Depression — Scientific Evidence

Based on scientific evidence the following approaches have shown to be effective. To review the supporting scientific evidence, select a treatment option.

In order to help interpret the strength of the scientific evidence (the level of proof) provided, descriptions of the different types of studies, reviews and guidelines are available in the glossary. Please click on each term for a discussion of the topic: Case review, consensus statement, controlled clinical trial, guidelines and recommendations, literature review, meta-analysis, multi-center study, outcome study, systematic review.

Acupuncture
Author(s):
Roschke J, Wolf C, Muller MJ, et al
Institution:
Department of Psychiatry, University of Mainz, Germany
Title:
The benefit from whole body acupuncture in major depression.
Source:
Journal of Affective Disorders. 57(1-3):73-81, 2000
Type of study:
randomized, controlled clinical trial
Control/comparison:
placebo acupuncture applied at non-specific locations and a control group
Sample characteristics:
70 inpatients with a major depressive episode pharmacologically treated with the antidepressant mianserin
Type of intervention:
the verum group = subjects had acupuncture applied at specific points considered effective in the treatment of depression, given 3 times a week for 4 weeks
Primary outcome measure(s):
psychopathology was rated by judges (who were blind to verum/placebo conditions) twice a week over 8 weeks
Outcome:
Patients who received acupuncture improved slightly more than patients treated with mianserin alone. However, no differences were seen between the verum group and the placebo group who had acupuncture applied non-specifically. Acupuncture, in addition to treatment with antidepressants, may improve the course of depression more so than medication alone. Further studies are necessary to test if acupuncture works well with other antidepressants besides mianserin as well as to see if similar results are found in larger trials.

Author(s):
Wang H, Qi H, Wang BS, et al.
Institution:
Shanghai Jiaotong University School of Medicine, China.
Title:
Is acupuncture beneficial in depression: a meta-analysis of 8 randomized controlled trials?
Source:
Journal of Affective Disorders. 111(2-3):125-34, 2008.
Type of study:
review (29 refs)
Control/comparison:
Not applicable
Sample characteristics:
Not applicable
Type of intervention:
Not applicable
Primary outcome measure(s):
Not applicable
Outcome:
This updated meta-analysis was conducted to assess the beneficial effect of acupuncture in depression therapy. Eight small-randomized controlled trials comparing 477 subjects were included in the meta-analysis. Results confirmed that acupuncture could significantly reduce the severity of depression, which was indicated by decreased scores of Hamilton rating scale for depression or Beck Depression Inventory. No significant effect of active acupuncture was found on the response rate and remission rate. More full-scale randomized clinical trials with reliable designs are recommended to further warrant the effectiveness of acupuncture.

Author(s):
Samuels N, Gropp C, Singer SR, Oberbaum M.
Institution:
The Center for Integrative Complementary Medicine, Jerusalem, Israel.
Title:
Acupuncture for psychiatric illness: a literature review.
Source:
Behavioral Medicine. 34(2):55-64, 2008.
Type of study:
Review (71 refs)
Control/comparison:
Not applicable
Sample characteristics:
Not applicable
Type of intervention:
Not applicable
Primary outcome measure(s):
Not applicable
Outcome:
Research has found that acupuncture increases a number of central nervous system hormones (ACTH, beta-endorphins, serotonin, and noradrenaline) and urinary levels of MHPG-sulfate, an adrenergic metabolite inversely related to the severity of illness in schizophrenics. Acupuncture can have positive effects on depression and anxiety, although evidence is still lacking as to its true efficacy for these conditions.

Author(s):
Ortiz, M., Manbera, R., Schnyera, R.N., et al.
Institution:
Department of Psychiatry and Behavioral Sciences, Stanford
Title:
Acupuncture for Depression during Pregnancy: a Randomized Controlled Trial
Source:
Obstet Gynecol. 115:511–20, 2010.
Type of study:
randomized controlled trial
Control/comparison:
massage
Sample characteristics:
150 pregnant women with major depressive disorder
Type of intervention:
12 acupuncture treatments, specific for depression, over 8 weeks
Primary outcome measure(s):
Hamilton Rating Scale for Depression was done at baseline, after 4 weeks and then after 8 weeks
Outcome:
Patients in the acupuncture treatment group demonstrated similar symptom improvements to patients that received standard depression treatments. These findings suggest that acupuncture may be a useful alternative for treating depression in pregnant women.

Author(s):
Zhang ZJ, Chen HY, Yip KC, et al.
Institution:
University of Hong Kong, China.
Title:
The effectiveness and safety of acupuncture therapy in depressive disorders: systematic review and meta-analysis.
Source:
Journal of Affective Disorders. 124(1-2):9-21, 2010.
Type of study:
Meta-analysis
Control/comparison:
Not applicable
Sample characteristics:
Not applicable
Type of intervention:
Not applicable
Primary outcome measure(s):
Not applicable
Outcome:
Twenty studies of major depressive disorder (1998 patients) and 15 of PSD (1680 patients) were included for meta-analysis. The effectiveness of acupuncture as sole therapy was comparable to antidepressants alone in improving clinical response and alleviating symptom severity of major depressive disorder, but not different from sham acupuncture. No sufficient evidence favored the combination of acupuncture with antidepressants over either one alone in treating major depressive disorder. Acupuncture was superior to antidepressants and waitlist controls in improving both response and symptom severity of PSD. The incidence of adverse events in acupuncture intervention was significantly lower than antidepressants. Acupuncture therapy is safe and effective in treating both health conditions and could be considered an alternative option for the two disorders. The efficacy in other forms of depression remains to be further determined.
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Aromatherapy
Author(s):
Yim VW, Ng AK, Tsang HW, Leung AY.
Institution:
The Hong Kong Polytechnic University, Hong Kong.
Title:
A review on the effects of aromatherapy for patients with depressive symptoms
Source:
Journal of Alternative & Complementary Medicine. 15(2):187-95, 2009.
Type of study:
Review (96 refs)
Control/comparison:
Not applicable
Sample characteristics:
Not applicable
Type of intervention:
Not applicable
Primary outcome measure(s):
Not applicable
Outcome:
The results were based on six studies examining the effects of aromatherapy on depressive symptoms in patients with depression and cancer. Some studies showed positive effects of this intervention among these three groups of patients. More controlled studies with sound methodology should be conducted in the future to ascertain its clinical effects and the underlying psychobiologic mechanisms.
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Art Therapy
Author(s):
Bar-Sela G, Atid L, Danos S, et al.
Institution:
Technion-Israel Institute of Technology, Haifa, Israel.
Title:
Art therapy improved depression and influenced fatigue levels in cancer patients on chemotherapy.
Source:
Psycho-Oncology. 16(11):980-4, 2007.
Type of study:
Controlled clinical trial
Control/comparison:
two or less art therapy sessions
Sample characteristics:
Sixty cancer patients on chemotherapy
Type of intervention:
four or more once-weekly art therapy sessions (painting with water-based paints)
Primary outcome measure(s):
Hospital Anxiety and Depression Scale (HADS) and the Brief Fatigue Inventory (BFI)
Outcome:
Fatigue scores were higher in the control group. In the intervention group, the median score for depression was 9 at the beginning and 7 after the fourth appointment. The median fatigue score changed from 5.7 to 4.1. Art therapy is worthy of further study in the treatment of cancer patients with depression or fatigue during chemotherapy treatment.
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Biofeedback
Author(s):
Karavidas MK, Lehrer PM, Vaschillo E, et al.
Institution:
University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Piscataway, NJ.
Title:
Preliminary results of an open label study of heart rate variability biofeedback for the treatment of major depression.
Source:
Applied Psychophysiology & Biofeedback. 32(1):19-30, 2007.
Type of study:
clinical trial
Control/comparison:
none
Sample characteristics:
Eleven participants
Type of intervention:
All participants attended 10 weekly biofeedback sessions.
Primary outcome measure(s):
Hamilton Depression Scale (HAM-D) and the Beck Depression Inventory (BDI-II). Questionnaires and physiological data were collected in an orientation (baseline) session and Treatment Sessions 1, 4, 7 and 10.
Outcome:
This study assessed the feasibility of using heart rate variability biofeedback to treat major depression. Significant improvements were noted in the Hamilton Depression Scale and the Beck Depression Inventory by Session four. Clinically and statistically significant improvement in depression persisted. HRV biofeedback appears to be a useful additional treatment for major depressive disorder.

