Relaxation for depression.

Full Abstract

BACKGROUND: 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. OBJECTIVES: To determine whether relaxation techniques reduce depressive symptoms and improve response/remission. SEARCH STRATEGY: 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. SELECTION CRITERIA: 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. DATA COLLECTION AND ANALYSIS: 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. MAIN RESULTS: 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. AUTHORS' CONCLUSIONS: 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.

Author information

Author/s: Jorm, Anthony F (AF); Morgan, Amy J (AJ); Hetrick, Sarah E (SE);

Affiliation: Department of Psychiatry, Orygen Youth Health Research Centre, University of Melbourne , Locked Bag 10, 35 Poplar Road, Parkville, Melbourne, VIC, Australia, 3052.

Journal and publication information

Publication Type: Journal Article; Meta-Analysis; Review

Journal: Cochrane database of systematic reviews (Online) (Cochrane Database Syst Rev), published in England. (Language: eng)

Reference: 2008-; vol (issue 4) : pp CD007142

Dates: Created 2008/10/09; Completed 2009/01/15; Revised 2009/09/30;

PMID: 18843744, status: MEDLINE (last retrieval date: 9/30/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: Evid Based Ment Health. 2009 Aug;12(3):76-7. (PMID: 19633244)

External Links for this article
(including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.