A groundbreaking study published in The Lancet reveals that remote-delivered, online lifestyle therapy is as effective as traditional psychotherapy in reducing depression. The CALM non-inferiority, randomized trial compared the clinical and cost-effectiveness of both treatments over an 8-week period, showing promising results for lifestyle interventions involving nutrition and physical activity.
Key Takeaways
- Remote lifestyle therapy is as effective as psychotherapy for reducing depression.
- The study involved 182 adults with indicative depression, split into two groups: lifestyle therapy and psychotherapy.
- Both treatments were delivered via online videoconferencing over six 90-minute sessions.
- The primary outcome was measured using the Patient Health Questionnaire-9 (PHQ-9).
- Lifestyle therapy was found to be delivered at a lower cost compared to psychotherapy.
Study Design and Methods
The CALM trial was conducted between May 2021 and April 2022, recruiting 182 adults from a tertiary mental health service in regional Victoria, Australia. Participants were randomly assigned to either lifestyle therapy or psychotherapy, each consisting of six 90-minute sessions over eight weeks. The primary outcome was the reduction in depression symptoms, measured by the PHQ-9.
Results
Both lifestyle therapy and psychotherapy groups showed significant reductions in depression symptoms. The lifestyle therapy group had a mean difference of -3.97 in PHQ-9 scores, while the psychotherapy group had a mean difference of -3.74. The study confirmed the non-inferiority of lifestyle therapy to psychotherapy, with a beta coefficient of -0.59.
Cost-Effectiveness
While lifestyle therapy was delivered at a lower cost, there were no significant differences in total costs from a health sector and societal perspective. The cost of delivering lifestyle therapy was approximately AUD $482 per participant, compared to AUD $503 for psychotherapy.
Implications
The findings suggest that accredited dietitians and exercise physiologists could provide mental health care comparable to that of psychologists, potentially alleviating the burden on mental health services. This approach could be particularly beneficial in areas where psychological services are unavailable or inaccessible.
Conclusion
The CALM trial provides compelling evidence that remote-delivered, online lifestyle therapy is a viable alternative to traditional psychotherapy for reducing depression. If replicated in larger studies, this could pave the way for more accessible and cost-effective mental health care options.