Author(s):
Choi SW, Chi SE, Chung SY, et al.
Institution:
Daejeon University, Korea
Title:
Is alpha wave neurofeedback effective with randomized clinical trials in depression? A pilot study.
Source:
Neuropsychobiology. 63(1):43-51, 2011.
Type of study:
Randomized controlled trial
Control/comparison:
placebo control group
Sample characteristics:
not known
Type of intervention:
neurofeedback training
Primary outcome measure(s):
not known
Outcome:
The present study examined whether a neurofeedback training designed to increase right frontal brain activity would have an impact on symptoms of depression. Results indicated that the asymmetry neurofeedback training increased the relative right frontal alpha power, and it remained effective even after the end of the total training sessions. The neurofeedback training had profound effects on emotion and cognition. This study replicated earlier findings that enhancing the left frontal activity led to alleviation of depressive symptoms. These preliminary results indicate that asymmetry training is important for controlling and regulating emotion.
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Cognitive Behavioral Therapy
Author(s):
Bolton PG, Fergusson KJ, Parker SM
Institution:
General Practice Casualty, Balmain Hospital, Balmain NSW, Australia
Title:
Randomised controlled trial of cognitive-behavioural therapy and routine GP care for major depression
Source:
Medical Journal of Australia. 175(2):118-9, 2001
Type of study:
randomized, controlled clinical trial
Control/comparison:
standard GP care
Sample characteristics:
17 patients with moderate depression
Type of intervention:
GP care along with 8 – 10 cognitive-behavioral therapy (CBT) sessions
Primary outcome measure(s):
Hospital Anxiety and Depression Scale (HADS), a validated self-rating scale
Outcome:
The researchers found that the addition of a cognitive-behavioral therapist to usual GP care can improve outcomes for depressed patients in general practice. Larger studies are needed to confirm this hypothesis.

Author(s):
Clarke GN, Rohde P, Lewinsohn PM, et al
Institution:
Kaiser Permanente Center for Health Research, Portland, OR
Title:
Cognitive-behavioral treatment of adolescent depression: efficacy of acute group treatment and booster sessions
Source:
Journal of the American Academy of Child and Adolescent Psychiatry. 38(3):272-9, 1999
Type of study:
randomized, controlled clinical trial
Control/comparison:
wait-list
Sample characteristics:
123 adolescents with major depression or dysthymia
Type of intervention:
Adolescent group cognitive-behavioral therapy (CBT) alone (16 two-hour sessions for 8 weeks) or the same adolescent group CBT but with a parent present
Primary outcome measure(s):
Self-reported depression, clinical evaluation, and follow-up evaluations. The subjects who received CBT were randomly re-assigned to 1 of 3 methods of assessment during the 24 month follow-up period: 1) assessments every four months with booster CBT sessions; 2) assessments only every 4 months; or 3) assessments only every 12 months
Outcome:
This study examined the effects of both acute and maintenance CBT for adolescents. Researchers found that cognitive-behavioral groups showed a significant depression recovery rate over wait list participants as well as a greater reduction in self-reported depression. The booster CBT sessions did not reduce the recurrence in the follow-up period but appeared to accelerate recovery among participants who were still depressed at the end of the acute phase. This study supported the growing body of evidence that suggests cognitive-behavioral therapy is an effective intervention for adolescent depression.

Author(s):
Curry JF
Institution:
Duke University Medical Center, Durham, North Carolina
Title:
Specific psychotherapies for childhood and adult depression.
Source:
Biological Psychiatry. 49(12):1091-100, 2001
Type of study:
review (44 references)
Control/comparison:
not applicable
Sample characteristics:
not applicable
Type of intervention:
not applicable
Primary outcome measure(s):
not applicable
Outcome:
Cognitive Behavioral Therapy (CBT) administered in school settings to pre-adolescent children with elevated depressive symptoms has proven superior to no treatment or to wait-list controls in almost all studies. One child study indicated that CBT is better than alternative psychosocial intervention during acute treatment but not at longer term follow-up. In the child studies reviewed, no one type of CBT was proven more effective than another. Seven of nine adolescent studies showed that CBT was more beneficial than a wait-listing condition or than a non-CBT alternative psychotherapy at the end of acute intervention. For longer term follow-up, CBT showed similar results to other forms of psychotherapy in regards to rates of remission or recovery. CBT did, however, show more rapid remission of symptoms than family or supportive therapy. In two acute treatment studies, interpersonal therapy also demonstrated more effectiveness than a wait-list condition or minimal contact clinical management. More research is necessary to assess the comparative efficacy of psychotherapeutic interventions, antidepressant medication, and their combination.

Author(s):
Reinecke MA, Ryan NE, DuBois DL
Institution:
Department of Psychiatry, University of Chicago, IL
Title:
Cognitive-behavioral therapy of depression and depressive symptoms during adolescence: a review and meta-analysis
Source:
Journal of the American Academy of Child and Adolescent Psychiatry. 37(1):26-34, 1998
Type of study:
meta-analysis
Control/comparison:
not applicable
Sample characteristics:
not applicable
Type of intervention:
not applicable
Primary outcome measure(s):
not applicable
Outcome:
This article critically reviews the literature on cognitive-behavioral therapy with depressed and dysphoric adolescents. Fourteen post-treatment-control comparisons and ten follow-up control comparisons were made, using six studies containing 217 subjects. Results indicate that short and long term effects of cognitive-behavioral approaches for treating adolescents with depression are positive.

