Nonpharmacological Treatment for Supporting Social Participation of Adults with Depression

Abstract

Background. Social withdrawal is predominantly seen among adults with depression. However, a dearth of reviews exists that explore nonpharmacological treatments, especially occupational therapy (OT) interventions and their effect in promoting social participation. The aim of this research was to review what intervention programs are conducted to support the social participation of adults with depression and their effectiveness. Method. A systematic review was performed wherein relevant articles were searched in PubMed, CINAHL, Wiley Online Library, PsycINFO, and OTseeker databases and AJOT, BJOT, SJOT, and OTMH journals. Only English articles published from January 2010 to December 2018, which tackled intervention for adults aged 20–60 years with depression, were considered. Ten out of 918 studies met the screening criteria. Result. Among the ten studies, the effective intervention programs were categorized as either occupation-based intervention (OBI) or cognitive behavioral therapy-based intervention (CBT-BI). These programs sought the following outcomes: behavioral change in social participation ( n = 4 ), reduction of depression or depressive symptoms ( n = 13 ), life satisfaction ( n = 4 ), and quality of life (QoL) ( n = 1 ). Studies showed moderate ( n = 3 ) to strong ( n = 7 ) level of certainty, whereas they also revealed high to unclear ( n = 3 ) and low ( n = 7 ) risk of bias. Conclusion. Both OBI such as animal-assisted therapy and CBT-BI such as behavioral change program and health education have a strong level of certainty and low risk of bias in promoting social participation by supporting positive behavioral change and reducing depressive symptoms. Furthermore, the sport and exercise program of OBI was popular in encouraging participation and engagement with other people. Other programs were suggested for combined interventions to support social participation, life satisfaction, and QoL.

Psychological aspects of rehabilitation nutrition: A position paper by the Japanese Association of Rehabilitation Nutrition (secondary publication)

“…Those who lived alone were at higher risk for depression 88 . In non‐pharmacological treatment of social participation in depressed people, the most effective intervention programs were occupation‐based or cognitive‐behavioral interventions 89 . Social support was also useful in preventing depression 90 .…”

“… 88 In non‐pharmacological treatment of social participation in depressed people, the most effective intervention programs were occupation‐based or cognitive‐behavioral interventions. 89 Social support was also useful in preventing depression. 90 Occupational therapy interventions aimed at returning to work were useful in improving depressive symptoms.…”

Perceived barriers to implementing occupation-based intervention

“…However, OBI yielded similar benefits in clients with hand-related disorders compared to physical exercise-based tasks (Hansen et al, 2020). Occupational therapists in mental health settings reported significant benefits of OBI among clients with stress (Olsson et al, 2019), traumatic experiences (Mangum et al, 2019), depression (Phadsri et al, 2021), addictive disorders (Wasmuth et al, 2016), and mild dementia (Ibrahim et al, 2021). OBI may be used with other interventions.…”

Relationship Between Social Participation and Depressive Symptoms in Patients with Multimorbidity: The Chained Mediating Role of Cognitive Function and Activities of Daily Living

“…Long-term depression signi cantly adversely affects an individual's work, life, and interpersonal relationships [13,14] . Social participation is one of the effective ways to alleviate depressive emotions, and active engagement in social activities serves as a protective factor against depression [15][16][17] . Social participation refers to the active engagement of individuals or groups in social activities and affairs, exerting a positive in uence on both individuals and society.…”