Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Maintained superiority of chronotherapeutics vs. exercise in a 20-week randomized follow-up trial in major depression

Research output: Contribution to journalJournal articleResearchpeer-review

Harvard

APA

CBE

MLA

Vancouver

Author

Bibtex

@article{e3760a59c1f849c390af683b56369a5e,
title = "Maintained superiority of chronotherapeutics vs. exercise in a 20-week randomized follow-up trial in major depression",
abstract = "OBJECTIVE: To investigate the long-term antidepressant effect of a chronotherapeutic intervention.METHOD: In this randomized controlled trial 75 patients with major depression were allocated to fixed duloxetine and either a chronotherapeutic intervention (wake group) with three initial wake therapies, daily bright light therapy, and sleep time stabilization or to a group using daily exercise. Patients were followed 29 weeks. We report the last 20 weeks, a follow-up phase, where medication could be altered. Patients were assessed every 4 weeks. Remission rates were primary outcome.RESULTS: Patients in the wake group had a statistically significant higher remission rate of 61.9% vs. 37.9% in the exercise group at week 29 (OR = 2.6, CL = 1.3-5.6, P = 0.01). This indicated continued improvement compared with the 9 weeks of treatment response (44.8% vs. 23.4%) with maintenance of the large difference between groups. HAM-D17 endpoint scores were statistically lower in the wake group with endpoint scores of 7.5 (SE = 0.9) vs. 10.1 (SE = 0.9) in the exercise group (difference 2.7, CL = 0.5-4.8, P = 0.02).CONCLUSION: In this clinical study patients continued to improve in the follow-up phase and obtained very high remission rates. This is the first study to show adjunct short-term wake therapy and long-term bright light therapy as an effective and feasible method to attain and maintain remission.",
keywords = "Adult, Aged, Antidepressive Agents, Combined Modality Therapy, Depressive Disorder, Major, Drug Chronotherapy, Duloxetine Hydrochloride, Exercise, Exercise Therapy, Female, Follow-Up Studies, Humans, Male, Middle Aged, Phototherapy, Self-Assessment, Sleep, Treatment Outcome",
author = "K Martiny and Middelboe, {Else Refsgaard} and V Lund and M Lunde and Britta Thougaard and Lone Lindberg and P Bech",
note = "{\textcopyright} 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.",
year = "2015",
month = jun,
doi = "10.1111/acps.12402",
language = "English",
volume = "131",
pages = "446--57",
journal = "Acta Psychiatrica Scandinavica",
issn = "0001-690X",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "6",

}

RIS

TY - JOUR

T1 - Maintained superiority of chronotherapeutics vs. exercise in a 20-week randomized follow-up trial in major depression

AU - Martiny, K

AU - Middelboe, Else Refsgaard

AU - Lund, V

AU - Lunde, M

AU - Thougaard, Britta

AU - Lindberg, Lone

AU - Bech, P

N1 - © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

PY - 2015/6

Y1 - 2015/6

N2 - OBJECTIVE: To investigate the long-term antidepressant effect of a chronotherapeutic intervention.METHOD: In this randomized controlled trial 75 patients with major depression were allocated to fixed duloxetine and either a chronotherapeutic intervention (wake group) with three initial wake therapies, daily bright light therapy, and sleep time stabilization or to a group using daily exercise. Patients were followed 29 weeks. We report the last 20 weeks, a follow-up phase, where medication could be altered. Patients were assessed every 4 weeks. Remission rates were primary outcome.RESULTS: Patients in the wake group had a statistically significant higher remission rate of 61.9% vs. 37.9% in the exercise group at week 29 (OR = 2.6, CL = 1.3-5.6, P = 0.01). This indicated continued improvement compared with the 9 weeks of treatment response (44.8% vs. 23.4%) with maintenance of the large difference between groups. HAM-D17 endpoint scores were statistically lower in the wake group with endpoint scores of 7.5 (SE = 0.9) vs. 10.1 (SE = 0.9) in the exercise group (difference 2.7, CL = 0.5-4.8, P = 0.02).CONCLUSION: In this clinical study patients continued to improve in the follow-up phase and obtained very high remission rates. This is the first study to show adjunct short-term wake therapy and long-term bright light therapy as an effective and feasible method to attain and maintain remission.

AB - OBJECTIVE: To investigate the long-term antidepressant effect of a chronotherapeutic intervention.METHOD: In this randomized controlled trial 75 patients with major depression were allocated to fixed duloxetine and either a chronotherapeutic intervention (wake group) with three initial wake therapies, daily bright light therapy, and sleep time stabilization or to a group using daily exercise. Patients were followed 29 weeks. We report the last 20 weeks, a follow-up phase, where medication could be altered. Patients were assessed every 4 weeks. Remission rates were primary outcome.RESULTS: Patients in the wake group had a statistically significant higher remission rate of 61.9% vs. 37.9% in the exercise group at week 29 (OR = 2.6, CL = 1.3-5.6, P = 0.01). This indicated continued improvement compared with the 9 weeks of treatment response (44.8% vs. 23.4%) with maintenance of the large difference between groups. HAM-D17 endpoint scores were statistically lower in the wake group with endpoint scores of 7.5 (SE = 0.9) vs. 10.1 (SE = 0.9) in the exercise group (difference 2.7, CL = 0.5-4.8, P = 0.02).CONCLUSION: In this clinical study patients continued to improve in the follow-up phase and obtained very high remission rates. This is the first study to show adjunct short-term wake therapy and long-term bright light therapy as an effective and feasible method to attain and maintain remission.

KW - Adult

KW - Aged

KW - Antidepressive Agents

KW - Combined Modality Therapy

KW - Depressive Disorder, Major

KW - Drug Chronotherapy

KW - Duloxetine Hydrochloride

KW - Exercise

KW - Exercise Therapy

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Male

KW - Middle Aged

KW - Phototherapy

KW - Self-Assessment

KW - Sleep

KW - Treatment Outcome

U2 - 10.1111/acps.12402

DO - 10.1111/acps.12402

M3 - Journal article

C2 - 25689725

VL - 131

SP - 446

EP - 457

JO - Acta Psychiatrica Scandinavica

JF - Acta Psychiatrica Scandinavica

SN - 0001-690X

IS - 6

ER -

ID: 45954824