Author(s):
Teasdale JD, Segal ZV, Williams JM, et al
Institution:
Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK.
Title:
Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy
Source:
Journal of Consulting & Clinical Psychology. 76(6):966-78, 2008.
Type of study:
randomized, controlled clinical trial
Control/comparison:
standard therapy
Sample characteristics:
145 recovered recurrently depressed patients
Type of intervention:
mindfulness-based cognitive therapy (MBCT)
Primary outcome measure(s):
relapse/recurrence to major depression assessed over the 60-week study period
Outcome:
This study evaluated MBCT, a group intervention designed to train recovered recurrently depressed patients to disengage from mood-related depressive thinking that may affect relapse/recurrence. For patients with 3 or more previous episodes of depression (77% of the sample), MBCT significantly reduced the risk of relapse/recurrence. MBCT was not effective in reducing relapse/recurrence for people who had only 2 previous episodes of depression. The researchers believe that MBCT offers a promising cost-efficient psychological approach to preventing relapse/recurrence in recovered recurrently depressed patients.

Author(s):
Godfrin KA, van Heeringen C.
Institution:
University of Ghent, Belgium.
Title:
The effects of mindfulness-based cognitive therapy on recurrence of depressive episodes, mental health and quality of life: A randomized controlled study.
Source:
Behaviour Research & Therapy. 48(8):738-46, 2010.
Type of study:
Randomized controlled study
Control/comparison:
Usual treatment
Sample characteristics:
106 recovered depressed patients with a history of at least 3 depressive episodes
Type of intervention:
Mindfulness-based cognitive therapy (MBCT) in addition to usual treatment for 56 weeks
Primary outcome measure(s):
depression recurrence and time to first relapse
Outcome:
At the end of the study period relapse/recurrence was significantly reduced and the time until first relapse increased in the MBCT plus usual treatment condition in comparison with usual treatment alone. The MBCT plus usual treatment group also showed a significant reduction in both short and longer-term depressive mood and better mood states and quality of the life. For patients with a history of at least three depressive episodes who are not acutely depressed, MBCT, added to usual treatment, may help prevent depression relapse.
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Exercise
Author(s):
Mikkelsen SS, Tolstrup JS, Flachs EM, et al.
Institution:
University of Southern Denmark
Title:
A cohort study of leisure time physical activity and depression.
Source:
Preventive Medicine. 51(6):471-5, 2010
Type of study:
Prospective cohort study
Control/comparison:
not applicable
Sample characteristics:
18,146 individuals from the Copenhagen City Heart Study,Denmark
Type of intervention:
not applicable
Primary outcome measure(s):
measures of lesiure time physical activity level and levels of depression
Outcome:
Among women, a low level of physical activity was significantly associated with a greater risk of depression.
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General
Author(s):
van der Watt G. Laugharne J. Janca A.
Institution:
University of Western Australia, Perth, Australia.
Title:
Complementary and alternative medicine in the treatment of anxiety and depression.
Source:
Current Opinion in Psychiatry. 21(1):37-42, 2008.
Type of study:
Review (32 refs)
Control/comparison:
Not applicable
Sample characteristics:
Not applicable
Type of intervention:
Not applicable
Primary outcome measure(s):
Not applicable
Outcome:
With regard to herbal treatments, kava is effective in reducing anxiety symptoms and St John's wort in treating mild to moderate depression. The association of kava with liver toxicity, however, is a significant concern. Promising data continue to emerge for the use of omega-3 fatty acids in managing depression. Evidence for the use of acupuncture in treating anxiety disorders is growing. There is minimal empirical evidence for the use of aromatherapy or mindfulness-based meditation.

Author(s):
Meeks TW, Wetherell JL, Irwin MR, et al.
Institution:
Department of Psychiatry, University of California, San Diego, CA
Title:
Complementary and alternative treatments for late-life depression, anxiety, and sleep disturbance: a review of randomized controlled trials.
Source:
Journal of Clinical Psychiatry. 68(10):1461-71, 2007.
Type of study:
Review (73 refs)
Control/comparison:
Not applicable
Sample characteristics:
Not applicable
Type of intervention:
Not applicable
Primary outcome measure(s):
Not applicable
Outcome:
Twenty-nine studies were included in this review, with 67% of the studies reviewed being positive. Mind-body and body-based therapies had somewhat higher rates of positive results than energy- or biologically-based therapies. Most studies had substantial methodological limitations. A few well-conducted studies suggested therapeutic potential for certain interventions in older adults such as mind-body interventions for sleep disturbances and acupressure for sleep and anxiety.

Author(s):
Lieverse R, Van Someren EJ, Nielen MM, Uitdehaag BM, Smit JH, Hoogendijk WJ.
Institution:
VU University Medical Center, Amsterdam, The Netherlands
Title:
Bright light treatment in elderly patients with nonseasonal major depressive disorder: a randomized placebo-controlled trial.
Source:
Arch Gen Psychiatry. 68(1):61-70, 2011
Type of study:
Randomized, controlled trial
Control/comparison:
placebo treatment
Sample characteristics:
Eighty-nine outpatients 60 years or older who had major depressive disorder
Type of intervention:
Three weeks of 1-hour early-morning BLT (pale blue, approximately 7500 lux) vs placebo (dim red light, approximately 50 lux).
Primary outcome measure(s):
Mean improvement in Hamilton Scale for Depression scores using parameters of sleep and cortisol and melatonin levels.
Outcome:
In older patients with major depressive disorder, bright light therapy improved mood, enhanced sleep efficiency, and increased the upslope melatonin level gradient. In addition, it produced continuing improvement in mood and a lessening of cortisol hyperexcretion after discontinuation of treatment.

