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Randomized Controlled Trial
. 2020 Mar 12;20(1):116.
doi: 10.1186/s12888-020-02518-y.

Bouldering psychotherapy is more effective in the treatment of depression than physical exercise alone: results of a multicentre randomised controlled intervention study

Nina Karg  1 , Lisa Dorscht  2 , Johannes Kornhuber  3 , Katharina Luttenberger  2
Affiliations
Randomized Controlled Trial

Bouldering psychotherapy is more effective in the treatment of depression than physical exercise alone: results of a multicentre randomised controlled intervention study

Nina Karg et al. BMC Psychiatry. .

Abstract

Background: Recent scientific studies have suggested that climbing/bouldering is effective in alleviating depression when the comparison group was a waitlist control group, even when physical activity and other therapeutic approaches were controlled for. In the present study, we aimed to investigate the effectiveness of a manualised psychotherapeutic bouldering intervention for depressed individuals, compared with an active control group performing physical exercise alone.

Methods: In a multicentre randomised controlled intervention trial, 133 outpatients with depression were assigned to either a bouldering psychotherapy (BPT) group or a home-based supervised exercise programme (EP). Severity of depression as the primary outcome was assessed at baseline and directly after a ten-week intervention period using the Montgomery-Åsberg Depression Rating Scale (MADRS). Secondary outcomes included anxiety, coping skills, self-esteem, body image, and interpersonal sensitivity. We applied t-tests to test for differences within the groups (t0 vs. t1) and between the BPT and the EP and a multiple regression analysis with the post-intervention MADRS score as the dependent variable. The robustness of estimates was investigated with a sensitivity analyses.

Results: Patients in the BPT group showed a significantly larger decrease in depression scores compared with the EP on the MADRS (drop of 8.4 vs. 3.0 points, p = .002, Cohen's d = 0.55). In the confounder-adjusted regression analyses, group allocation was found to be the only significant predictor of the post-intervention MADRS score (β = - 5.60, p = .001) besides the baseline MADRS score. Further significant differences in change scores between the BPT and the EP were found for anxiety (p = .046, d = 0.35), body image (p = .018, d = 0.42), and global self-esteem (p = .011, d = 0.45).

Conclusions: The study provides evidence that the manualised BPT is not only effective in alleviating depressive symptoms but even goes beyond the effect of mere physical exercise. Based on these findings, the BPT should be considered as a complementary therapeutic approach.

Trial registration: Trial identification number: ISRCTN12457760: Study KuS (Klettern und Stimmung - Climbing and Mood) combined boulder and psychotherapy against depression, registered retrospectively on July 26th, 2017.

Keywords: Bouldering; Depression; Physical exercise; Psychotherapy.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Study Design. Notes. BPT: Bouldering psychotherapy; CBT: cognitive behavioural therapy; EP: exercise programme; Erlangen and Weyarn/Munich: four waves, Berlin: two waves; measurement occasions are shown by using the fourth wave as an example
Fig. 2
Fig. 2
Consort Flow Chart. Notes. BPT: Bouldering psychotherapy, CBT: cognitive behavioural therapy, EP: exercise programme
Fig. 3
Fig. 3
Change in Depression Scores between t0 and t1 on the MADRS. Notes. BPT: Bouldering psychotherapy, CBT: cognitive behavioural therapy, EP: exercise programme
See this image and copyright information in PMC

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