title: Effects of hyperthermic baths on depression, sleep and heart rate variability in patients with depressive disorder: a randomized clinical pilot trial.
abstract: BACKGROUND
  Despite advances in the treatment of depression, one-third of depressed patients fail to respond to conventional antidepressant medication. There is a need for more effective treatments with fewer side effects. The primary aim of this study was to determine whether hyperthermic baths reduce depressive symptoms in adults with depressive disorder.
  
  
  METHODS
  Randomized, two-arm placebo-controlled, 8-week pilot trial. Medically stable outpatients with confirmed depressive disorder (ICD-10: F32/F33) who were moderately depressed as determined by the 17-item Hamilton Scale for Depression (HAM-D) score ≥18 were randomly assigned to 2 hyperthermic baths (40 °C) per week for 4 weeks or a sham intervention with green light and follow-up after 4 weeks. Main outcome measure was the change in HAM-Dtotal scorefrom baseline (T0) to the 2-week time point (T1).
  
  
  RESULTS
  A total of 36 patients were randomized (hyperthermic baths, n = 17; sham condition, n = 19). The intention-to-treat analysis showed a significant (P = .037) difference in the change in HAM-Dtotal scorewith 3.14 points after 4 interventions (T1) in favour of the hyperthermic bath group compared to the placebo group.
  
  
  CONCLUSIONS
  This pilot study suggests that hyperthermic baths do have generalized efficacy in depressed patients.
  
  
  BACKGROUND
  DRKS00004803 at drks-neu.uniklinik-freiburg.de, German Clinical Trials Register (registration date 2016-02-02), retrospectively registered.
authors.affiliation: Interdisciplinary Center for Treatment and Research in Balneology, Institute for Environmental Health Sciences and Hospital Infection Control, Medical Faculty, Medical Center University of Freiburg, Breisacher Straße 115b, Freiburg im Breisgau, 79106, Germany. johannes.naumann@uniklinik-freiburg.de.
authors.forename: Johannes
authors.initials: J
authors.lastname: Naumann
authors.affiliation: Center for Complementary Medicine, Institute for Environmental Health Sciences and Hospital Infection Control, Medical Faculty, Medical Center University of Freiburg, Breisacher Straße 115b, Freiburg im Breisgau, 79106, Germany.
authors.forename: Julian
authors.initials: J
authors.lastname: Grebe
authors.affiliation: Center for Complementary Medicine, Institute for Environmental Health Sciences and Hospital Infection Control, Medical Faculty, Medical Center University of Freiburg, Breisacher Straße 115b, Freiburg im Breisgau, 79106, Germany.
authors.forename: Sonja
authors.initials: S
authors.lastname: Kaifel
authors.affiliation: Center for Complementary Medicine, Institute for Environmental Health Sciences and Hospital Infection Control, Medical Faculty, Medical Center University of Freiburg, Breisacher Straße 115b, Freiburg im Breisgau, 79106, Germany.
authors.forename: Tomas
authors.initials: T
authors.lastname: Weinert
authors.affiliation: Interdisciplinary Center for Treatment and Research in Balneology, Institute for Environmental Health Sciences and Hospital Infection Control, Medical Faculty, Medical Center University of Freiburg, Breisacher Straße 115b, Freiburg im Breisgau, 79106, Germany.
authors.forename: Catharina
authors.identifier: http://orcid.org/0000-0003-1088-9643
authors.initials: C
authors.lastname: Sadaghiani
authors.affiliation: Center for Complementary Medicine, Institute for Environmental Health Sciences and Hospital Infection Control, Medical Faculty, Medical Center University of Freiburg, Breisacher Straße 115b, Freiburg im Breisgau, 79106, Germany.
authors.forename: Roman
authors.initials: R
authors.lastname: Huber
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001494:Baths / Q000706:statistics & numerical data*; D003863:Depression / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012890:Sleep; D016896:Treatment Outcome; D055815:Young Adult
keywords: Depression; Heart rate variability; Hyperthermic baths; RCT