression.
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