Author(s):
Freeman MP, Mischoulon D, Tedeschini E,
Institution:
Massachusetts General Hospital, Boston, MA
Title:
Complementary and alternative medicine for major depressive disorder: a meta-analysis of patient characteristics, placebo-response rates, and treatment outcomes relative to standard antidepressants.
Source:
J Clin Psychiatry. 71(6):682-8, 2010.
Type of study:
Meta-analysis
Control/comparison:
Not applicable
Sample characteristics:
Not applicable
Type of intervention:
Not applicable
Primary outcome measure(s):
Not applicable
Outcome:
Assessment was limited to widely used integrative therapies most frequently studied in randomized controlled trials with pill placebo: St John's wort, omega-3 fatty acids, and S-adenosyl-L-methionine (SAMe). There were a total of 185 trials. Patient variables, including illness severity, were similar across studies. Meta-analysis indicated that both antidepressant and complementary therapies resulted in superior response rates compared with placebo. Placebo-response rates were significantly lower for patients enrolled in complementary vs. antidepressant trials. Discontinuation due to adverse events was higher in antidepressant trials compared to complementary trials.
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Herbal Medicine
Author(s):
Brenner R, Azbel V, Madhusoodanan, et al
Institution:
St. John’s Episcopal Hospital, Far Rockaway, New York
Title:
Comparison of an extract of hypericum (LI 160) and sertraline in the treatment of depression: a double-blind, randomized pilot study
Source:
Clinical Therapeutics. 22(4):411-9, 2000
Type of study:
randomized, double-blind, controlled clinical trial
Control/comparison:
sertraline 50 mg daily for one week, followed by sertraline 75 mg daily for 6 weeks
Sample characteristics:
30 patients (19 women, 11 men, mean age 45.5 years) with mild to moderate depression
Type of intervention:
600 mg daily of standardized extract of hypericum (St. John’s wort) for one week, followed by 6 weeks of hypericum 900 mg per day
Primary outcome measure(s):
Hamilton Rating Scale for Depression, Clinical Global Impression Scale
Outcome:
The goal of this study was to compare hypericum to a selective serotonin reuptake inhibitor (SSRI), such as setraline, for the treatment of depression. Researchers found that the severity of symptoms was significantly reduced in both treatment groups, and both agents were well tolerated. There was no significant difference between the effectiveness of the two agents. Hypericum extract was found to be at least as effective as sertraline in the treatment of mild to moderate depression.

Author(s):
Woelk H
Institution:
Klinik fur Psychiatrie und Psychotherapie, Akademisches Lehrkrankenhaus der Universitat Giessen. D-35394 Giessen, Germany
Title:
Comparison of St. John’s wort and imipramine for treating depression: a randomized controlled trial.
Source:
BMJ. 321(7260): 536-9, 2000
Type of study:
randomized, double-blind, controlled clinical trial
Control/comparison:
imipramine 75 mg twice daily for 6 weeks
Sample characteristics:
324 patients with mild to moderate depression from 40 outpatient clinics in Germany
Type of intervention:
250 mg hypericum extract ZE 117 (St. John’s wort extract) twice daily for 6 weeks
Primary outcome measure(s):
Hamilton depression rating scale, clinical global impression scale, and patient’s global impression scale.
Outcome:
Researchers found that this hypericum extract was therapeutically equivalent to imipramine in treating mild to moderate depression, with patients tolerating hypericum better.

Author(s):
Linde K. Berner MM. Kriston L.
Institution:
Department of Internal Medicine II, Technische Universitaet Muenchen, Munich, Germany
Title:
St John's wort for major depression.
Source:
Cochrane Database of Systematic Reviews. (4):CD000448, 2008.
Type of study:
Systematic Review (123 refs)
Control/comparison:
Not applicable
Sample characteristics:
Not applicable
Type of intervention:
Not applicable
Primary outcome measure(s):
Not applicable
Outcome:
This review investigated whether St. john's wort is more effective than placebo and as effective as standard antidepressants in the treatment of major depression; and whether it has fewer adverse effects than standard antidepressant drugs. The available evidence suggests that the St. John's wort extracts tested in the included trials 1) are superior to placebo in patients with major depression; 2) are similarly effective as standard antidepressants; 3) and have fewer side effects than standard antidepressants.

Author(s):
Darbinyan V, Aslanyan G, Amroyan E, et al.
Institution:
Department of Neurology, Armenian State Medical University, Yerevan, Armenia.
Title:
Clinical trial of Rhodiola rosea L. extract SHR-5 in the treatment of mild to moderate depression.
Source:
Nordic Journal of Psychiatry. 61(5):343-8, 2007.
Type of study:
Randomized Controlled Trial
Control/comparison:
group C: (29 patients) received two placebo tablets daily
Sample characteristics:
89 patients with mild to moderate depression
Type of intervention:
group A: (31 patients) received two tablets daily of standardized extract SHR-5 of rhizomes of Rhodiola rosea L.(340 mg/day). Group B: (29 patients) received two tablets twice per day of SHR-5 (680 mg/day)
Primary outcome measure(s):
The efficacy of SHR-5 extract with respect to depressive complaints was assessed on days 0 and 42 of the study period.
Outcome:
For individuals in groups A and B, overall depression, together with insomnia, emotional instability and somatization, but not self-esteem, improved significantly following medication, while the placebo group did not show such improvements. No serious side-effects were reported in any of the groups A-C. It is concluded that the standardized extract SHR-5 shows anti-depressive potency in patients with mild to moderate depression when administered in dosages of either 340 or 680 mg/day over a 6-week period.

Author(s):
Papakostas GI, Mischoulon D, Shyu I, et al.
Institution:
Massachusetts General Hospital, Harvard Medical School, Boston, MA
Title:
S-adenosyl methionine (SAMe) augmentation of serotonin reuptake inhibitors for antidepressant nonresponders with major depressive disorder: a double-blind, randomized clinical trial.
Source:
Am J Psychiatry. 167(8):942-8, 2010.
Type of study:
double-blind, randomized controlled trial
Control/comparison:
serotonin reuptake inhibitors (an anti-depressant medication)for 6 weeks plus placebo
Sample characteristics:
73 serotonin reuptake inhibitor (SRI) nonresponders with major depressive disorder
Type of intervention:
Patients continued to receive their anti-depressant medication plus adjunctive oral SAMe (target dose: 800 mg/twice daily)for 6 weeks.
Primary outcome measure(s):
The primary outcome measure for the study was the response rates according to the 17-item Hamilton Depression Rating Scale (HAM-D).
Outcome:
The HAM-D response and remission rates were higher for patients treated with adjunctive SAMe (36.1% and 25.8%, respectively) than adjunctive placebo (17.6% versus 11.7%,respectively). There was no difference in adverse events. These preliminary results suggest that SAMe can be an effective, well-tolerated, and safe additional treatment strategy for patients with major depressive disorder who do not respond to SRI medication. Further studies are warranted.
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Hypnosis
Author(s):
Shih M. Yang YH. Koo M.
Institution:
Nanhua University, Chiayi, Taiwan
Title:
A meta-analysis of hypnosis in the treatment of depressive symptoms: a brief communication
Source:
International Journal of Clinical & Experimental Hypnosis. 57(4):431-42, 2009
Type of study:
Review
Control/comparison:
Not applicable
Sample characteristics:
Not applicable
Type of intervention:
Not applicable
Primary outcome measure(s):
Not applicable
Outcome:
Six studies were included. Hypnosis appeared to significantly improve symptoms of depression. Hypnosis appears to be a viable non-pharmacologic intervention for depression.
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Imagery
Author(s):
Apóstolo JL, Kolcaba K
Institution:
Coimbra Nursing School, UiCiSa_dE, Coimbra,
Title:
The effects of guided imagery on comfort, depression, anxiety, and stress of psychiatric inpatients with depressive disorders.
Source:
Arch Psychiatr Nurs. 23(6):403-11, 2009
Type of study:
clinical trial
Control/comparison:
usual care with no added intervention
Sample characteristics:
60 short-term hospitalized depressive patients
Type of intervention:
listening to a guided imagery compact disk once a day for 10 days
Primary outcome measure(s):
The Psychiatric Inpatients Comfort Scale and the Depression, Anxiety, and Stress Scales
Outcome:
Repeated measures revealed that the treatment group had significantly improved comfort and decreased depression,anxiety, and stress over the ten day period.
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Massage Therapy
Author(s):
Field T, Grizzle N, Scafidi F, et al
Institution:
Touch Research Institute, University of Miami School of Medicine, Florida
Title:
Massage and relaxation therapies’ effects on depressed adolescent mothers.
Source:
Adolescence. 31(124):903-11, 1996
Type of study:
randomized, controlled, clinical trial
Control/comparison:
ten 30 minute sessions of relaxation therapy over 5 weeks
Sample characteristics:
32 depressed adolescent mothers
Type of intervention:
ten 30 minute sessions of massage therapy over 5 weeks
Primary outcome measure(s):
behavioral and laboratory assessments, including salivary cortisol levels, stress hormone levels, and urine cortisol levels
Outcome:
Both groups reported lower anxiety following their first and last sessions. However, the massage group showed both behavioral and stress hormone changes marked by a decrease in anxious behavior, pulse, and salivary cortisol levels. Following the five weeks of treatment, a decrease in urine cortisol levels further indicated lower stress levels for the massage therapy group. Future studies involving a larger population may help support these findings.

