Cochrane analysts examined five randomized, controlled trials of the efficacy of exercise therapy for Chronic Fatigue Syndrome (CFS) and found that after 12 weeks, those receiving exercise therapy were less fatigued than the control participants (SMD -0.77, 95% CIs -1.26 to -0.28).  Additionally, physical functioning was significantly improved with exercise therapy (SMD -0.64, CIs -0.96 to -0.33) but there were more dropouts with exercise therapy (RR 1.73, CIs 0.92 to 3.24). 

Dear Belleruth,

I have 2 small children, a full time job and a husband. These are wonderful gifts in my life, but I recently was diagnosed with clinical depression and am frustrated because I have so many great things (healthy kids, loving husband, great job) and can not get excited about anything.  How do I understand, accept and move forward toward enjoying my life again? 

Frances

Romanian researchers from Babes-Bolyai University in Cluj, Romania, undertook a randomized clinical trial to investigate the relative efficacy of rational-emotive behavior therapy (REBT), cognitive therapy (CT), and pharmacotherapy in the treatment of 170 outpatients with nonpsychotic, major depressive disorder.

The patients were randomly assigned to one of the following: 14 weeks of REBT, 14 weeks of CT, or 14 weeks of pharmacotherapy (fluoxetine or prozac). The outcome measures used were the Hamilton Rating Scale for Depression and the Beck Depression Inventory.

British researchers from the University of York in Road, Durham, UK, performed a meta-analysis of studies testing the efficacy of various behavioral therapies for depression. [Ed. Note: Generally speaking, behavioral therapies use changes in reactivity and behavior as opposed to changes in insight, thoughts and feelings to catalyze improvements.]

The study identified randomized trials of behavioral treatments for depression and compared them to controls or other psychotherapies.  Seventeen randomized controlled trials, encompassing a total of 1109 subjects, were included in this meta-analysis.

A random-effects meta-analysis of symptom-levels, post-treatment, showed that behavioral therapies were superior to controls*, brief psychotherapy, supportive therapy and equal to cognitive behavioral therapy (CBT).

The results in this study indicate behavioral therapy is an effective treatment for depression, with outcomes equal to Cognitive Behavioral Therapy, the current recommended psychological intervention and preferable to brief psychotherapy and supportive therapy.  Future research is needed to clarify and better sort out these findings.
 
Citation:  Ekers D, Richards D, Gilbody S. A meta-analysis of randomized trials of behavioural treatment of depression. Psychological Medicine. 2008 May;38 (5): pages 611-23. Epub 2007 Oct 1, This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
 

"A friend had used guided imagery recordings to help her through her battle with cancer and lent them to me when I was going through a very rough time.  I was suffering from severe depression.  I had days when I could not get out of bed.  I considered suicide."

"I am a father, son and husband struggling with anxiety and depression for a long time, but to an almost debilitating extent for the past year ..."

A woman whose daughter was declared brain dead 3 days after a car accident nearly eight years ago wonders why she is getting so depressed lately and what she can do about it..

Dear Belleruth,
My daughter had a car accident nearly 8 years ago and was declared brain dead after three days. During the hospitalization period, I was totally dissociated. My body was sitting there, but there was nobody home inside. Emotionally, I had vacated the premises.

Now I’m having bouts of depression. I’m not sure why it’s so bad lately. Any suggestions? 

Thanks.
Nancy