Claire L Young1, Karen Trapani2, Samantha Dawson1, Adrienne O'Neil1,2, Frances Kay-Lambkin3, Michael Berk1, Felice N Jacka1,4,5. 1. 1 Deakin University, Food & Mood Centre, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Australia. 2. 2 Centre for Mental Health, Melbourne School of Population & Global Health, The University of Melbourne, Carlton, VIC, Australia. 3. 3 School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Australia, Newcastle, NSW, Australia. 4. 4 Centre for Adolescent Health, Murdoch Children's Research Institute, VIC, Australia. 5. 5 Black Dog Institute, Randwick, NSW, Australia.
Abstract
BACKGROUND: It is well established that depression and non-communicable diseases are highly co-morbid and bi-directional in nature. 'Lifestyle medicine' has recently gained traction in the field of psychiatry, aimed at improvement of both physical and mental health. Online interventions can be an effective and inexpensive alternative or supplement to therapy that is delivered using more traditional modes, overcoming barriers that may prohibit people from accessing treatment by promoting flexibility and accessibility. METHODS: This systematic review evaluates the existing evidence for the efficacy or effectiveness of lifestyle interventions for (1) individuals with depressive symptoms, (2) clinically depressed populations or discussing the outcomes of depression within a subset of a larger cohort that are delivered online or via smart phone. Included studies were randomised controlled trials, with active comparator conditions, in adult populations and with reported lifestyle and depression-related outcomes. The analysis examined attrition, engagement, adherence and behaviour change techniques employed to achieve the target behaviours. RESULTS: Seven studies were included in the review and targeted behaviour change in five domains: alcohol reduction, improved sleep quality/insomnia reduction, increased physical activity, reduced/cessation of substance abuse and smoking cessation. Four of the studies achieved significant improvements in the targeted behaviour; of these three also reported significant improvements in depressive symptoms. No studies reported significant improvements in depressive symptoms without a change in the target lifestyle behaviour. CONCLUSION: The results of this review highlight the potential of online lifestyle interventions as adjunctive treatments for depression, and the possibility of achieving significant improvements in depressive symptoms when targeting lifestyle behaviour change.
BACKGROUND: It is well established that depression and non-communicable diseases are highly co-morbid and bi-directional in nature. 'Lifestyle medicine' has recently gained traction in the field of psychiatry, aimed at improvement of both physical and mental health. Online interventions can be an effective and inexpensive alternative or supplement to therapy that is delivered using more traditional modes, overcoming barriers that may prohibit people from accessing treatment by promoting flexibility and accessibility. METHODS: This systematic review evaluates the existing evidence for the efficacy or effectiveness of lifestyle interventions for (1) individuals with depressive symptoms, (2) clinically depressed populations or discussing the outcomes of depression within a subset of a larger cohort that are delivered online or via smart phone. Included studies were randomised controlled trials, with active comparator conditions, in adult populations and with reported lifestyle and depression-related outcomes. The analysis examined attrition, engagement, adherence and behaviour change techniques employed to achieve the target behaviours. RESULTS: Seven studies were included in the review and targeted behaviour change in five domains: alcohol reduction, improved sleep quality/insomnia reduction, increased physical activity, reduced/cessation of substance abuse and smoking cessation. Four of the studies achieved significant improvements in the targeted behaviour; of these three also reported significant improvements in depressive symptoms. No studies reported significant improvements in depressive symptoms without a change in the target lifestyle behaviour. CONCLUSION: The results of this review highlight the potential of online lifestyle interventions as adjunctive treatments for depression, and the possibility of achieving significant improvements in depressive symptoms when targeting lifestyle behaviour change.
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