Centre for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany.
Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany.
BMC Psychiatry. 2020 Mar 12;20(1):116. doi: 10.1186/s12888-020-02518-y.
Recent scientific studies have suggested that climbing/bouldering is effective in alleviating depression when the comparison group was a waitlist control group, even when physical activity and other therapeutic approaches were controlled for. In the present study, we aimed to investigate the effectiveness of a manualised psychotherapeutic bouldering intervention for depressed individuals, compared with an active control group performing physical exercise alone.
In a multicentre randomised controlled intervention trial, 133 outpatients with depression were assigned to either a bouldering psychotherapy (BPT) group or a home-based supervised exercise programme (EP). Severity of depression as the primary outcome was assessed at baseline and directly after a ten-week intervention period using the Montgomery-Åsberg Depression Rating Scale (MADRS). Secondary outcomes included anxiety, coping skills, self-esteem, body image, and interpersonal sensitivity. We applied t-tests to test for differences within the groups (t0 vs. t1) and between the BPT and the EP and a multiple regression analysis with the post-intervention MADRS score as the dependent variable. The robustness of estimates was investigated with a sensitivity analyses.
Patients in the BPT group showed a significantly larger decrease in depression scores compared with the EP on the MADRS (drop of 8.4 vs. 3.0 points, p = .002, Cohen's d = 0.55). In the confounder-adjusted regression analyses, group allocation was found to be the only significant predictor of the post-intervention MADRS score (β = - 5.60, p = .001) besides the baseline MADRS score. Further significant differences in change scores between the BPT and the EP were found for anxiety (p = .046, d = 0.35), body image (p = .018, d = 0.42), and global self-esteem (p = .011, d = 0.45).
The study provides evidence that the manualised BPT is not only effective in alleviating depressive symptoms but even goes beyond the effect of mere physical exercise. Based on these findings, the BPT should be considered as a complementary therapeutic approach.
Trial identification number: ISRCTN12457760: Study KuS (Klettern und Stimmung - Climbing and Mood) combined boulder and psychotherapy against depression, registered retrospectively on July 26th, 2017.
最近的科学研究表明，当对照组为候补对照组时，攀岩/抱石对于缓解抑郁症是有效的，即使控制了体育活动和其他治疗方法。在本研究中，我们旨在调查一种针对抑郁症患者的规范化心理治疗抱石干预的有效性，与单独进行身体锻炼的主动对照组进行比较。
在一项多中心随机对照干预试验中，将 133 名门诊抑郁症患者分为抱石心理治疗（BPT）组或家庭监督运动方案（EP）组。使用蒙哥马利-阿斯伯格抑郁评定量表（MADRS）在基线和十周干预期后直接评估抑郁严重程度作为主要结局。次要结局包括焦虑、应对技能、自尊、身体形象和人际敏感。我们使用 t 检验测试组内（t0 与 t1）和 BPT 与 EP 之间的差异，并使用多元回归分析将干预后 MADRS 评分作为因变量。使用敏感性分析来检查估计值的稳健性。
与 EP 相比，BPT 组的患者在 MADRS 上的抑郁评分下降幅度显著更大（下降 8.4 分 vs. 3.0 分，p =.002，Cohen's d =.55）。在调整混杂因素的回归分析中，除了基线 MADRS 评分外，组分配被发现是干预后 MADRS 评分的唯一显著预测因素（β= -5.60，p =.001）。在 BPT 和 EP 之间，焦虑（p =.046，d =.35）、身体形象（p =.018，d =.42）和总体自尊（p =.011，d =.45）的变化评分也存在显著差异。
该研究提供了证据表明，规范化的 BPT 不仅能有效缓解抑郁症状，甚至优于单纯的身体运动。基于这些发现，BPT 应该被视为一种补充性的治疗方法。
试验识别号：ISRCTN8351412：Kus（抱石与情绪）研究结合抱石和心理治疗治疗抑郁症，于 2017 年 7 月 26 日回顾性注册。
