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Randomized Controlled Trial
. 2012 Jun 6:344:e2758.
doi: 10.1136/bmj.e2758.

Facilitated physical activity as a treatment for depressed adults: randomised controlled trial

Melanie Chalder  1 , Nicola J Wiles, John Campbell, Sandra P Hollinghurst, Anne M Haase, Adrian H Taylor, Kenneth R Fox, Ceire Costelloe, Aidan Searle, Helen Baxter, Rachel Winder, Christine Wright, Katrina M Turner, Michael Calnan, Deborah A Lawlor, Tim J Peters, Deborah J Sharp, Alan A Montgomery, Glyn Lewis
Affiliations
Randomized Controlled Trial

Facilitated physical activity as a treatment for depressed adults: randomised controlled trial

Melanie Chalder et al. BMJ. .

Abstract

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.

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Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; and no other relationships or activities that could appear to have influenced the submitted work.

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Flow of participants through trial
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References

    1. McCrone P, Dhanisiri S, Patel A, Knapp M, Lawton-Smith S. Paying the price: the cost of mental health care in England to 2026. King’s Fund, 2008.
    1. Hyde J, Calnan M, Prior L, Lewis G, Kessler D, Sharp D. Reluctant medicalisers? A qualitative study exploring how general practitioners decide to prescribe antidepressants. Br J Gen Pract 2005;55:755-62. - PMC - PubMed
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    1. National Institute for Health and Clinical Excellence. Depression: the treatment and management of depression in adults (updated edition). British Psychological Society and Royal College of Psychiatrists, 2009.
    1. Baxter H, Winder R, Chalder M, Wright C, Sherlock S, Haase A, et al. Physical activity as a treatment for depression: the TREAD randomised trial protocol. Trials 2010;11:105. - PMC - PubMed

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