Author(s):
Jones NA, Field T
Institution:
Florida Atlantic University, Jupiter 33458, USA
Title:
Massage and music therapies attenuate frontal EEG asymmetry in depressed adolescents.
Source:
Adolescence. 34(135):529-34, 1999
Type of study:
randomized, controlled clinical trial
Control/comparison:
music therapy
Sample characteristics:
30 depressed adolescents with greater relative right frontal activation
Type of intervention:
massage therapy
Primary outcome measure(s):
EEG measurement recorded for three-minute periods before, during, and after therapy
Outcome:
Researchers found that greater relative right frontal activation in EEGs, which is associated with negative affect in depressed individuals, was significantly reduced during and after both massage and music sessions.

Author(s):
Coelho HF. Boddy K. Ernst E.
Institution:
Complementary Medicine, Peninsula Medical School, Universities of Exeter and Plymouth, Exeter, UK.
Title:
Massage therapy for the treatment of depression: a systematic review.
Source:
International Journal of Clinical Practice. 62(2):325-33, 2008
Type of study:
review (48 references)
Control/comparison:
Not applicable
Sample characteristics:
Not applicable
Type of intervention:
Not applicable
Primary outcome measure(s):
Not applicable
Outcome:
Four studies were reviewed. There is currently a lack of evidence to support massage therapy as an effective treatment for depression.

Author(s):
Hou WH, Chiang PT, Hsu TY, Chiu SY, Yen YC.
Institution:
Department of Physical Medicine and Rehabilitation, E-Da Hospital and College of
Title:
Treatment effects of massage therapy in depressed people: a meta-analysis.
Source:
J Clin Psychiatry. 71(7):894-901, 2010
Type of study:
Meta-analysis
Control/comparison:
Not applicable
Sample characteristics:
Not applicable
Type of intervention:
Not applicable
Primary outcome measure(s):
Not applicable
Outcome:
Seventeen studies of 786 people were included. All trials showed positive effect of massage therapy on depressed people compared with the control group. Massage therapy is significantly associated with alleviated depressive symptoms. However,standardized protocols of massage therapy, depression rating scales, and target populations in further studies are suggested.
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Meditation/Relaxation
Author(s):
Jorm AF, Morgan AJ, Hetrick SE.
Institution:
University of Melbourne, Melbourne, Australia
Title:
Relaxation for depression
Source:
Cochrane Database System Review. (4):CD007142, 2008
Type of study:
meta-analysis
Control/comparison:
no treatment, minimal treatment, psychological treatment
Sample characteristics:
People with depression or having a high level of depressive symptoms
Type of intervention:
relaxation techniques (progressive muscle relaxation, relaxation imagery, autogenic training)
Primary outcome measure(s):
self-rated and clinician-rated depression scores and response/remission
Outcome:
Relaxation techniques were more effective at reducing self-rated depressive symptoms than no or minimal treatment. However, they were not as effective as psychological treatment. Further research is needed to investigate the possibility of relaxation being used as a first-line treatment in a stepped care approach to managing depression, especially in younger populations and people with first episodes of depression.

Author(s):
Butler LD, Waelde LC, Hastings TA, et al.
Institution:
Stanford University School of Medicine, Stanford,
Title:
Meditation with yoga, group therapy with hypnosis, and psychoeducation for long-term depressed mood: a randomized pilot trial.
Source:
Journal of Clinical Psychology. 64(7):806-20, 2008.
Type of study:
Randomized Controlled Trial
Control/comparison:
psychoeducation alone
Sample characteristics:
46 individuals with long-term depressive disorders
Type of intervention:
meditation with yoga (and psychoeducation)or group therapy with hypnosis (and psychoeducation)
Primary outcome measure(s):
diagnostic status and symptom levels
Outcome:
Results indicate that significantly more meditation group participants experienced a remission than did controls at 9-month follow-up. Eight hypnosis group participants also experienced a remission, but the difference from controls was not statistically significant. Overall, these results suggest that these two interventions show promise for treating low- to moderate-level depression.

Author(s):
Tsang HW. Chan EP. Cheung WM.
Institution:
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
Title:
Effects of mindful and non-mindful exercises on people with depression: a systematic review.
Source:
British Journal of Clinical Psychology. 47(Pt 3):303-22, 2008 Sep.
Type of study:
review (64 references)
Control/comparison:
Not applicable
Sample characteristics:
Not applicable
Type of intervention:
Not applicable
Primary outcome measure(s):
Not applicable
Outcome:
This review found that both mindful and non-mindful physical exercises were effective in the short term in reducing depression levels or depressive symptoms. Future research should be focused on unveiling the differential effects of mindful and non-mindful exercises on depression and the underlying mechanisms of their therapeutic action.
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Music Therapy
Author(s):
Hanser SB, Thompson, LW
Institution:
Stanford University School of Medicine
Title:
Effects of a music therapy strategy on depressed older adults.
Source:
Journal of Gerontology. 49(6):P265-9, 1994
Type of study:
randomized, controlled, clinical trial
Control/comparison:
waiting list
Sample characteristics:
30 older adults with major or minor depressive disorder
Type of intervention:
subjects were assigned to one of three music therapy groups that lasted for 8 weeks: 1) a home-based program where participants learned music listening stress reduction techniques at weekly home visits by a music therapist; 2) a self-administered program where participants applied these same techniques with moderate therapist intervention (a weekly telephone call); or 3) the wait-list control group
Primary outcome measure(s):
standardized tests of depression, distress, self-esteem, and mood
Outcome:
Participants in both music groups showed significant improvement in all measured areas over the waiting list group. Improvements were maintained over the nine month follow-up period. Researchers concluded that listening to music may be a beneficial, cost-effective intervention for housebound elderly depressed individuals.

