title: Telephone-based physical activity counseling for major depression in people with multiple sclerosis.
abstract: OBJECTIVE
  Physical activity represents a promising treatment for major depressive disorder (MDD) in people with multiple sclerosis (MS). We conducted a single-blind, two-arm randomized controlled trial comparing a 12-week physical activity counseling intervention delivered primarily by telephone (n = 44) to a wait-list control group (N = 48).
  
  
  METHODS
  Ninety-two adults with MS and MDD or dysthymia (M(age) = 48 years; 86% female, 92% White) completed an in-person baseline assessment and were randomized to wait-list control or an intervention involving motivational-interviewing-based promotion of physical activity. The treatment group received an initial in-person session; 7 telephone counseling sessions (Weeks 1, 2, 3, 4, 6, 8, and 10), and an in-person session at Week 12. The primary outcome, treatment response, was defined as those with 50% or greater reduction in the Hamilton Depression Rating Scale (HAM-D) score.
  
  
  RESULTS
  Our primary hypothesis, that the proportion of responders in the treatment group would be significantly greater than in the control group, was not confirmed. However, compared with the control group, those in the treatment group evidenced significantly lower depression severity on the HAM-D, on self-reported depression, and on a measure of potential side effects and at 12 weeks were less likely to meet the criteria for MDD as set forth in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Physical activity increased significantly more in the treatment condition, though it did not mediate improvement in depression severity.
  
  
  CONCLUSIONS
  Telephone-based physical activity promotion represents a promising approach to treating MDD in MS. Further research is warranted on ways to bolster the impact of the intervention and on mediators of the treatment effect.
authors: Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA 98104, USA. chb@uw.edu
authors: Charles H
authors: CH
authors: Bombardier
authors: Dawn M
authors: DM
authors: Ehde
authors: Laura E
authors: LE
authors: Gibbons
authors: Roini
authors: R
authors: Wadhwani
authors: Mark D
authors: MD
authors: Sullivan
authors: Dori E
authors: DE
authors: Rosenberg
authors: George H
authors: GH
authors: Kraft
mesh_terms: D000328:Adult; D003376:Counseling / Q000379:methods*; D003863:Depression / Q000150:complications / Q000523:psychology / Q000628:therapy; D003865:Major Depressive Disorder / Q000150:complications / Q000523:psychology / Q000628:therapy*; D005081:Exercise Therapy / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062405:Motivational Interviewing; D009103:Multiple Sclerosis / Q000150:complications / Q000523:psychology*; D019114:Remote Consultation; D012720:Severity of Illness Index; D016037:Single-Blind Method; D013689:Telephone; D016896:Treatment Outcome