Stelzer Eva-Maria, Book Stephanie, Graessel Elmar, Hofner Benjamin, Kornhuber Johannes, Luttenberger Katharina
Friedrich-Alexander-Universität Erlangen-Nürnberg Psychiatric and Psychotherapeutic University Clinic Erlangen, Department of Medical Psychology and Medical Sociology, Schwabachanlage 6, 91054 Erlangen, Germany.
University of Arizona, Department of Psychology, 1503 E University Blvd, Tucson, AZ 85719, USA.
Heliyon. 2018 Mar 23;4(3):e00580. doi: 10.1016/j.heliyon.2018.e00580. eCollection 2018 Mar.
Bouldering psychotherapy (BPT) combines psychotherapeutic elements with physical activity (PA). It might be effective for reducing symptoms of depression, but so far, no study has assessed individuals' levels of PA to control for whether positive effects on depression can also be found when adjusting for participants' levels of PA. This is important because PA itself has been proven effective in reducing depression and therefore might be an important variable to account for - especially in therapies using sport as one therapeutic mechanism.
Using a waitlist control group design, outpatients with depression were assessed at baseline and after eight, 16, and 24 weeks. The intervention group took part in an eight-week bouldering psychotherapy which met once a week for three hours. Self-report measures before and after the intervention included the Symptom Checklist-90-R (SCL-90-R), the Beck Depression Inventory (BDI-II), and the questionnaire on resources and self-management skills (FERUS). PA was assessed during the first 16-week period via FitBit Zip accelerometers.
Altogether, 47 complete cases (20 men and 27 women) were included in the final analyses. Depression scores dropped by up to 6.74 (CI 2.80-10.67) points on the SCL-90-R depression scale and by up to 8.26 (CI 4.21-12.31) points on the BDI-II during the BPT intervention, the control group remained stable (SCL-90-R Cohen's = 0.60; BDI-II: Cohen's = .50). All Participants accrued an average of 6,515 steps per day, which is considered "low-active." Participants of the BPT intervention were significantly more likely to reduce their depressive symptoms ( = .025) than participants of the control group, even when PA was controlled for in a regression analysis.
Limitations of the study are the relatively small number of patients and the assessment of outcome scores via self-report.
This study provides evidence that short-term BPT can be effective for reducing symptoms of depression even if controlled for other therapeutically active confounders including antidepressant medication, psychotherapy and general level of PA.
抱石心理治疗（BPT）将心理治疗元素与体育活动（PA）相结合。它可能对减轻抑郁症状有效，但到目前为止，尚无研究评估个体的体育活动水平，以控制在调整参与者的体育活动水平时是否也能发现对抑郁的积极影响。这很重要，因为体育活动本身已被证明对减轻抑郁有效，因此可能是一个需要考虑的重要变量——尤其是在将运动作为一种治疗机制的疗法中。
采用候补对照组设计，对抑郁症门诊患者在基线时以及8周、16周和24周后进行评估。干预组参加了为期8周的抱石心理治疗，每周进行一次，每次3小时。干预前后的自我报告测量包括症状自评量表-90修订版（SCL-90-R）、贝克抑郁量表（BDI-II）以及资源和自我管理技能问卷（FERUS）。在最初的16周内，通过FitBit Zip加速度计评估体育活动情况。
最终分析共纳入47例完整病例（20名男性和27名女性）。在抱石心理治疗干预期间，SCL-90-R抑郁量表上的抑郁得分下降了多达6.74（CI 2.80 - 10.67）分，BDI-II上的得分下降了多达8.26（CI 4.21 - 12.31）分，对照组保持稳定（SCL-90-R Cohen's d = 0.60；BDI-II：Cohen's d = 0.50）。所有参与者平均每天步数为6515步，这被认为是“低运动量”。即使在回归分析中控制了体育活动，抱石心理治疗干预组的参与者比对照组的参与者更有可能减轻抑郁症状（p = 0.025）。
该研究的局限性在于患者数量相对较少，且通过自我报告评估结果分数。
本研究提供了证据，即短期抱石心理治疗即使在控制了包括抗抑郁药物、心理治疗和体育活动总体水平等其他治疗活性混杂因素的情况下，也能有效减轻抑郁症状。
