Efficacy of Home-based Non-pharmacological Interventions for Treating Depression: a Systematic Review and Network Meta-analysis of Randomised Controlled Trials

Overview

Journal BMJ Open

Specialty General Medicine

Date 2017 Jul 15

PMID 28706086

Citations 13

Authors

Kanokporn Sukhato

Manote Lotrakul

Alan Dellow

Pichai Ittasakul

Ammarin Thakkinstian

Thunyarat Anothaisintawee

Affiliations

Soon will be listed here.

Abstract

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 âˆ'0.57 (95% CI âˆ'0.84 to âˆ'0.31), âˆ'1.03 (95% CI âˆ'2.89 to 0.82) and âˆ'0.78 (95% CI âˆ'1.09 to âˆ'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%â€‰CI 1.19 to 1.98) and combined home-based psychological intervention with exercise intervention (pooled risk ratio=3.47; 95%â€‰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.

Citing Articles

Home Environment as a Therapeutic Target for Prevention and Treatment of Chronic Diseases: Delivering Restorative Living Spaces, Patient Education and Self-Care by Bridging Biophilic Design, E-Commerce and Digital Health Technologies.

Huntsman D, Bulaj G Int J Environ Res Public Health. 2025; 22(2).

PMID: 40003451 PMC: 11855921. DOI: 10.3390/ijerph22020225.

The effect of mindfulness meditation on depressive symptoms during the COVID-19 pandemic: a systematic review and meta-analysis.

Fu Y, Song Y, Li Y, Sanchez-Vidana D, Jiaqi Zhang J, Lau W Sci Rep. 2024; 14(1):20189.

PMID: 39215203 PMC: 11364622. DOI: 10.1038/s41598-024-71213-9.

Immersive Technologies for Depression Care: Scoping Review.

Mahony Reategui-Rivera C, Villarreal-Zegarra D, De la Cruz-Torralva K, Diaz-Sanchez P, Finkelstein J JMIR Ment Health. 2024; 11:e56056.

PMID: 38663004 PMC: 11082738. DOI: 10.2196/56056.

The effect of the Yara smartphone application on anxiety, sleep quality, and suicidal thoughts in patients with major depressive disorder in Iran: a randomized controlled trial.

Soltani Z, Parizad N, Radfar M, Alinejad V, Arzanlo M, Haghighi M BMC Psychiatry. 2024; 24(1):231.

PMID: 38539144 PMC: 10967041. DOI: 10.1186/s12888-024-05688-1.

Subthreshold Depression: A Systematic Review and Network Meta-Analysis of Non-Pharmacological Interventions.

Hao X, Jia Y, Chen J, Zou C, Jiang C Neuropsychiatr Dis Treat. 2023; 19:2149-2169.

PMID: 37867932 PMC: 10588757. DOI: 10.2147/NDT.S425509.

References

Cuijpers P, van Straten A, van Schaik A, Andersson G . Psychological treatment of depression in primary care: a meta-analysis. Br J Gen Pract. 2009; 59(559):e51-60. PMC: 2629842. DOI: 10.3399/bjgp09X395139. View

Banerjee S, Shamash K, Macdonald A, Mann A . Randomised controlled trial of effect of intervention by psychogeriatric team on depression in frail elderly people at home. BMJ. 1996; 313(7064):1058-61. PMC: 2352357. DOI: 10.1136/bmj.313.7064.1058. View

Joling K, Van Hout H, Veer-Tazelaar P, van der Horst H, Cuijpers P, van de Ven P . How effective is bibliotherapy for very old adults with subthreshold depression? A randomized controlled trial. Am J Geriatr Psychiatry. 2010; 19(3):256-65. DOI: 10.1097/JGP.0b013e3181ec8859. View

Faraone S . Interpreting estimates of treatment effects: implications for managed care. P T. 2009; 33(12):700-11. PMC: 2730804. View

Gellis Z, McGinty J, Horowitz A, Bruce M, Misener E . Problem-solving therapy for late-life depression in home care: a randomized field trial. Am J Geriatr Psychiatry. 2007; 15(11):968-78. DOI: 10.1097/JGP.0b013e3180cc2bd7. View