Author(s):
Gold C. Solli HP. Kruger V. Lie SA.
Institution:
Unifob Health, Bergen, Norway
Title:
Dose-response relationship in music therapy for people with serious mental disorders: systematic review and meta-analysis.
Source:
Clinical Psychology Review. 29(3):193-207, 2009.
Type of study:
Meta-analysis (77 refs)
Control/comparison:
Not applicable
Sample characteristics:
Not applicable
Type of intervention:
Not applicable
Primary outcome measure(s):
Not applicable
Outcome:
Music therapy may be beneficial in depression and psychosis, including treatment-resistant cases. The aim of this review was to examine the benefits of music therapy for people with serious mental disorders. Results showed that music therapy, when added to standard care, has strong and significant effects on global state, general symptoms, negative symptoms, depression, anxiety, functioning, and musical engagement. The findings suggest that music therapy is an effective treatment which helps people with serious severe mental disorders improve global state, symptoms, and functioning. Slight improvements can be seen with a few therapy sessions, but longer courses or more frequent sessions are needed to achieve more substantial benefits.

Author(s):
Gold C. Solli HP. Kruger V. Lie SA.
Institution:
Unifob Health, Bergen, Norway
Title:
Dose-response relationship in music therapy for people with serious mental disorders: systematic review and meta-analysis
Source:
Clinical Psychology Review. 29(3):193-207, 2009 Apr.
Type of study:
Meta-analysis
Control/comparison:
Not applicable
Sample characteristics:
Not applicable
Type of intervention:
Not applicable
Primary outcome measure(s):
Not applicable
Outcome:
This review examined several studies testing the effectiveness of music therapy in treating patients with serious mental disorders. The review found that, in coordination with standard care, music therapy was effective in treating depression, anxiety, and general functioning in both psychotic and non-psychotic patients and that its effects are dependent on the frequency and duration of treatment.

Author(s):
Brandes V, Terris DD, Fischer C, et al.
Institution:
Paracelsus Medical University, Salzburg, Austria.
Title:
Music programs designed to remedy burnout symptoms show significant effects after five weeks.
Source:
Ann N Y Acad Sci. 1169:422-5, 2009.
Type of study:
randomized controlled trial
Control/comparison:
no additional intervention
Sample characteristics:
150 people with burnout
Type of intervention:
two specific music therapy programs
Primary outcome measure(s):
not known
Outcome:
The two music programs significantly reduced burnout symptoms after 5 weeks. The effects were maintained over a long time period. This newly developed method of receptive music therapy was also evaluated for the treatment of depression and dysthymia, with significant outcomes.
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Nutrition/Supplementation
Author(s):
Bruinsma KA, Taren DL
Institution:
University of Arizona College of Public Health, Tucson
Title:
Dieting, essential fatty acid intake, and depression.
Source:
Nutrition Reviews. 58(4): 98-108, 2000
Type of study:
review (116 references)
Control/comparison:
not applicable
Sample characteristics:
not applicable
Type of intervention:
not applicable
Primary outcome measure(s):
not applicable
Outcome:
A recent study revealed that high intake of omega 6 fatty acids in relation to omega-3 fatty acids was associated with increased levels of depression. Several studies indicate that the overall level of omega-3 fatty acids rather than the ratio of omega 6 to omega-3 fatty acids served as a better predictor of emotional mood states. The reviewers concluded that the relationship between essential fatty acids, dieting behaviors, and depression remains unclear. They recommend that dietary advice regarding serum cholesterol reduction, cancer prevention, and weight loss should emphasize the importance of obtaining adequate omega-3 fatty acids. This review raises the question of whether an extremely low-fat diet may be counterregulatory and have harmful psychological effects. Further studies are needed to understand the relationships among essential fatty acid intake, brain lipid compositional changes, dietary behaviors, the psychological effects of dietary restriction and depression.

Author(s):
Coppen A, Bailey J
Institution:
MRC Neuropsychiatry Laboratory, West Park Hospital, KT19 8PB, Surrey, Epsom, UK
Title:
Enhancement of the antidepressant action of fluoxetine by folic acid: a randomized, placebo controlled clinical trial
Source:
Journal of Affective Disorders. 60(2):121-30, 2000
Type of study:
randomized, controlled clinical trial
Control/comparison:
placebo plus 20 mg fluoxetine daily
Sample characteristics:
127 patients who met the DSM-III-R criteria for major depression and had a baseline Hamilton Rating Scale score for depression of 20 or more
Type of intervention:
500 microg folic acid plus 20 mg flouxetine daily
Primary outcome measure(s):
plasma folate and homocysteine levels measured at baseline and at 10 weeks, Hamilton Rating Scale score
Outcome:
Poor response to antidepressants has previously been linked to low folate levels often found in depressed patients. This investigation sought to determine whether the co-administration of folic acid would enhance the antidepressant action of fluoxetine. Patients receiving folate showed a significant increase in plasma folate. This increase was lower in men than in women. Plasma homocysteine significantly decreased in women, but there was no significant change in men. 93.9% of the women in the flouxetine plus folate group experienced a greater than 50% reduction in the depression on the Hamilton Rating Scale score as compared to 61.1% of the women receiving the placebo. These results indicate that folic acid is a simple method of greatly improving the antidepressant action of fluoxetine and probably other antidepressants. The researchers suggest folic acid should be given in doses sufficient enough to decrease plasma homocysteine. Men require a higher dose of folic acid to achieve this than women, but further research is required to ascertain the optimum dose of folic acid.

Author(s):
Lucas M, Asselin G, Mérette C, et al.
Institution:
Laval University, Saint-François
Title:
Ethyl-eicosapentaenoic acid (Omega-3 fatty acids) for the treatment of psychological distress and depressive symptoms in middle-aged women: a double-blind, placebo-controlled, randomized clinical trial.
Source:
American Journal of Clinical Nutrition. 89(2):641-51, 2009
Type of study:
Randomized Controlled Trial
Control/comparison:
Placebo
Sample characteristics:
120 women with moderate to severe psychological distress
Type of intervention:
8 weeks of .15g of ethyl-docosahexaenoic acid (DHA)
Primary outcome measure(s):
Analysis of psychological distress levels.
Outcome:
In women with psychological distress without major depressive episodes at baseline, the 8-week changes in psychological distress and depressive scales improved significantly more with E-EPA than with placebo.

