Current clinical guidance recommends physical activity to alleviate the symptoms of depression (1). However, new research published today [6 June] in the BMJ, suggests that adding a physical activity intervention to usual care did not reduce symptoms of depression more than usual care alone, even though it increased levels of physical activity.

Depression is one of the most common reasons for seeking GP help and reportedly affects one in six adults in Britain at any one time (2).  Until now, most of the evidence for the positive effect of physical activity in treating depression has originated from studies of small, non-clinical samples using interventions that would not be practicable in an NHS setting. 

The TREAD study, led by researchers from the Universities of Bristol, Exeter and the Peninsula College of Medicine and Dentistry, is the first large-scale, randomised controlled trial to establish whether a physical activity intervention should be used in primary health care to help treat adults with depression.

Researchers recruited 361 patients aged 18-69 years who had recently been diagnosed with depression.  Trial participants were then split into two groups to receive either the physical activity intervention in addition to usual care or usual care on its own and were followed up for 12 months to assess any change in their symptoms.

Melanie Chalder, from University of Bristol’s School of Social and Community Medicine, said: “Numerous studies have reported the positive effects of physical activity for people suffering with depression but our intervention was not an effective strategy for reducing symptoms.  However, it is important to note that increased physical activity is beneficial for people with other medical conditions such as obesity, diabetes and cardiovascular disease and, of course, these conditions can affect people with depression.”

John Campbell, Professor of General Practice and Primary Care at Peninsula College of Medicine and Dentistry (University of Exeter), commented: “Many patients suffering from depression would prefer not to have to take traditional antidepressant medication, preferring instead to consider alternative non-drug based forms of therapy. Exercise and activity appeared to offer promise as one such treatment, but this carefully designed research study has shown that exercise does not appear to be effective in treating depression. An important finding however, is the observation that the approach we were using did result in a sustained increase in activity in people who were working with our activity facilitators. Although their increased activity did not result in improved depression, the approach we used offers potential in areas other than depression, and we hope to explore this in due course."

Adrian Taylor, Professor of Sport and Health Sciences at the University of Exeter, added: “We were pleased that people responded to the tailored physical activity intervention, which focused on increasing sustainable moderate intensity physical activity. However, reducing depression more than is possible through usual care is clearly a huge challenge.” 

The study was funded as part of the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme, with contributions from the Department of Health and local primary care trusts.  The paper entitled Facilitated physical activity as a treatment for depressed adults: randomised controlled trial, is published in the BMJ (British Medical Journal) and will be presented as a keynote paper at the World Family Doctors Caring for People (WONCA) conference in Vienna in July 2012.

Paper

‘Facilitated physical activity as a treatment for depressed adults: randomised controlled trial’ by Melanie Chalder et al in BMJ

Footnotes

1 ‘Depression: the treatment and management of depression in adults’ (2009) NICE clinical guideline (update) CG90

2 ‘Depression: the treatment and management of depression in adults’ (2004) NICE clinical guideline CG23