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Efficacy of home-based non-pharmacological interventions for treating depression: a systematic review and network meta-analysis of randomised controlled trials

OBJECTIVES: To systematically review and compare the efficacy of all available home-based non-pharmacological treatments of depression. DESIGN: Systematic review and network meta-analysis of randomised controlled trials. DATA SOURCES: Medline, Scopus and Cumulative Index to Nursing and Allied Health...

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Autores principales: Sukhato, Kanokporn, Lotrakul, Manote, Dellow, Alan, Ittasakul, Pichai, Thakkinstian, Ammarin, Anothaisintawee, Thunyarat
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5734422/
https://www.ncbi.nlm.nih.gov/pubmed/28706086
http://dx.doi.org/10.1136/bmjopen-2016-014499
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author Sukhato, Kanokporn
Lotrakul, Manote
Dellow, Alan
Ittasakul, Pichai
Thakkinstian, Ammarin
Anothaisintawee, Thunyarat
author_facet Sukhato, Kanokporn
Lotrakul, Manote
Dellow, Alan
Ittasakul, Pichai
Thakkinstian, Ammarin
Anothaisintawee, Thunyarat
author_sort Sukhato, Kanokporn
collection PubMed
description OBJECTIVES: To systematically review and compare the efficacy of all available home-based non-pharmacological treatments of depression. DESIGN: Systematic review and network meta-analysis of randomised controlled trials. DATA SOURCES: Medline, Scopus and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched since inceptions to 7 August 2016. ELIGIBILITY CRITERIA: Randomised controlled trials comparing the efficacy of home-based non-pharmacological interventions with usual care of patients with depression were included in the review. MAIN OUTCOMES: Depression symptom scores and disease remission rates at the end of treatment. RESULTS: Seventeen studies were included in the review. Home-based non-pharmacological interventions were categorised as (1) home-based psychological intervention, (2) home-based exercise intervention, (3) combined home-based psychological intervention with exercise intervention and (4) complementary medicine. Complementary medicine approaches were excluded from the meta-analysis due to heterogeneity. The standardised mean differences of post-treatment depression symptom scores between usual care groups and home-based psychological intervention, home-based exercise intervention and combined home-based psychological intervention with exercise intervention were −0.57 (95% CI −0.84 to −0.31), −1.03 (95% CI −2.89 to 0.82) and −0.78 (95% CI −1.09 to −0.47), respectively. These results suggest that only home-based psychological intervention and combined home-based psychological intervention with exercise intervention could significantly decrease depression scores. Compared with usual care groups, the disease remission rate was also significantly higher for home-based psychological intervention (pooled risk ratio=1.53; 95% CI 1.19 to 1.98) and combined home-based psychological intervention with exercise intervention (pooled risk ratio=3.47; 95% CI 2.11 to 5.70). Of all the studied interventions, combined home-based psychological intervention with exercise intervention had the highest probability of resulting in disease remission. CONCLUSION: Our study confirms the efficacy of home-based psychological intervention and combined home-based psychological intervention with exercise intervention in the treatment of depression. Combined home-based psychological intervention and exercise intervention was the best treatment and should be considered for inclusion in clinical guidelines for managing depression.
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spelling pubmed-57344222017-12-20 Efficacy of home-based non-pharmacological interventions for treating depression: a systematic review and network meta-analysis of randomised controlled trials Sukhato, Kanokporn Lotrakul, Manote Dellow, Alan Ittasakul, Pichai Thakkinstian, Ammarin Anothaisintawee, Thunyarat BMJ Open Mental Health OBJECTIVES: To systematically review and compare the efficacy of all available home-based non-pharmacological treatments of depression. DESIGN: Systematic review and network meta-analysis of randomised controlled trials. DATA SOURCES: Medline, Scopus and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched since inceptions to 7 August 2016. ELIGIBILITY CRITERIA: Randomised controlled trials comparing the efficacy of home-based non-pharmacological interventions with usual care of patients with depression were included in the review. MAIN OUTCOMES: Depression symptom scores and disease remission rates at the end of treatment. RESULTS: Seventeen studies were included in the review. Home-based non-pharmacological interventions were categorised as (1) home-based psychological intervention, (2) home-based exercise intervention, (3) combined home-based psychological intervention with exercise intervention and (4) complementary medicine. Complementary medicine approaches were excluded from the meta-analysis due to heterogeneity. The standardised mean differences of post-treatment depression symptom scores between usual care groups and home-based psychological intervention, home-based exercise intervention and combined home-based psychological intervention with exercise intervention were −0.57 (95% CI −0.84 to −0.31), −1.03 (95% CI −2.89 to 0.82) and −0.78 (95% CI −1.09 to −0.47), respectively. These results suggest that only home-based psychological intervention and combined home-based psychological intervention with exercise intervention could significantly decrease depression scores. Compared with usual care groups, the disease remission rate was also significantly higher for home-based psychological intervention (pooled risk ratio=1.53; 95% CI 1.19 to 1.98) and combined home-based psychological intervention with exercise intervention (pooled risk ratio=3.47; 95% CI 2.11 to 5.70). Of all the studied interventions, combined home-based psychological intervention with exercise intervention had the highest probability of resulting in disease remission. CONCLUSION: Our study confirms the efficacy of home-based psychological intervention and combined home-based psychological intervention with exercise intervention in the treatment of depression. Combined home-based psychological intervention and exercise intervention was the best treatment and should be considered for inclusion in clinical guidelines for managing depression. BMJ Publishing Group 2017-07-12 /pmc/articles/PMC5734422/ /pubmed/28706086 http://dx.doi.org/10.1136/bmjopen-2016-014499 Text en © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Mental Health
Sukhato, Kanokporn
Lotrakul, Manote
Dellow, Alan
Ittasakul, Pichai
Thakkinstian, Ammarin
Anothaisintawee, Thunyarat
Efficacy of home-based non-pharmacological interventions for treating depression: a systematic review and network meta-analysis of randomised controlled trials
title Efficacy of home-based non-pharmacological interventions for treating depression: a systematic review and network meta-analysis of randomised controlled trials
title_full Efficacy of home-based non-pharmacological interventions for treating depression: a systematic review and network meta-analysis of randomised controlled trials
title_fullStr Efficacy of home-based non-pharmacological interventions for treating depression: a systematic review and network meta-analysis of randomised controlled trials
title_full_unstemmed Efficacy of home-based non-pharmacological interventions for treating depression: a systematic review and network meta-analysis of randomised controlled trials
title_short Efficacy of home-based non-pharmacological interventions for treating depression: a systematic review and network meta-analysis of randomised controlled trials
title_sort efficacy of home-based non-pharmacological interventions for treating depression: a systematic review and network meta-analysis of randomised controlled trials
topic Mental Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5734422/
https://www.ncbi.nlm.nih.gov/pubmed/28706086
http://dx.doi.org/10.1136/bmjopen-2016-014499
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