Comparative effectiveness of mindfulness and physical exercise on rumination in patients with major depression: An integrated evaluation of an open label randomized trial

IF 2.3 3区医学 Q2 PSYCHIATRY

Mental Health and Physical Activity Pub Date : 2025-03-01 DOI:10.1016/j.mhpa.2025.100679

Hanna Gabriela Bezerra de Macedo Tinôco , Geovan Menezes de Sousa , Elissa Beatriz Araújo Ribeiro , Jovita Eduarda de Mendonça Maciel , Vagner Deuel de O. Tavares , Maria Luiza de Morais , Renali Camilo Bezerra , Leonardo Alves Fernandes , Rodolfo Aragão Lira , Geissy Lainny de Lima-Araujo , Emerson Arcoverde Nunes , Megan Teychenne , Patrícia Cavalcanti-Ribeiro , Fernanda Palhano-Fontes , Maria Bernardete Cordeiro de Sousa , Nicole Leite Galvão-Coelho

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引用次数: 0

Abstract

Background and aims

Rumination, characterized by repetitive and prolonged negative thoughts, is a common symptom of Major Depressive Disorder (MDD) that can impair treatment effectiveness. Among MDD treatments, pharmacological and non-pharmacological approaches have been demonstrating important changes in brain and behavior. Therefore, this randomized controlled trial aimed to evaluate the level of rumination of individuals who underwent the combined use of escitalopram and physical exercise or mindfulness practice, compared to those who used the medication as a stand-alone.

Methods

Rumination was evaluated in 88 MDD patients who were randomly assigned to three groups: stand-alone pharmacotherapy (control group, CG, n = 33), escitalopram adjunct to exercise (exercise group, EG, n = 26, 2 h/week), and escitalopram adjunct to mindfulness (mindfulness group, MG, n = 29, 2 h/week), in a 12-week treatment. The Ruminative Response Scale-Short Form (RRS-SF) was administered pre- and post-treatment to assess changes in rumination levels.

Results

While all groups exhibited reductions in general rumination, the mindfulness group demonstrated larger effect sizes (MG: d = 1.30; EG: d = 0.68; CG: d = 0.96), particularly among patients with high baseline rumination levels (MG: d = 1.51; EG: d = 0.88; CG: d = 0.42). Results for patients with low baseline levels of rumination were mixed. Further analysis of the reflective factor of the RRS-SF showed reductions only for EG and MG. A greater reduction in the brooding factor was found for MG in patients with high level of rumination.

Conclusion

These findings suggest that mindfulness, when used as a complementary therapy, may reduce the burden of MDD by promoting a more resilient state of mind that fosters less ruminative thought patterns, particularly in patients with intense rumination.

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正念和体育锻炼对重度抑郁症患者反刍的比较效果：一项开放标签随机试验的综合评价

背景与目的反刍是重度抑郁症（MDD）的一种常见症状，其特征是反复和长时间的消极想法，会损害治疗效果。在重度抑郁症的治疗中，药物和非药物方法已经证明了大脑和行为的重要变化。因此，这项随机对照试验旨在评估将艾司西酞普兰与体育锻炼或正念练习结合使用的个体的反刍水平，与单独使用药物的个体进行比较。方法将88例重度抑郁症患者随机分为3组：独立药物治疗组（对照组，CG, n = 33）、艾司西酞普兰辅助运动组（运动组，n = 26, 2 h/周）和艾司西酞普兰辅助正念组（正念组，n = 29, 2 h/周），为期12周。在治疗前和治疗后分别使用反刍反应量表短表（RRS-SF）来评估反刍水平的变化。结果所有组均表现出一般反刍的减少，但正念组表现出更大的效应量(MG: d = 1.30；EG: d = 0.68；CG: d = 0.96)，特别是在高基线反刍水平的患者中(MG: d = 1.51；EG: d = 0.88；CG: d = 0.42)。反刍基线水平较低的患者的结果好坏参半。进一步分析RRS-SF的反射因子显示只有EG和MG降低。在高反刍水平的患者中，MG的沉思因子有更大的降低。这些发现表明，当正念作为一种补充疗法使用时，可以通过促进更有弹性的精神状态来减轻重度抑郁症的负担，这种状态可以促进较少的反刍思维模式，特别是在强烈反刍的患者中。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Mental Health and Physical Activity PSYCHIATRY-

CiteScore

6.70

自引率

6.40%

发文量

审稿时长

32 days

期刊介绍： The aims of Mental Health and Physical Activity will be: (1) to foster the inter-disciplinary development and understanding of the mental health and physical activity field; (2) to develop research designs and methods to advance our understanding; (3) to promote the publication of high quality research on the effects of physical activity (interventions and a single session) on a wide range of dimensions of mental health and psychological well-being (eg, depression, anxiety and stress responses, mood, cognitive functioning and neurological disorders, such as dementia, self-esteem and related constructs, psychological aspects of quality of life among people with physical and mental illness, sleep, addictive disorders, eating disorders), from both efficacy and effectiveness trials;