Motivational Multicomponent Lifestyle Interventions as a Supportive Treatment for Depression in Primary Health Care (DEPKuopio)

Motivational Multicomponent Lifestyle Interventions as a Supportive Treatment for Depression in Primary Health Care

Motivational Multicomponent Lifestyle Interventions as a Supportive Treatment for Depression in Primary Health Care

The investigators aim to examine whether a motivational multicomponent lifestyle intervention as a supportive treatment for depression has a beneficial effect on recovery from depression in a primary health care setting.

Depression causes a significant global burden of disease. Among depressed individuals, poor lifestyles, such as physical inactivity, unhealthy diet, and smoking, are common and play a role in the development and maintenance of depression. Robust research evidence recommends applying one-component lifestyle interventions that focus on factors such as a healthy diet or exercise, as a supportive treatment for depression. Currently, however, there is increasing interest in identifying the most effective multicomponent lifestyle intervention that targets more than one unhealthy lifestyle simultaneously in order to reduce depressive symptoms. The study aims to examine whether a motivational multicomponent lifestyle intervention as a supportive treatment for depression has a beneficial effect on recovery from depression in a primary health care setting. The specific study questions are as follows: What is the effect of the intervention on depressive symptoms at 3- and 12-month follow-ups? What is the effect of the intervention on mental well-being at 3- and 12-month follow-ups? What kind of physical health do depressed patients in primary health care have? What kinds of effects does the intervention have on common physical health risk factors at 12- and 24- month follow-ups? What is the effect of the intervention on health-related quality of life? What is the cost-effectiveness of the intervention?

The study is a 2-arm, randomized controlled clinical trial, in which participants are randomized to the study arms at an individual level. After the baseline data is collected, the study nurse (nurse 1), who conducts the baseline data collection, uses opaque capsules to randomize patients to the study arms.

Study intervention and treatment as usual The study intervention is a multicomponent lifestyle intervention that targets exercise, diet, and stress management, and is conducted by motivational interviewing. The study nurse provides the study intervention. The intervention is conducted by motivational interviewing and includes the key elements of lifestyle interventions identified as effective (assessment of behavior at the baseline, giving information and advising, individualized goal setting, setting an action plan, monitoring a behavioral change, and giving feedback). The intervention consists of individual appointments (2 x 45-60 min) and a telephone session ( 2 x 15 min) for three months. The participants receive a short educational guide (A4) on the lifestyle behavior recommendations.

Inclusion Criteria: adults ≥ 18 years depression (ICD-10, F32-F33) Beck Depression Inventory (BDI-1A) ≥ 10 points the initiation of treatment in a primary health care center Exclusion Criteria: bipolar disorder psychosis substance abuse pregnancy or lactation a long-term rehabilitative psychotherapy.