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Lifestyle physical activity counselling in in-patients with major depressive disorders (PACINPAT): Randomized controlled trial on physical activity, cardiorespiratory fitness, depression, and cardiovascular health risk markers

English title Lifestyle physical activity counselling in in-patients with major depressive disorders (PACINPAT): Randomized controlled trial on physical activity, cardiorespiratory fitness, depression, and cardiovascular health risk markers
Applicant Gerber Markus
Number 179353
Funding scheme Project funding (Div. I-III)
Research institution Departement Sport, Bewegung und Gesundheit Universität Basel
Institution of higher education University of Basel - BS
Main discipline Mental Disorders, Psychosomatic Diseases
Start/End 01.06.2018 - 31.01.2023
Approved amount 691'458.00
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All Disciplines (2)

Discipline
Mental Disorders, Psychosomatic Diseases
Sport Medicine

Keywords (11)

cardiovascular health risk markers; coaching; counselling; depression; exercise; fitness; in-patients; major depressive disorder; multi-centric study; physical activity; randomised controlled trial

Lay Summary (German)

Lead
Depressive Störungen sind weit verbreitet und verursachen grosses Leiden. Personen mit depressiven Störungen weisen häufig ein erhöhtes Risiko für kardiovaskuläre Erkrankungen auf. Regelmässige körperliche Aktivität kann diesem Risiko entgegenwirken. Ob mit einem gezielten Lifestyle-Bewegungscoaching das Aktivitätsverhalten von Personen mit depressiven Störungen verbessert werden kann, ist noch weitgehend unerforscht. Dieses Projekt leistet dazu einen Beitrag.
Lay summary

Inhalte und Ziele des Forschungsprojekts
Zwischen 10-20% der Bevölkerung erleiden eine depressive Störung. Die mit depressiven Störungen assoziierten Kosten sind erheblich. Menschen mit depressiven Störungen haben eine tiefere Lebenserwartung als gesunde Kontrollpersonen, u.a. weil sie ein erhöhtes Risiko für metabolische oder kardiovaskuläre Krankheiten aufweisen. Menschen mit depressiven Störungen sind häufig körperlich wenig aktiv. Dies ist problematisch, da mit regelmässiger körperlicher Aktivität nicht nur depressive Symptome gelindert werden können, sondern auch Risikofaktoren für kardiovaskuläre Erkrankungen entgegengewirkt werden kann.

Das Forschungsprojekt untersucht deshalb mittels randomisierter Kontrollgruppenstudie die Wirksamkeit eines Lifestyle-Bewegungscoaching-Programms bei depressiven Patienten in stationärer Behandlung im Vergleich zu einer Placebo-Kontrollgruppe. Die Wirksamkeit wird im Hinblick auf folgende Parameter untersucht: Körperliche Aktivität, Determinanten der Sportaktivität, kardiorespiratorische Fitness, depressive Symptome, Schlafbeschwerden, subjektives Gesundheitsempfinden, kognitive Leistungsfähigkeit und kardiovaskuläre Risikofaktoren. Die Daten werden 2-3 Wochen nach Einweisung, 6 Wochen nach Ende des Klinikaufenthalts und nach 12 Monaten Follow-up erfasst. Die Interventionsgruppe erhält ein individualisiertes Bewegungscoaching und bleibt mit dem Bewegungscoach über die ganze Follow-up Phase im Kontakt (Telefon, SMS). Die Placebo-Kontrollgruppe erhält schriftliche Informationen über gesundheitsförderliche körperliche Aktivität.

Wissenschaftlicher und gesellschaftlicher Kontext des Forschungsprojekts
Das Projekt untersucht erstmalig die Möglichkeiten eines systematischen Bewegungscoachings zur Förderung körperlicher Aktivität bei depressiven Patienten in stationärer Behandlung. Das Projekt kann Wege aufzeigen, wie bei depressiven Patienten das Gesundheitsverhalten längerfristig positiv verändert werden kann.

