RESIDENT: The effectiveness of Group CBT and Exercise in management of Depression: A three arm randomized controlled pilot trial

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Presenting Author(s): Dr. Mojtaba Yekrang Safakar

Co-Author(s): Dr. Vincent I.O. Agyapong, Dr. Allen Fu, Dr. Marianne Hrabok, Dr. Liana Urichuk

Date and time: 24 Mar 2018 from 14:00 to 14:15

Location: Bluebell  Floor Map

Learning Objectives:

  1. To review of the effectiveness of CBT in management of Depression
  2. To review the effectiveness of Physical Exercise in management of Depression
  3. To review the synergistic effect of CBT and Physical Exercise in management of Depression

 Literature References:

 Abdollahi, A., LeBouthillier, D. M., Najafi, M., Asmundson, G. J. G., Hosseinian, S., Shahidi, S., … Jalili, M. (2017). Effect of exercise augmentation of cognitive behavioural therapy for the treatment of suicidal ideation and depression. Journal of Affective Disorders, 219, 58–63.

https://doi.org/10.1016/j.jad.2017.05.012

Bridle, C., Spanjers, K., Patel, S., Atherton, N. M., & Lamb, S. E. (2012). Effect of exercise on depression severity in older people: systematic review and meta-analysis of randomised controlled trials. The British Journal of Psychiatry, 201(3), 180–185.

 https://doi.org/10.1192/bjp.bp.111.095174

Catalan-Matamoros, D., Gomez-Conesa, A., Stubbs, B., & Vancampfort, D. (2016). Exercise improves depressive symptoms in older adults: An umbrella review of systematic reviews and meta-analyses. Psychiatry Research, 244, 202–209.

https://doi.org/10.1016/j.psychres.2016.07.028

Cooney, G. M., Dwan, K., Greig, C. A., Lawlor, D. A., Rimer, J., Waugh, F. R., … Mead, G. E. (2013). Exercise for depression. The Cochrane Database of Systematic Reviews, (9), CD004366.

https://doi.org/10.1002/14651858.CD004366.pub6

Craft, L. L., & Perna, F. M. (2004). The Benefits of Exercise for the Clinically Depressed. Primary Care Companion to The Journal of Clinical Psychiatry, 6(3), 104–111.

Depression in adults: recognition and management | Guidance and guidelines | NICE. (n.d.). Retrieved October 26, 2017, from https://www.nice.org.uk/guidance/cg90/ifp/chapter/treatments-for-mild-to-moderate-depression Edmonton, C. of. (2017, September 14). 2016 Municipal Census Results. Retrieved September 14, 2017, from https://www.edmonton.ca/city_government/facts_figures/municipal-census-results.aspx

Euteneuer, F., Dannehl, K., del Rey, A., Engler, H., Schedlowski, M., & Rief, W. (2017). Immunological effects of behavioral activation with exercise in major depression: an exploratory randomized controlled trial. Translational Psychiatry, 7(5), e1132.

https://doi.org/10.1038/tp.2017.76

Gill, A., Womack, R., & Safranek, S. (2010). Does exercise alleviate symptoms of depression? Clinical Inquiries, 2010 (MU).

Heinzel, S., Lawrence, J. B., Kallies, G., Rapp, M. A., & Heissel, A. (2015). Using Exercise to Fight Depression in Older Adults: A Systematic Review and Meta-Analysis. GeroPsych, 28(4), 149–162.

https://doi.org/10.1024/1662-9647/a000133

Huang, T.-T., Liu, C.-B., Tsai, Y.-H., Chin, Y.-F., & Wong, C.-H. (2015). Physical fitness exercise versus cognitive behavior therapy on reducing the depressive symptoms among community-dwelling elderly adults: A randomized controlled trial. International Journal of Nursing Studies, 52(10), 1542–1552.

https://doi.org/10.1016/j.ijnurstu.2015.05.013

Josefsson, T., Lindwall, M., & Archer, T. (2014). Physical exercise intervention in depressive disorders: Meta-analysis and systematic review: Exercise intervention in depressive disorders. Scandinavian Journal of Medicine & Science in Sports, 24(2), 259–272.

https://doi.org/10.1111/sms.12050

Mead, G. E., Morley, W., Campbell, P., Greig, C. A., McMurdo, M., & Lawlor, D. A. (2009). Exercise for depression. The Cochrane Database of Systematic Reviews, (3), CD004366.

https://doi.org/10.1002/14651858.CD004366.

pub4 Organization, W. H. (2017). Depression and other common mental disorders: global health estimates. Schuch, F. B., Vancampfort, D., Richards, J., Rosenbaum, S., Ward, P. B., & Stubbs, B. (2016). Exercise as a treatment for depression: A meta-analysis adjusting for publication bias. Journal of Psychiatric Research, 77, 42–51.

https://doi.org/10.1016/j.jpsychires.2016.02.023  

  Abstract:

 The effectiveness of Group CBT and Exercise in management of Depression: Protocol for a  three arm randomized controlled pilot trial  Background: Despite strong evidence in scientific literature indicating the effectiveness of CBT in management of Major Depressive Disorder (MDD) and some clinical trials presenting physical exercise as an effective treatment for the disorder, the probable synergistic effect of a combined therapy with both has never been studied.   Objectives: To evaluate and compare the effectiveness of group CBT alone, scheduled physical exercise alone, and a combination of those in the management of MDD.   Design: This prospective rater-blinded randomized controlled trial assessing the benefits for  patients with major depressive disorder who will be randomly assigned to one of the three arms of the study for 12 weeks and will be assessed at baseline, 6 and 12 weeks. Their assessment will cover primary outcomes including recovery variables, functional variables (quality of life, employment) and symptom variables (changes in depressive symptoms scores, overall outcomes). Secondary client outcomes will be service variables (patient’s satisfaction with the service). Hypothesis: We hypothesize that patients with MDD assigned to the CBT only and the Exercise only arms of the study will achieve similar outcomes whereas those assigned to the CBT plus Exercise arm will achieve superior outcomes.  Results: Statistical analysis of the findings of this study will guide the design of future, more highly powered studies by providing estimates for the calculation of sample and effect sizes regarding clinically meaningful difference between the intervention and control groups.



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