Relaxation for depression

Department of Psychiatry, Orygen Youth Health Research Centre, University of Melbourne , Locked Bag 10, 35 Poplar Road, Parkville, Melbourne, VIC, Australia, 3052.
Cochrane database of systematic reviews (Online) (Impact Factor: 6.03). 02/2008; DOI: 10.1002/14651858.CD007142.pub2
Source: PubMed


Many members of the public have negative attitudes towards antidepressants. Psychological interventions are more acceptable but require considerable therapist training. Acceptable psychological interventions that require less training and skill are needed to ensure increased uptake of intervention. A potential intervention of this sort is relaxation techniques.
To determine whether relaxation techniques reduce depressive symptoms and improve response/remission.
The register of trials kept by the Cochrane Collaboration Depression, Anxiety and Neurosis Group was searched up to February 2008. We also searched the reference lists of included studies.
Studies were included if they were randomised or quasi-randomised controlled trials of relaxation techniques (progressive muscle relaxation, relaxation imagery, autogenic training) in participants diagnosed with depression or having a high level of depression symptoms. Self-rated and clinician-rated depression scores and response/remission were the primary outcomes.
Two reviewers selected the trials, assessed the quality and extracted trial and outcome data, with discrepancies resolved by consultation with a third. Trial authors were approached for missing data where possible and missing data were estimated or imputed in some cases. Continuous measures were summarised using standardised mean differences and dichotomous outcomes by risk ratios.
There were 15 trials with 11 included in the meta-analysis. Five trials showed relaxation reduced self-reported depression compared to wait-list, no treatment, or minimal treatment post intervention (SMD -0.59 (95% CI -0.94 to -0.24)). For clinician-rated depression, two trials showed a non-significant difference in the same direction (SMD -1.35 (95% CI -3.06 to 0.37)).Nine trials showed relaxation produced less effect than psychological (mainly cognitive-behavioural) treatment on self-reported depression (SMD = 0.38 (95% CI 0.14 to 0.62)). Three trials showed no significant difference between relaxation and psychological treatment on clinician-rated depression at post intervention (SMD 0.29 (95% CI -0.18 to 0.75)).Inconsistent effects were found when comparing relaxation training to medication and there were few data available comparing relaxation with complementary and lifestyle treatments.
Relaxation techniques were more effective at reducing self-rated depressive symptoms than no or minimal treatment. However, they were not as effective as psychological treatment. Data on clinician-rated depressive symptoms were less conclusive. Further research is required to investigate the possibility of relaxation being used as a first-line treatment in a stepped care approach to managing depression, especially in younger populations and populations with subthreshold or first episodes of depression.

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    • "Medical students were included in this analysis because early interventions can potentially have a lasting impact during the course of a medical career. Although meta-analyses have previously been conducted on the use of various models of intervention for mixed groups of people with anxiety and depression (Hunot et al., 2007; Jorm et al., 2008; Krisanaprakornkit et al., 2006; Regehr et al., 2013), meta-analyses and reviews have not determined whether such interventions are effective for physicians. "
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    The Journal of nervous and mental disease 04/2014; 202(5). DOI:10.1097/NMD.0000000000000130 · 1.69 Impact Factor
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    • "Aside from recreational activities that may provide psychological relaxation, formalized relaxation techniques may also be incorporated into people’s lifestyle. A Cochrane Review and meta-analysis by Jorm and colleagues [127] of 11 trials using relaxation techniques (progressive muscle relaxation, relaxation imagery, autogenic training) versus control (wait-list, no or minimal treatment), found that although clinician-rated outcomes were non-significant, self-rated depressive symptoms were reduced, with a moderate effect size reported. Specifically, a meta-analysis of five trials found that relaxation reduced self-reported depression compared to wait-list, no treatment, or minimal treatment post intervention (although these are not optimal control conditions). "
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    BMC Psychiatry 04/2014; 14(1):107. DOI:10.1186/1471-244X-14-107 · 2.21 Impact Factor
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    • "While the use of a simple usual care control group is often the most feasible, this may limit the attractiveness for potential participants. Despite widespread use, the usual care for depression has many limitations including patient reluctance to take medications, lack of access to qualified psychotherapists related to cost or availability, and patients being refractory to treatment, among others [40]. Furthermore, researchers must consider how to control for expectation and how to prevent the high rate of attrition typically seen in control groups, particularly in depressed study populations. "
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