Author(s):
Cherniack EP. Troen BR. Florez HJ. Roos BA. Levis S.
Institution:
Miller School of Medicine, University of Miami
Title:
Some new food for thought: the role of vitamin D in the mental health of older adults.
Source:
Current Psychiatry Reports. 11(1):12-9, 2009.
Type of study:
Review (58 refs)
Control/comparison:
Not applicable
Sample characteristics:
Not applicable
Type of intervention:
Not applicable
Primary outcome measure(s):
Not applicable
Outcome:
Low levels of vitamin D are prevalent among older adults, and several studies suggest an association between these low levels and cognitive functions, depression, bipolar disorder, and schizophrenia. Vitamin D activates receptors on neurons in the brain that are involved in the regulation of behavior, stimulates neurotrophin release, and protects the brain from vascular injury while improving metabolic and cardiovascular function. Although additional studies are needed to assess the impact of Vitamin D supplements on cognition and mood disorders, given the known health benefits, it is recommended that older adults are given greater supplementation.

Author(s):
Freeman MP.
Institution:
University of Texas Southwestern Medical Center, Dallas, TX
Title:
Complementary and alternative medicine for perinatal depression.
Source:
Journal of Affective Disorders. 112(1-3):1-10, 2009
Type of study:
Review (95 refs)
Control/comparison:
Not applicable
Sample characteristics:
Not applicable
Type of intervention:
Not applicable
Primary outcome measure(s):
Not applicable
Outcome:
Omega-3 fatty acids have received the most specific study for perinatal depression. Three randomized placebo-controlled trials have been conducted in which investigators assessed omega-3 fatty acids vs. placebo for perinatal depression, with conflicting results. Interventions that can be easily added to a treatment plan with little risk and general health benefits for most women include omega-3 fatty acids, exercise, and folate, although data are insufficient at this time to recommend any of these as alone as a treatment for perinatal depression. S-adenosyl-methionine (SAMe) and bright light therapy may be reasonable to consider based on the evidence in major depressive disorder. St. John's Wort requires further study with regard to safety in pregnancy, and drug interactions can be a potential problem.

Author(s):
Almeida OP, McCaul K, Hankey GJ, et al.
Institution:
University of Western Australia, Crawley, Australia.
Title:
Homocysteine and depression in later life.
Source:
Archives of General Psychiatry. 65(11):1286-94, 2008.
Type of study:
Review (37 refs)
Control/comparison:
Not applicable
Sample characteristics:
Not applicable
Type of intervention:
Not applicable
Primary outcome measure(s):
Not applicable
Outcome:
This meta-analysis sought to determine if plasma total homocysteine concentration is causally related to depression in later life. Results indicate that higher concentrations of total homocysteine increase the risk of depression and that lowering total homocysteine by 0.19 mg/L could reduce the odds of depression by about 20%. Data from robust randomized controlled trials of homocysteine-lowering therapy are now required to test if the relationship between total homocysteine and depression is truly causal.

Author(s):
Kim JM, Stewart R, Kim SW, et al.
Institution:
Chonnam National University Medical School, Kwangju, Republic of Korea.
Title:
Predictive value of folate, vitamin B12 and homocysteine levels in late-life depression.
Source:
British Journal of Psychiatry. 192(4):268-74, 2008.
Type of study:
Multicenter study
Control/comparison:
not applicable
Sample characteristics:
521 people over 65 years of age followed for 2-3 years
Type of intervention:
not applicable
Primary outcome measure(s):
Serum folate, serum vitamin B(12) and plasma homocysteine levels were tested at both baseline and follow-up.
Outcome:
Lower levels of folate and vitamin B(12) and higher homocysteine levels at baseline were associated with a higher risk of incident depression at follow-up. Incident depression was associated with a decline in vitamin B(12) and an increase in homocysteine levels over the follow-up period. Lower folate, lower vitamin B(12) and raised homocysteine levels may be risk factors for late-life depression.

Author(s):
Lin PY, Su KP.
Institution:
Chang Gung University College of Medicine, Kaohsiung, Taiwan
Title:
A meta-analytic review of double-blind, placebo-controlled trials of antidepressant efficacy of omega-3 fatty acids
Source:
Journal of Clinical Psychiatry. 68(7): 1056-1061, 2007.
Type of study:
meta-analysis
Control/comparison:
Not applicable
Sample characteristics:
Not applicable
Type of intervention:
Not applicable
Primary outcome measure(s):
Not applicable
Outcome:
Ten double-blind, placebo-controlled studies in patients with mood disorders receiving omega-3 fatty acids were included in this meta-analysis. When pooling the results of the studies on 329 patients, a significant antidepressant effect of omega-3 fatty acids was found. Omega-3 fatty acids significantly improved depression in patients with clearly defined depression or with bipolar disorder. The dosage of eicosapentaenoic acid (EPA) did not change the antidepressant efficacy significantly. More large-scale, well-controlled trials are needed to find out which patients are likely to respond positively, the therapeutic dose of EPA, and the composition of omega-3 fatty acids in treating depression.

Author(s):
Ganji V, Milone C, Cody MM, McCarty F, Wang YT.
Institution:
Division of Nutrition, School of Health Professions, College of Health and Human Sciences, Georgia State University
Title:
Serum vitamin D concentrations are related to depression in young adult US population: the Third National Health and Nutrition Examination Survey.
Source:
International Archives of Medicine. 3:29, 2010
Type of study:
Population based study
Control/comparison:
not applicable
Sample characteristics:
7,970 US residents, aged 15-39 years
Type of intervention:
not applicable
Primary outcome measure(s):
Assessment of depression was done using the Diagnostic Interview Schedule developed by the National Institute of Mental Health
Outcome:
The odds ratios for having depression in vitamin D deficient persons in comparison to vitamin D sufficient persons were determined. Women, non-Hispanic blacks, persons living below poverty, persons who did not consume supplements, persons living in South and West regions and in urban areas, persons with higher BMI, and persons with current depression had higher prevalence of vitamin D deficiency compared to their counterparts. The odds ratio for having current depressive episodes in persons with serum vitamin D levels below 50 nmol/L is significantly higher relative to those with serum vitamin D levels above75 nmol/L. In this large population based study, likelihood of having depression in persons with vitamin D deficiency is significantly higher compared to those with vitamin D sufficiency. Early diagnosis and intervention are paramount because coexistence of vitamin D deficiency and depression has serious negative consequences on health.

