Adults with depression receive no additional benefit from exercise as an adjunctive treatment for depression, a new study has found.
The treatment of depression with physical activity (TREAD) trial, reported in the BMJ, allocated 361 adults who had recently consulted their GP with symptoms of depression to usual care or usual care plus exercise.
The randomised controlled trial gave those in the exercise group up to three face-to-face sessions and 10 phone calls with a trained physical activity facilitator over eight months, with the aim of providing individually tailored support and encouragement to engage in physical activity.
The researchers found no evidence that people in the exercise group reported a greater improvement in mood at four, eight and twelve-month follow-up than those receiving usual care. Both groups started with a mean Beck depression inventory score of 32.1 and those in the exercise group had a mean score of 12.59 at 12 months’ follow up, compared with a mean score of 13.47 in the usual care group.
They also found no evidence that the intervention reduced antidepressant use compared with usual care. However, participants reported more physical activity during the follow-up period than those allocated to the usual care group.
Research author Professor John Campbell, from the Primary Care Research Group at the Peninsula Medical School, told Pulse the study raised a `question mark’ about the use of exercise as a treatment for depression.
He said: `People get a buzz and a sense of well-being and there are many other benefits, but in terms of treatment for depression, usual care – drugs and talking therapies – should be first line.’
He said that the benefits of usual care demonstrated in the study were `quite substantial and to demonstrate almost anything beyond that would have been difficult’. He added that studies to date suggesting that exercise might be useful in treating depression had often been small and not always good quality.
However, he said the exercise group had made quite a substantial increase in activity, and that this had been sustained. He said the exercise was `tailored to the individual – people stuck with it because it was acceptable to them’ and that this approach to physical activity might be useful for people with obesity, diabetes and cardiovascular disease `with or without depression’.
Professor Helen Lester, professor of primary care at the University of Birmingham, said the researchers’ conclusions were `wise – that as GPs we should not tell our patients that exercise is an excellent way to combat depression though of course it is good for many other aspects of physical health’.
Professor Lester said: `CCGs may want to review the services they are thinking about commissioning for depression in the light of this excellent study to ensure they are evidence-based.’