Bruce M, Hoff R . Social and physical health risk factors for first-onset major depressive disorder in a community sample. Soc Psychiatry Psychiatr Epidemiol. 1994; 29(4):165-71. DOI: 10.1007/BF00802013. View

Kiosses D, Ravdin L, Gross J, Raue P, Kotbi N, Alexopoulos G . Problem adaptation therapy for older adults with major depression and cognitive impairment: a randomized clinical trial. JAMA Psychiatry. 2014; 72(1):22-30. PMC: 4583822. DOI: 10.1001/jamapsychiatry.2014.1305. View

Krishnan K, George L, Pieper C, Jiang W, Arias R, Look A . Depression and social support in elderly patients with cardiac disease. Am Heart J. 1998; 136(3):491-5. DOI: 10.1016/s0002-8703(98)70225-x. View

Unutzer J, Katon W, Callahan C, Williams Jr J, Hunkeler E, Harpole L . Collaborative care management of late-life depression in the primary care setting: a randomized controlled trial. JAMA. 2002; 288(22):2836-45. DOI: 10.1001/jama.288.22.2836. View

10.

Caldwell D, Ades A, Higgins J . Simultaneous comparison of multiple treatments: combining direct and indirect evidence. BMJ. 2005; 331(7521):897-900. PMC: 1255806. DOI: 10.1136/bmj.331.7521.897. View

11.

Ciechanowski P, Chaytor N, Miller J, Fraser R, Russo J, Unutzer J . PEARLS depression treatment for individuals with epilepsy: a randomized controlled trial. Epilepsy Behav. 2010; 19(3):225-31. DOI: 10.1016/j.yebeh.2010.06.003. View

12.

Gitlin L, Harris L, McCoy M, Chernett N, Pizzi L, Jutkowitz E . A home-based intervention to reduce depressive symptoms and improve quality of life in older African Americans: a randomized trial. Ann Intern Med. 2013; 159(4):243-52. PMC: 4091662. DOI: 10.7326/0003-4819-159-4-201308200-00005. View

13.

Prince M, Harwood R, Thomas A, Mann A . A prospective population-based cohort study of the effects of disablement and social milieu on the onset and maintenance of late-life depression. The Gospel Oak Project VII. Psychol Med. 1998; 28(2):337-50. DOI: 10.1017/s0033291797006478. View

14.

Danielsson L, Noras A, Waern M, Carlsson J . Exercise in the treatment of major depression: a systematic review grading the quality of evidence. Physiother Theory Pract. 2013; 29(8):573-85. DOI: 10.3109/09593985.2013.774452. View

15.

Kerse N, Hayman K, Moyes S, Peri K, Robinson E, Dowell A . Home-based activity program for older people with depressive symptoms: DeLLITE--a randomized controlled trial. Ann Fam Med. 2010; 8(3):214-23. PMC: 2866718. DOI: 10.1370/afm.1093. View

16.

Schoevers R, Beekman A, Deeg D, Geerlings M, Jonker C, van Tilburg W . Risk factors for depression in later life; results of a prospective community based study (AMSTEL). J Affect Disord. 2000; 59(2):127-37. DOI: 10.1016/s0165-0327(99)00124-x. View

17.

Geerlings S, Beekman A, Deeg D, van Tilburg W . Physical health and the onset and persistence of depression in older adults: an eight-wave prospective community-based study. Psychol Med. 2000; 30(2):369-80. DOI: 10.1017/s0033291799001890. View

18.

Schuch F, Vasconcelos-Moreno M, Borowsky C, Zimmermann A, Rocha N, Fleck M . Exercise and severe major depression: effect on symptom severity and quality of life at discharge in an inpatient cohort. J Psychiatr Res. 2014; 61:25-32. DOI: 10.1016/j.jpsychires.2014.11.005. View

19.

Katon W, Ciechanowski P . Impact of major depression on chronic medical illness. J Psychosom Res. 2002; 53(4):859-63. DOI: 10.1016/s0022-3999(02)00313-6. View

20.

Jaycox L, Miranda J, Meredith L, Duan N, Benjamin B, Wells K . Impact of a primary care quality improvement intervention on use of psychotherapy for depression. Ment Health Serv Res. 2003; 5(2):109-20. DOI: 10.1023/a:1023233612022. View