 

Direct link to Lay Summary Last update: 04.04.2018

Responsible applicant and co-applicants

Employees

Project partner

Publications

Publication
The impact of lifestyle Physical Activity Counselling in IN-PATients with major depressive disorders on physical activity, cardiorespiratory fitness, depression, and cardiovascular health risk markers
Gerber Markus, Beck Johannes, Brand Serge, Cody Robyn, Donath Lars, Eckert Anne, Faude Oliver, Fischer Xenia, Hatzinger Martin, Holsboer-Trachser Edith, Imboden Christian, Lang Undine, Mans Sarah, Mikoteit Thorsten, Oswald Anja, Pühse Uwe, Rey Sofia, Schreiner Anne-Katrin, Schweinfurth Nina, Spitzer Ursula, Zahner Lukas (2019), The impact of lifestyle Physical Activity Counselling in IN-PATients with major depressive disorders on physical activity, cardiorespiratory fitness, depression, and cardiovascular health risk markers, in Trials, 20(367), 1-21.
Sport und Depression: Was bewegt Depressive?
CodyRobyn, KreppkeJan-Niklas, FaudeOliver, GerberMarkus, Sport und Depression: Was bewegt Depressive?, in Kerbe - Forum für soziale Psychiatrie, ---.

Collaboration

Group / person Country
Types of collaboration
Prof. Dunja Nicca, Nursing Science (INS), University of Basel Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
12. Jahrestagung der sportwissenschaftlichen Gesellschaft der Schweiz (SGS) Talk given at a conference The PACINPAT study: First experiences with a 12-month physical activity-counselling program in in-patients with major depressive disorders 06.02.2020 Basel, Switzerland Kreppke Jan-Niklas;
12. Jahrestagung der sportwissenschaftlichen Gesellschaft der Schweiz (SGS) Talk given at a conference Face-to-face and remote physical activity counselling in in-patients with major depressive disorders – The PACINPAT randomized controlled trial 06.02.2020 Basel, Switzerland Cody Robyn;
Kongress der Schweizerischen Gesellschaft für Psychiatrie und Psychotherapie (SGPP) Talk given at a conference Persönliche und telefonische Beratung zum Aufbau eines körperlich aktiven Lebensstils bei depressiven Patienten in stationärer Behandlung: Die PACINPAT-Studie 05.09.2019 Bern, Switzerland Cody Robyn;
Nachwuchstagung der Arbeitsgemeinschaft für Sportpsychologie Talk given at a conference Face-to-face and remote physical activity counselling in in-patients with major depressive disorders 20.05.2019 Halle, Germany Cody Robyn;
CBC Conference 2019: Behaviour Change for Health: Digital and other Innovative Methods Talk given at a conference Face-to-face and remote physical activity counselling in in-patients with major depressive disorders 09.04.2019 London, Great Britain and Northern Ireland Cody Robyn;
11. Jahrestagung der Sportwissenschaftlichen Gesellschaft der Schweiz Talk given at a conference Remote personal health coaching 14.02.2019 Fribourg, Switzerland Gerber Markus; Kreppke Jan-Niklas; Cody Robyn; Faude Oliver; Fischer Xenia; Rey Sofia;


Knowledge transfer events

Active participation

Title Type of contribution Date Place Persons involved
Diabetesregionbasel ("Körperliche Aktivität bei Diabetes: Die beste Medizin) Talk 12.05.2020 Basel, Switzerland Gerber Markus;
Kolloquium für Psychotherapie und Psychsomatik, Klinik für Konsiliarpsychiatrie und Psychosomatik (Individuell massgeschneiderte Bewegungsberatung – auch bei Personen mit depressiven Störungen) Talk 02.12.2019 Zürich, Switzerland Gerber Markus;
Individuell massgeschneiderte Bewegungsberatung – auch bei Personen mit psychischen Störungen? Talk 25.04.2019 Brugg, Switzerland Gerber Markus;
Individuell massgeschneiderte Bewegungsberatung – auch bei Depression? Talk 14.11.2018 Münchenbuchsee, Switzerland Gerber Markus;
Individuell massgeschneiderte Bewegungsberatung: Ein neuer Zugang zu «Personalized Health» Talk 27.06.2018 Basel, Switzerland Gerber Markus;


