title: The effectiveness of simple psychological and physical activity interventions for high prevalence mental health problems in young people: A factorial randomised controlled trial.
abstract: BACKGROUND
  The prevalence and burden of disease of depression and anxiety disorders in young people necessitates effective early intervention strategies. The aim of this study was to evaluate the effectiveness of low-intensity interventions (problem solving therapy (PST) and physical activity promotion) in young people (15-25 years) with mild-moderate depression and/or anxiety.
  
  
  METHODS
  A 2×2 factorial randomised controlled trial (RCT) with factors of PST versus supportive counselling (control) and behavioural activation physical activity versus lifestyle psychoeducation (control). Help-seeking participants (n=176) were randomised to receive up to 6 manualised intervention sessions. Primary outcomes were post-intervention depressive symptoms (Beck Depression Inventory-II (BDI-II), anxiety symptoms (Beck Anxiety Inventory), and Montgomery-Åsberg Depression Rating Scale (MADRS)). Trial registration ACTRN12608000550303.
  
  
  RESULTS
  Depression symptoms were significantly reduced in the physical activity group compared to psychoeducation (BDI-II: d=0.41 (95% CI: 0.07-0.76); MADRS: d=0.48 (95% CI: 0.13-0.82), but not post-intervention anxiety symptoms. PST was not superior to supportive counselling, nor were any interactions between interventions significant.
  
  
  CONCLUSIONS
  As self reported levels of physical activity did not significantly differ between baseline and end-point in those randomised to the physical activity intervention, it is unclear as to whether some form of physical activity not measured in the trial may have led to the difference in depression symptoms.
  
  
  CONCLUSIONS
  PST was not superior to supportive counselling in reducing depression and anxiety symptoms in young people. Participants who received the physical activity intervention reported the greatest reduction in depression symptoms, however further research is required to establish the mechanism of action and to determine its effectiveness as an adjunct intervention in routine clinical practice.
authors.affiliation: Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, University of Melbourne, Locked Bag 10, Parkville, Victoria 3052, Australia. Electronic address: alex.parker@orygen.org.au.
authors.forename: Alexandra G
authors.initials: AG
authors.lastname: Parker
authors.affiliation: Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, University of Melbourne, Locked Bag 10, Parkville, Victoria 3052, Australia.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Hetrick
authors.affiliation: Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, Victoria 3010, Australia.
authors.forename: Anthony F
authors.initials: AF
authors.lastname: Jorm
authors.affiliation: Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, University of Melbourne, Locked Bag 10, Parkville, Victoria 3052, Australia.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Mackinnon
authors.affiliation: Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, University of Melbourne, Locked Bag 10, Parkville, Victoria 3052, Australia.
authors.forename: Patrick D
authors.initials: PD
authors.lastname: McGorry
authors.affiliation: Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, University of Melbourne, Locked Bag 10, Parkville, Victoria 3052, Australia; Institute of Brain, Behaviour and Mental Health, University of Manchester, Oxford Road, Manchester M13 9PL, UK.
authors.forename: Alison R
authors.initials: AR
authors.lastname: Yung
authors.affiliation: Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, University of Melbourne, Locked Bag 10, Parkville, Victoria 3052, Australia.
authors.forename: Faye
authors.initials: F
authors.lastname: Scanlan
authors.affiliation: Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, University of Melbourne, Locked Bag 10, Parkville, Victoria 3052, Australia.
authors.forename: Jessica
authors.initials: J
authors.lastname: Stephens
authors.affiliation: Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, University of Melbourne, Locked Bag 10, Parkville, Victoria 3052, Australia.
authors.forename: Shelley
authors.initials: S
authors.lastname: Baird
authors.affiliation: Orygen Youth Health Clinical Program, 35 Poplar Road, Parkville, Victoria 3052, Australia.
authors.forename: Bridget
authors.initials: B
authors.lastname: Moller
authors.affiliation: Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, University of Melbourne, Locked Bag 10, Parkville, Victoria 3052, Australia.
authors.forename: Rosemary
authors.initials: R
authors.lastname: Purcell
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000523:psychology / Q000628:therapy*; D003863:Depression / Q000523:psychology / Q000628:therapy*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D009043:Motor Activity; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Anxiety; Depression; Early intervention; Physical activity; Problem solving therapy; Young people