Efficacy of an adjuvant non-face-to-face multimodal lifestyle modification program for patients with treatment-resistant major depression: A randomized controlled trial
Aurora Garcia, Aina M Yáñez, Miquel Bennasar-Veny, Capilla Navarro, Joan Salva, Olga Ibarra, Rocío Gomez-Juanes, María J Serrano-Ripoll, Bárbara Oliván, Margalida Gili, Miquel Roca, Pau Riera-Serra, Alejandra Aguilar-Latorre, Jesús Montero-Marin, Mauro Garcia-Toro, Aurora Garcia, Aina M Yáñez, Miquel Bennasar-Veny, Capilla Navarro, Joan Salva, Olga Ibarra, Rocío Gomez-Juanes, María J Serrano-Ripoll, Bárbara Oliván, Margalida Gili, Miquel Roca, Pau Riera-Serra, Alejandra Aguilar-Latorre, Jesús Montero-Marin, Mauro Garcia-Toro
Abstract
Background: The high prevalence of depression is partly attributable to the poor response of patients to first-line antidepressants. Multimodal programs that promote a healthy lifestyle are successful in treating depression when used as a complementary therapy, but their medium- and long-term benefits have not been demonstrated for patients with treatment-resistant depression (TRD). The main aim of this study was to compare the effectiveness of a lifestyle modification program (LMP) with mindfulness-based cognitive therapy (MBCT) and a placebo-control (written suggestions for lifestyle changes) in Spanish patients with TRD.
Methods: This controlled clinical trial randomized 94 patients with TRD into 3 arms. The primary outcome was the Beck Depression Inventory-II (BDI-II) score at baseline, 2, 6 and 12 months. The secondary outcomes were changes in scores that evaluated quality-of-life, adherence to the Mediterranean diet, physical activity, and social support.
Results: Relative to the placebo group, the LMP and MBCT groups had significantly better quality of life (p = 0.017; p = 0.027), and the LMP group had significantly better adherence to the Mediterranean diet (p<0.001) and reduced use of antidepressants (p = 0.036). However, the three groups showed no significant differences in BDI-II score.
Limitations: Only about half of the planned 180 patients were recruited, in part due to the COVID-19 pandemic.
Conclusions: There was no evidence that the LMP treatment significantly reduced symptoms of depression relative to the other groups during the COVID-19 lockdown.
Keywords: Depressive disorder; Healthy lifestyle; Mindfulness; Treatment-resistant.
Conflict of interest statement
Declaration of Competing Interest All authors declare have no potential conflicts of interest.
Copyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.
Source: PubMed