Self-organised

Title Date Place
CAS Personal Health Coach 07.10.2019 Basel, Switzerland

Communication with the public

Communication Title Media Place Year
Talks/events/exhibitions Wie man Inaktive zum Sporttreiben bringt! German-speaking Switzerland 2019

Awards

Title Year
AIESEP Fellowship (Association Internationale des Ecoles Supérieures et de l'Education Physique) 2018

Use-inspired outputs

Software

Name Year
PACINPAT Coaching-APP (www.accounts.pacinpat.com) 2019
PACINPAT Homepage (www.pacinpat.com) 2019


Abstract

Background: Major depressive disorder (MDD) is an extremely wide-spread and burdensome condition. MDD is associated with the second greatest number of life years lost due to premature death or disability (DALY) and will most likely be the leading cause in 2030. Physical activity counselling may increase lifestyle physical activity and cardiorespiratory fitness in a particularly vulnerable population which often suffers from a mix of mental and physical health problems.Goal and specific objectives: This study will examine the effectiveness of lifestyle physical activity counselling intervention among in-patients diagnosed with MDD compared to (placebo) controls. Secondary purposes are to examine the acceptability and perceived usefulness of the intervention among the patients, to compare baseline values with an age- and gender-matched group of healthy controls, and to find out whether the effectiveness of the intervention is moderated by genetic factors.Methods: The study is designed as a multi-centric two-arm randomized clinical trial including an intervention and placebo control group, allocation concealment, double-blinding, and intention-to-treat analysis. Participants (N=334) will be continuously recruited from four clinics specialized in the treatment of MDD. The intervention builds on a standardized, theory-based, low cost lifestyle physical activity counselling program, which was specifically designed for an in-patient rehabilitation setting. The placebo control condition consists of general instructions about health-enhancing physical activity. Data assessment will take place 2-3 weeks after admission to in-patient treatment (baseline), six weeks (post) and 12 months (follow-up) after discharge from in-patient treatment. Primary outcome is objectively assessed physical activity at follow-up. Secondary outcomes are self-reported physical activity, cardiorespireatory fitness, autonomic function, cognitive and social determinants of exercise, depression severity, self-perceived physical and psychological health, insomnia symtpoms, cognitive function, cardiovascular health risk markers (blood pressure, heart rate variability, BMI, percentage body fat, total/LDL/HDL cholesterol, triglycerides, HbA1c), and biomarkers of MDD (cortisol awakening response, brain-derived neurotrophic factor, tumor necrosis factor-alpha, and insulin-like growth factor). Moreover, the serotonin transporter (5-HTT) polymorphic promoter region (5-HTTLPR) will be assessed as a potential moderator of intervention effects.Expected results: Because regular physical activity has proved to be an important predictor of long-term response and remission in patients with major depression, we believe that our planned study may lay important groundwork by showing how individually-tailored lifestyle physical activity counselling can be integrated into given clinical structures. Our primary hypothesis is that compared to treatment as usual, individually-tailored physical activity counselling in patients with MDD will lead to clinically relevant increases in physical activity and CRF, and that these outcomes will persist beyond clinical discharge. The planned study is innovative for several reasons. For instance, we will test for the first time the potential of individually-tailored physical activity counselling in psychiatric in-patients, (b) focus on patients with low physical activity levels, and (c) assess physical activity objectively via accelerometry. Significance and feasibility: Improving physical activity and cardiorespiratory fitness may have important implications for tackling metabolic and cardiovascular disease and increasing cognitive functioning in this at-risk population, hence, reducing the future burden of multiple chronic conditions. Increased physical activity and cardiorespiratory fitness may also reduce the likelihood of future depressive episodes. By moving toward the primary prevention of chronic physical conditions, much can be done to enhance the quality and quantity of life of people with MDD. These findings will strengthen the evidence for “exercise as medicine” as a holistic care option in routine clinical practice for people with MDD, by helping patients to adopt and maintain physically active lifestyles after the end of their hospital stay. The study can show feasible ways to achieve long-term behaviour change by integrating lifestyle physical activity counselling into given clinical structures. Moreover, the study will show whether such an approach is acceptable for in-patients treated for MDD, and how much financial resources are needed to implement lifestyle physical activity counselling.
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