A Goracci1, P Rucci2, R N Forgione1, G Campinoti1, M Valdagno1, I Casolaro1, E Carretta3, S Bolognesi1, A Fagiolini1. 1. Department of Molecular and Developmental Medicine, University of Siena, Italy. 2. Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, Italy. Electronic address: paola.rucci2@unibo.it. 3. Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, Italy.
Abstract
BACKGROUND: Research evidence on the effects of integrated multifaceted lifestyle interventions for depression is scanty. The aim of the present study is to report on the development, acceptability and efficacy of a standardized healthy lifestyle intervention, including exercise, eating habits, sleep hygiene and smoking cessation in preventing relapses. METHODS:One hundred-sixty outpatients with recurrent unipolar depression or bipolar disorder were recruited after achieving full remission or recovery from the most recent depressive episode. Patients were randomized to 3-months of usual care or to an intervention aimed at promoting a healthy lifestyle (HLI), as an augmentation of pharmacological maintenance treatment. Usual care consisted of clinical management visits. At the end of the intervention, follow-up visits were scheduled at 3,6,9 and 12 months. RESULTS: During the intervention phase, 1 relapse occurred in the HLI group and 4 in the control group. Over the 12 months of follow-up, relapses were 5 in the HLI group and 16 in control group. Using an intent-to-treat approach, the overall percentage of relapses was 6/81 (7.4%) in the HLI group vs. 20/79 (25.3%) in the control group.. In a Kaplan-Meier survival analysis the risk of relapse was significantly lower in patients receiving the HLI intervention (log-rank test, p=0.003) over the 60 weeks of observation. The majority of patients assigned to HLI adhered to the program, and were highly motivated throughout the intervention. LIMITATIONS: The retention rate was low because patients were recruited during the maintenance phase and the 1-year follow-up was relatively short to detect a long-term effect of HLI. CONCLUSIONS: The HLI program proved to be efficacious in preventing relapses. Given the absence of contraindications and its cost-effectiveness in routine practice, the use of HLI should be encouraged to promote the well-being of patients with recurrent depression.
RCT Entities:
BACKGROUND: Research evidence on the effects of integrated multifaceted lifestyle interventions for depression is scanty. The aim of the present study is to report on the development, acceptability and efficacy of a standardized healthy lifestyle intervention, including exercise, eating habits, sleep hygiene and smoking cessation in preventing relapses. METHODS: One hundred-sixty outpatients with recurrent unipolar depression or bipolar disorder were recruited after achieving full remission or recovery from the most recent depressive episode. Patients were randomized to 3-months of usual care or to an intervention aimed at promoting a healthy lifestyle (HLI), as an augmentation of pharmacological maintenance treatment. Usual care consisted of clinical management visits. At the end of the intervention, follow-up visits were scheduled at 3,6,9 and 12 months. RESULTS: During the intervention phase, 1 relapse occurred in the HLI group and 4 in the control group. Over the 12 months of follow-up, relapses were 5 in the HLI group and 16 in control group. Using an intent-to-treat approach, the overall percentage of relapses was 6/81 (7.4%) in the HLI group vs. 20/79 (25.3%) in the control group.. In a Kaplan-Meier survival analysis the risk of relapse was significantly lower in patients receiving the HLI intervention (log-rank test, p=0.003) over the 60 weeks of observation. The majority of patients assigned to HLI adhered to the program, and were highly motivated throughout the intervention. LIMITATIONS: The retention rate was low because patients were recruited during the maintenance phase and the 1-year follow-up was relatively short to detect a long-term effect of HLI. CONCLUSIONS: The HLI program proved to be efficacious in preventing relapses. Given the absence of contraindications and its cost-effectiveness in routine practice, the use of HLI should be encouraged to promote the well-being of patients with recurrent depression.
Authors: Chloe Wilson; Alissa Nichles; Natalia Zmicerevska; Joanne Sarah Carpenter; Yun Ju Christine Song; Catherine McHugh; Blake Hamilton; Samuel Hockey; Elizabeth M Scott; Ian B Hickie Journal: BMJ Open Date: 2021-06-29 Impact factor: 2.692
Authors: Marián Kolenič; Filip Španiel; Jaroslav Hlinka; Martin Matějka; Pavel Knytl; Antonín Šebela; Jiří Renka; Tomas Hajek Journal: Front Psychiatry Date: 2020-09-23 Impact factor: 4.157
Authors: Capilla Navarro; Aina M Yáñez; Aurora Garcia; Andrea Seguí; Francisco Gazquez; Jose Antonio Marino; Olga Ibarra; Maria J Serrano-Ripoll; Rocio Gomez-Juanes; Miquel Bennasar-Veny; Joan Salva; Bárbara Oliván; Miquel Roca; Margalida Gili; Mauro Garcia-Toro Journal: Medicine (Baltimore) Date: 2020-11-06 Impact factor: 1.817