Lifestyle medicine for depression: A meta-analysis of randomized controlled trials

Wong, Vincent Wing-Hei; Ho, Fiona Yan Yee; Shi, Nga-Kwan; Sarris, Jerome; Chung, Ka Fai; Yeung, Wing Fai

doi:10.1016/j.jad.2021.02.012

Cited by 56 publications

(50 citation statements)

References 79 publications

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“…Our results showed that 22% of participants dropped the study at post-treatment assessment. Our result is similar from a previous meta-analysis of 47 RCTs carried out by Wong et al, 2021 [ 19 ], which estimated an attrition rate of 21% in the intervention group and 20% in the control group.…”

Section: Discussionsupporting

confidence: 91%

“…A recent meta-analysis suggested that universal multiple-risk lifestyle interventions may produce a modest but statistically significant effect decreasing depressive symptomatology in adults, although the available evidence base is still low [ 18 ]. These findings are supported by another recent meta-analysis, which concluded that multicomponent lifestyle medicine interventions may be effective reducing depressive symptomatology at short-term follow-up [ 19 ].…”

Section: Introductionsupporting

confidence: 56%

“…In recent years, there has been an increasing interest in the study of the multiple lifestyle interventions on depressive symptomatology, and the results are promising [ 18 , 19 , 20 ]. A recent meta-analysis suggested that universal multiple-risk lifestyle interventions may produce a modest but statistically significant effect decreasing depressive symptomatology in adults, although the available evidence base is still low [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Adherence to Lifestyle Interventions for Treatment of Adults with Depression: A Systematic Review and Meta-Analysis

Castro

Roca

Ricci‐Cabello

et al. 2021

IJERPH

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The aim of this systematic review was to determine the adherence to lifestyle interventions for adults with depression and to estimate the dropout rates in trials examining the impact of these interventions. A bibliographic search was conducted in PubMed, Embase, PsycINFO, the Cochrane library, and several sources of grey literature. We included randomised controlled trials examining the impact of multiple lifestyle interventions on depressive symptomatology in adults when compared to control or other active treatments. Two reviewers independently screened citations, extracted the relevant data, and assessed the risk of bias using Cochrane tools. A random effects meta-analysis of proportions was used to summarise the proportion of participants who completed the intervention and to determine the proportion of dropouts at post-treatment assessment. Multiple subgroup analyses were also carried out. We identified six trials. The meta-analysis of proportions showed that 53% (95%CI 49% to 58%) of the participants assigned to the intervention group fully adhered to the intervention program. The weighted mean proportion of completed intervention sessions was 66%. The pooled trial dropout rate was 22% (95%CI 20% to 24%). Around half of adults with depression adhere to lifestyle interventions. Future research is needed to develop interventions to support adherence to lifestyle interventions in depressive patients.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionsupporting

confidence: 56%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Adherence to Lifestyle Interventions for Treatment of Adults with Depression: A Systematic Review and Meta-Analysis

Castro

Roca

Ricci‐Cabello

et al. 2021

IJERPH

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“…Encouragingly, no adverse effects resulting from the LM intervention were reported in this study. In line with the meta-analysis and recent RCTs, we showed that LM interventions were superior to CAU in managing depressive symptoms [33][34][35][36][37]56].…”

Section: Discussionsupporting

confidence: 87%

Effects of a group-based lifestyle medicine for depression: A pilot randomized controlled trial

Yeung

et al. 2021

PLoS ONE

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Given the growing evidence that a range of lifestyle factors are involved in the etiology of depression, a ‘lifestyle medicine’ approach can be potentially safe and cost-effective to prevent or treat depression. To examine the effects and acceptability of a group-based, integrative lifestyle medicine intervention as a standalone treatment for managing depressive symptoms, a pilot randomized controlled trial (RCT) was conducted in a Chinese adult population in 2018. Participants (n = 31) with PHQ-9 score above the cut-off of ≥ 10, which was indicative of moderate to severe depression, were recruited from the general community in Hong Kong and randomly assigned to lifestyle medicine group (LM group) or care-as-usual group (CAU group) in a ratio of 1:1. Participants in the LM group received 2-hour group sessions once per week for six consecutive weeks, which covered diet, exercise, mindfulness, psychoeducation, and sleep management. Linear mixed-effects model analyses showed that the LM group had a significant reduction in PHQ-9 scores compared to the CAU group at immediate posttreatment and 12-week posttreatment follow-up (d = 0.69 and 0.73, respectively). Moreover, there were significantly greater improvements in anxiety, stress, and insomnia symptoms (measured by DASS-21 and ISI) at all time points in the LM group (d = 0.42–1.16). The results suggests that our 6-week group-based, integrative lifestyle intervention program is effective in lowering depressive, anxiety, stress, and insomnia symptoms in the Chinese population. Further studies in clinical populations with a larger sample size and longer follow-up are warranted.

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“…An adjunctive lifestyle-based model of care that drew on cognitive behavioural therapy and behavioural activation for patients with depression after a cardiac event reduced depression compared to a usual care control and its effects were far more pronounced for those with a lifetime history of major depression (effect size Cohen's d = 0.3 versus 0.6) [34]. Furthermore, a recent meta-analysis of 50 RCTs found that multi-component lifestyle interventions reduced depressive symptoms compared to usual care [35].…”

Section: Evidence Base For the Use Of Lifestyle Programs In Mental Healthmentioning

confidence: 99%

Designing Lifestyle Interventions for Common Mental Disorders: What Can We Learn from Diabetes Prevention Programs?

et al. 2021

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Lifestyle factors including diet, sleep, physical activity, and substance use cessation, are recognised as treatment targets for common mental disorders (CMDs). As the field of lifestyle-based mental health care evolves towards effectiveness trials and real-world translation, it is timely to consider how such innovations can be integrated into clinical practice. This paper discusses the utility and scale-up of lifestyle interventions for CMDs and draws on diabetes prevention literature to identify enablers and barriers to translation efforts. We discuss the extent to which lifestyle interventions aimed at managing CMDs and preventing diabetes share commonalities (program content, theoretical underpinnings, program structures, interventionists, frameworks promoting fidelity, quality, sustainability). Specific considerations when utilising these programs for mental health include personalising content with respect to symptoms and trajectories of depression and anxiety, medication regimen and genetic risk profile. As this field moves from efficacy to effectiveness and implementation, it is important to ensure issues in implementation science, including “voltage drop”, “program drift”, logistics, funding, and resourcing, are in line with evidence-based models that are effective in research settings. Ongoing considerations includes who is best placed to deliver this care and the need for models to support implementation including long-term financing, workforce training, supervision, stakeholder and organisational support.

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Lifestyle medicine for depression: A meta-analysis of randomized controlled trials

Cited by 56 publications

References 79 publications

Adherence to Lifestyle Interventions for Treatment of Adults with Depression: A Systematic Review and Meta-Analysis

Adherence to Lifestyle Interventions for Treatment of Adults with Depression: A Systematic Review and Meta-Analysis

Effects of a group-based lifestyle medicine for depression: A pilot randomized controlled trial

Designing Lifestyle Interventions for Common Mental Disorders: What Can We Learn from Diabetes Prevention Programs?

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