School of Social and Community Medicine, University of Bristol, Bristol BS8 2BN, UK.
BMJ. 2012 Jun 6;344:e2758. doi: 10.1136/bmj.e2758.
To investigate the effectiveness of facilitated physical activity as an adjunctive treatment for adults with depression presenting in primary care.
Pragmatic, multicentre, two arm parallel randomised controlled trial.
General practices in Bristol and Exeter.
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.
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.
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.
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).
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.
Current Controlled Trials ISRCTN16900744.
探讨促进身体活动作为辅助治疗对初级保健中出现抑郁的成年人的有效性。
实用、多中心、双臂平行随机对照试验。
布里斯托尔和埃克塞特的全科诊所。
361 名年龄在 18-69 岁之间的成年人，他们最近因抑郁症状咨询了他们的全科医生。所有随机分组的人都通过临床访谈时间表修订版和贝克抑郁量表评分 14 分或以上进行了发作性抑郁的诊断。
除了常规护理外，干预组还提供了最多三次的面对面会议和 10 次电话，与经过培训的身体活动促进者进行了 8 个月的联系。该干预措施基于理论，旨在为参与身体活动提供个性化的支持和鼓励。
主要结果是自我报告的抑郁症状，在随机分组后 4 个月使用贝克抑郁量表评估。次要结果包括在 4、8 和 12 个月的随访点使用抗抑郁药和身体活动，以及在 8 和 12 个月的随访点的抑郁症状。
与常规护理组相比，接受身体活动干预的参与者在 4 个月的随访时没有证据表明情绪有所改善；调整后的平均贝克抑郁量表评分组间差异为-0.54（95%置信区间-3.06 至 1.99；P=0.68）。同样，没有证据表明干预组在 8 个月和 12 个月的随访点报告情绪发生变化。也没有证据表明与常规护理相比，该干预措施减少了抗抑郁药的使用（调整后的比值比 0.63，95%置信区间 0.19 至 2.06；P=0.44）在整个试验期间。然而，与常规护理组相比，分配到干预组的参与者在随访期间报告了更多的身体活动（调整后的比值比 2.27，95%置信区间 1.32 至 3.89；P=0.003）。
与常规护理相比，在常规护理中增加促进身体活动的干预措施并不能改善抑郁结局或减少抗抑郁药的使用。
当前对照试验 ISRCTN82366354。
Zotero 插件