Effectiveness of a lifestyle modification programme in the treatment of depression symptoms in primary care

Abstract

BackgroundDepression symptoms are prevalent in the general population, and their onset and continuation may be related to biological and psychosocial factors, many of which are related to lifestyle aspects. Health promotion and lifestyle modification programmes (LMPs) may be effective on reducing the symptoms. The objective of this study was to analyse the clinical effectiveness of a LMP and a LMP plus Information and Communication Technologies, when compared to Treatment as Usual (TAU) over 6 months. The interventions were offered as an adjuvant treatment delivered in Primary Healthcare Centers (PHCs) for people with depression symptoms.MethodsWe conducted an open-label, multicentre, pragmatic, randomized clinical trial. Participants were recruited from several PHCs. Those participants visiting general practitioner for any reason, who also met the inclusion criteria (scoring 10 to 30 points on the Beck II Self-Applied Depression Inventory) were invited to take part in the study. TAU+LMP consisted of six weekly 90-min group sessions focused on improving lifestyle. TAU+LMP + ICTs replicated the TAU+LMP format, plus the addition of a wearable smartwatch to measure daily minutes walked and sleep patterns. A total of 188 participants consented to participate in the study and were randomized. We used linear mixed models, with a random intercept and an unstructured covariance to evaluate the impact of the interventions compared to TAU.ResultsBoth interventions showed a statistically significant reduction on depressive symptoms compared to TAU (TAU+LMP vs. TAU slope difference, b = −3.38, 95% CI= [−5.286, −1.474] p = 0.001 and TAU+LMP+ICTs vs. TAU slope difference, b = −4.05, 95% CI = [−5.919, −2.197], p < 0.001). These reductions imply a moderate effect size. In the TAU+LMP+ICTs there was a significant increase regarding minutes walking per week (b = 99.77) and adherence to Mediterranean diet (b = 0.702). In the TAU+LMP there was a significant decrease regarding bad sleep quality (b = −1.24).ConclusionTAU+LMPs administered in PHCs to people experiencing depression symptoms were effective on reducing these symptoms compared to TAU. They also have a positive impact on changing several lifestyle factors. These findings indicate that these interventions can be promising strategies for PHCs.

Higher amplitudes of visual networks are associated with trait-but not state-depression

“…This limits the generalization of our findings to more diverse populations with different demographic characteristics. Secondly, while we carefully generated two control groups and matched them for each of the target depression groups based on a set of crucial confounding variables, our analyses for group comparisons did not include psychosocial or lifestyle factors that can contribute to individual variations in depression symptoms (Aguilar-Latorre et al, 2022; Remes et al, 2021; Sarris et al, 2014; Zhao et al, 2023). These additional factors may also influence the associative effects under investigation, and future studies should consider integrating them into analysis.…”

Mindfulness skills and experiential avoidance as therapeutic mechanisms for treatment-resistant depression through mindfulness-based cognitive therapy and lifestyle modification

“…These weekly sessions covered the following topics: the causes, symptoms, and course of depression; treatment for depression; the importance of physical exercise for physical and mental health; how to exercise safely and comfortably; how to be motivated to incorporate physical exercise into daily routines; the importance of good nutrition, a social support network, and appropriate sleep–wake rhythms and sleep hygiene; the role of negative rumination in maintaining depression along with strategies to detect and stop this behavior; and the importance of getting outside and connecting with nature. Practical recommendations were made on how to combine some of these suggestions for long-term use ( Aguilar-Latorre et al, 2020 ; Navarro et al, 2020 ; Aguilar-Latorre et al, 2022 ).…”

Association between dietary calcium and depression among American adults: National health and nutrition examination survey

“…Lifestyle factors are considered to be one of the important mediators of the pathophysiology associated with mental disorders ( 7 ). An increasing number of epidemiological studies have shown an association between diet and mental health ( 8 ).…”