Facilitated physical activity as a treatment for depressed adults: randomised controlled trial.
Facilitated physical activity as a treatment for depressed adults: randomised controlled trial.
复制标题
DOI：
10.1136/bmj.e2758
复制
发表时间：
2012-06-06
期刊：
影响因子：
--
通讯作者：
Lewis G
中科院分区：
文献类型：
--
作者：
Chalder M;Wiles NJ;Campbell J;Hollinghurst SP;Haase AM;Taylor AH;Fox KR;Costelloe C;Searle A;Baxter H;Winder R;Wright C;Turner KM;Calnan M;Lawlor DA;Peters TJ;Sharp DJ;Montgomery AA;Lewis G
目的探讨促进体力活动辅助治疗成人初级保健抑郁症的效果。设计务实、多中心、双臂平行随机对照试验。制定布里斯托尔和埃克塞特的常规做法。参与者361名年龄在18-69岁之间的成年人，他们最近咨询了他们的全科医生，有抑郁症的症状。所有随机抽样的人都被诊断出患有抑郁症，根据修订后的临床访谈计划和贝克抑郁问卷评分为14或更高进行评估。干预措施除了常规护理外，干预参与者在8个月的时间里接受了最多3次面对面的会议和10次电话呼叫，由一名训练有素的体力活动协调员进行。这项干预是以理论为基础的，旨在提供个性化的支持和鼓励从事体力活动。主要观察指标随机分组后4个月，采用Beck抑郁量表对患者的抑郁症状进行自我报告。次要结果包括4个月、8个月和12个月随访点的抗抑郁药物的使用和体力活动，以及8个月和12个月随访点的抑郁症状。结果与常规护理组相比，在4个月的随访点，没有证据表明接受体育活动干预的参与者的情绪有所改善；调整了两组之间平均贝克抑郁问卷评分的差异−为0.54(95%可信区间−为3.06~1.99；P=0.68)。同样，没有证据表明干预组在8个月和12个月的跟踪点时情绪发生了变化。也没有证据表明，在试验期间，与常规护理相比，干预减少了抗抑郁药的使用(调整后的优势比为0.63，95%可信区间为0.19至2.06；P=0.44)。然而，被分配到干预组的参与者在随访期内报告的体力活动比被分配到常规护理组的参与者更多(调整后的优势比2.27，95%可信区间1.32至3.89；P=0.003)。结论：与单纯常规护理相比，在常规护理的基础上增加促进体力活动干预并不能改善抑郁结局或减少抗抑郁药物的使用。试验登记当前对照试验ISRCTN16900744。
Objective To investigate the effectiveness of facilitated physical activity as an adjunctive treatment for adults with depression presenting in primary care. Design Pragmatic, multicentre, two arm parallel randomised controlled trial. Setting General practices in Bristol and Exeter. Participants 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. Interventions 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. Main outcome measures 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. Results 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). Conclusions 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. Trial registration Current Controlled Trials ISRCTN16900744.
登录
查看更多内容
流行病学和临床研究中缺少数据的多重归因：潜力和陷阱。
DOI：
10.1136/bmj.b2393
发表时间：
2009-06-29
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Sterne JA;White IR;Carlin JB;Spratt M;Royston P;Kenward MG;Wood AM;Carpenter JR
通讯作者：
Carpenter JR
影响因子：
2.3
作者：
Dunn, G;Maracy, M;Tomenson, B
通讯作者：
Tomenson, B
DOI：
10.1016/j.jclinepi.2010.03.004
发表时间：
2010-01-01
期刊：
Open medicine : a peer-reviewed, independent, open-access journal
影响因子：
--
作者：
Schulz, Kenneth F;Altman, Douglas G;Moher, David
通讯作者：
Moher, David
影响因子：
3.6
作者：
Chalder, M.;Wiles, N. J.;Lewis, G.
通讯作者：
Lewis, G.
影响因子：
--
作者：
BECK, AT;ERBAUGH, J;MENDELSOHN, M
通讯作者：
MENDELSOHN, M