Schneider Kristin L, Bodenlos Jamie S, Ma Yunsheng, Olendzki Barbara, Oleski Jessica, Merriam Philip, Crawford Sybil, Ockene Ira S, Pagoto Sherry L
Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, USA.
BMC Psychiatry. 2008 Sep 15;8:77. doi: 10.1186/1471-244X-8-77.
Obesity is often comorbid with depression and individuals with this comorbidity fare worse in behavioral weight loss treatment. Treating depression directly prior to behavioral weight loss treatment might bolster weight loss outcomes in this population, but this has not yet been tested in a randomized clinical trial.
This randomized clinical trial will examine whether behavior therapy for depression administered prior to standard weight loss treatment produces greater weight loss than standard weight loss treatment alone. Obese women with major depressive disorder (N = 174) will be recruited from primary care clinics and the community and randomly assigned to one of the two treatment conditions. Treatment will last 2 years, and will include a 6-month intensive treatment phase followed by an 18-month maintenance phase. Follow-up assessment will occur at 6-months and 1- and 2 years following randomization. The primary outcome is weight loss. The study was designed to provide 90% power for detecting a weight change difference between conditions of 3.1 kg (standard deviation of 5.5 kg) at 1-year assuming a 25% rate of loss to follow-up. Secondary outcomes include depression, physical activity, dietary intake, psychosocial variables and cardiovascular risk factors. Potential mediators (e.g., adherence, depression, physical activity and caloric intake) of the intervention effect on weight change will also be examined.
Treating depression before administering intensive health behavior interventions could potentially boost the impact on both mental and physical health outcomes.
NCT00572520.
肥胖常与抑郁症并存，患有这种合并症的个体在行为减肥治疗中的效果较差。在行为减肥治疗之前直接治疗抑郁症可能会改善该人群的减肥效果，但这尚未在随机临床试验中得到验证。
这项随机临床试验将检验在标准减肥治疗之前给予抑郁症行为疗法是否比单纯的标准减肥治疗能带来更多的体重减轻。将从初级保健诊所和社区招募患有重度抑郁症的肥胖女性（N = 174），并将她们随机分配到两种治疗条件中的一种。治疗将持续2年，包括一个为期6个月的强化治疗阶段，随后是一个为期18个月的维持阶段。随机分组后6个月、1年和2年进行随访评估。主要结局是体重减轻。该研究旨在假设随访失访率为25%的情况下，为检测1年时两组间体重变化差异3.1千克（标准差5.5千克）提供90%的检验效能。次要结局包括抑郁、身体活动、饮食摄入、心理社会变量和心血管危险因素。还将检验干预对体重变化影响的潜在中介因素（如依从性、抑郁、身体活动和热量摄入）。
在实施强化健康行为干预之前治疗抑郁症可能会增强对身心健康结局的影响。
NCT00572520。
