Posted by Franz on August 8, 2008, at 6:11:57
In a recent discussion on National Public Radio about alternative approaches to mood disorder, I raised the “intention to treat” issue. Most studies of interventions like exercise are “completer” trials. They look at people who follow through on the regimen and see how many get better. But of course, people disinclined to exercise might drop out of the “active intervention” arm of a trial of say, jogging. If those are the same people who carry a predisposition for low mood, then any positive research outcomes become suspect. Perhaps it’s not the exercise but the pressure for vulnerable subjects to quit the study that makes running look better than placebo. The Archives analysis makes clear why we should hold alternative treatments to the same research standards that apply to psychotherapy and medication.
I recommend at least a trial of exercise for all my depressed patients. But a good number are already working out vigorously — exercise is no panacaea.
The new evidence notwithstanding, I’m back to my summer regimen of swimming and bicycling. I’ll return to the intention-to-treat issue presently, in my promised second posting on cognitive behavior therapy in the treatment in anxiety [http://blogs.psychologytoday.com/blog/in-practice/200807/debunking-cbt].
http://blogs.psychologytoday.com/blog/in-practice/200808/a-grand-week-couch-potatoes
---I get good results from exercise but this makes me think if they are good enough or if I am not in such a bad condition. It is true that when one feels too bad it is hard to move.
What do you think?.
poster:Franz
thread:844909
URL: http://www.dr-bob.org/babble/alter/20080612/msgs/844909.html