Author(s):
Lucas M, Mirzaei F, O’Reilly EJ, et al.
Institution:
 
Title:
Dietary intake of n-3 and n-6 fatty acids and the risk of clinical depression in women: a 10-y prospective follow-up study
Source:
Am J Clin Nutr, 2011; 93(6): 1337-43.
Type of study:
Prospective Study
Control/comparison:
Not applicable
Sample characteristics:
54,632 women between 50 and 77 years of age, free from depressive symptoms at baseline
Type of intervention:
intake of alpha linolenic acid monitored over 10 year follow up
Primary outcome measure(s):
risk of depression
Outcome:
Intake of alpha linolenic acid (ALA) was found to be inversely associated with depressive risk, with a stronger association found in women with low linoleic acid intake. Intake of long-chain omega-3 fatty acids from fish was not found to be associated with depressive symptoms. These data support the hypothesis that higher ALA and lower LA intakes reduce depression risk. This relationship warrants further investigation.
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Osteopathic Medicine
Author(s):
Plotkin BJ, Rodos JJ, Kappler R, et al
Institution:
Department of Microbiology, Chicago College of Osteopathic Medicine of Midwestern University, USA. Bplotk@Midwestern.edu
Title:
Adjunctive osteopathic manipulative treatment in women with depression: a pilot study
Source:
Journal of the American Osteopathic Association. 101(9):517-23, 2001
Type of study:
randomized, controlled clinical trial
Control/comparison:
osteopathic structural examination only
Sample characteristics:
17 pre-menopausal women with newly diagnosed depression receiving conventional therapy consisting of the antidepressant paroxentine (Paxil) hydrochloride plus weekly psychotherapy for 8 weeks
Type of intervention:
osteopathic manipulative treatment (OMT)
Primary outcome measure(s):
psychometric evaluation, levels of cytokine production, and levels of anti-HSV-1, anti-HSV-2, and anti-EBV antibodies
Outcome:
After 8 weeks, 100% of the OMT treatment group and 33% of the control group tested normal by psychometric evaluation. No significant differences were observed between groups in levels of cytokine production or in the levels of any of the antibodies. The researchers concluded that OMT may be a useful adjunctive treatment for alleviating depression in women. Larger studies with longer observation periods will be helpful in confirming this data.
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Prayer
Author(s):
O’Laoire S
Institution:
 
Title:
An experimental study of the effects of distant, intercessory prayer on self-esteem, anxiety, and depression
Source:
Alternative Therapies in Health and Medicine. 3(6):38-53, 1997
Type of study:
randomized, double-blind, controlled clinical trial
Control/comparison:
none
Sample characteristics:
496 volunteers, those who prayed (90 agents) and those who were prayed for (406 subjects)
Type of intervention:
agents were divided into a directed or nondirected prayer group; prayer was performed 15 minutes daily for 12 weeks; three different agents prayed for each subject; photos and names of subjects were used as a focus by prayer agents; subjects were randomly assigned to one of three groups: those prayed for by nondirected agents, a control group, and those prayed for by directed agents
Primary outcome measure(s):
five pre-test and post-test objective measures and six post-test subjective measures
Outcome:
Subjects improved significantly on all 11 measures. Agents improved significantly on 10 measures. A significant positive correlation was found on the amount of prayer the agents did and the five objective measures. Agents had significantly better scores on all the objective measures than the subjects. Subjects’ improvement of objective measures was significantly related to their belief in the power of prayer for others and to their conviction as to whether they had been assigned to a control or an experimental group.
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Qigong
Author(s):
Tsang HW. Fung KM.
Institution:
The Hong Kong Polytechnic University, Hong Kong.
Title:
A review on neurobiological and psychological mechanisms underlying the anti-depressive effect of qigong exercise.
Source:
Journal of Health Psychology. 13(7):857-63, 2008.
Type of study:
Reveiw (52 refs)
Control/comparison:
Not applicable
Sample characteristics:
Not applicable
Type of intervention:
Not applicable
Primary outcome measure(s):
not applicable
Outcome:
Qigong, a Chinese mindful exercise, is demonstrated to have anti-depressive effects. Results of earlier studies shed light on the psychological mechanism underlying this effect. The neurobiological mechanism remains unclear. This article reviews the evidence and suggests possible neurobiological pathways of the anti-depressive effect of qigong based on the neurotransmitter, neuroendocrine, and neurotropic perspectives.
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Reiki
Author(s):
Shore AG
Institution:
 
Title:
Long-term effects of energetic ehaling on symptoms of psychological depression and self-perceived stress
Source:
Alternative Therapies in Health & Medicine. 10(30:42-8, 2004
Type of study:
randomized controlled clinical trial
Control/comparison:
placebo reiki
Sample characteristics:
46 participants
Type of intervention:
hands-on Reiki and distance Reiki sessions 1 to 1.5 hour treatment for 6 weeks
Primary outcome measure(s):
Beck Depression Inventory, Beck Hopelessness, and Perceived Stress scales
Outcome:
Upon completion of treatment, there was a significant reduction in symptoms of psychological distress in treatment groups as compared with controls, and these differences continued to be present one year later.
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Tai Chi
Author(s):
Cho KL.
Institution:
The University of Hong Kong, Hong Kong SAR, China.
Title:
Effect of Tai Chi on depressive symptoms amongst Chinese older patients with major depression: the role of social support.
Source:
Medicine & Sport Science. 52:146-54, 2008.
Type of study:
Randomized Controlled Trial
Control/comparison:
wait list control
Sample characteristics:
14 older patients with depression
Type of intervention:
a 3-month Tai Chi intervention with 36 sessions
Primary outcome measure(s):
Depression was assessed by the Center for Epidemiological Studies Depression Scale (CES-D) and social support was measured by the Lubben Social Network Scale (LSNS)
Outcome:
Results indicate that social support might be partly responsible for the effect of Tai Chi on depressive symptoms because practicing Tai Chi is a social activity in nature.
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Yoga
Author(s):
Kjellgren A, Bood SA, Axelsson K., et al.
Institution:
Department of Psychology, Karlstad University, Karlstad, Sweden.
Title:
Wellness through a comprehensive yogic breathing program - a controlled pilot trial.
Source:
BMC Complementary & Alternative Medicine. 7:43, 2007.
Type of study:
Randomized Controlled Trial
Control/comparison:
relaxation time in an armchair each day during the same period as the intervention
Sample characteristics:
103 healthy adults
Type of intervention:
a 6-day intensive program of Sudarshan Kriya yoga practiced daily for six weeks.
Primary outcome measure(s):
Hospital Anxiety Depression Scale measured the degree of anxiety and depression, Life Orientation Test measured dispositional optimism, Stress and Energy Test measured individual's energy and stress experiences. Experienced Deviation from Normal State measured the experience of altered state of consciousness.
Outcome:
The goal of this pilot study was to design a protocol to investigate whether Sudarshan Kriya (yoga and yogic breathing exercises) can lead to increased feeling of wellness in healthy volunteers. The data suggest that participants in the yoga group, but not the control group, lowered their degree of anxiety, depression and stress, and increased their degree of optimism. The data obtained suggest that adult participants can improve their wellness by learning and applying a program based on yoga and yogic breathing exercises.
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