Several studies have reported individual benefits of yogurt and exercise on health; however, their combined effects remain unclear. Twenty-four healthy individuals participated in the study and were randomly assigned to the following four groups: control, yogurt, exercise, and combination. The participants consumed yogurt and exercised for 2 weeks, and we examined the combined effects of yogurt and exercise on physiological biomarkers. Individually, yogurt and exercise did not exert a significant effect on biomarkers of depression or cardiovascular disease, although vitamin D levels increased in the exercise group. However, in the combination group, serotonin levels increased, while levels of triglycerides and high-sensitivity C-reactive protein, which are biomarkers for cardiovascular diseases, decreased. In conclusion, the results of the study showed that, in healthy individuals, a combination of yogurt and exercise led to greater increases in serotonin levels and reductions in triglyceride and high-sensitivity C-reactive protein levels, relative to those observed for yogurt or exercise alone; therefore, this combination could have implications for the prevention of depression and cardiovascular disease.

Fatigue and depressive mood are the most significant symptoms experienced by patients with end-stage renal disease. The purpose of this study was to examine the effectiveness of acupressure with massage in fatigue and depression in patients with end-stage renal disease (ESRD) receiving hemodialysis treatment. The study applied an experimental pretest and posttest design. Sixty-two hemodialysis patients participated in the study. Data were collected from two hemodialysis clinics in major hospitals in southern Taiwan. Following consent to the study, subjects were randomly assigned to an acupressure group or a control group. Patients in the acupressure group received acupoint massage for 12 minutes per day, three days per week, for four weeks. Subjects in the control group only received routine unit care. The measures included the Revised Piper Fatigue Scale, and Beck ' s Depression Inventory. Descriptive statistics, chi 2 tests, t-test and analyses of covariance were used for data analysis. The results indicate that subjects experienced a moderate level of fatigue. Nearly 65 % of hemodialysis patients had a depressed mood. ANCOVA results indicated that fatigue (F((1.54)) = 9.05, p =.004) and depression (F((1.54)) = 4.20, p =.045) among patients in the acupressure group showed significantly greater improvement than patients in the control group. The findings of this study provide an interventional model for nurses taking care of ESRD patients.

We investigated the effects of exercise in multiple sessions on anxiety- and depression-like behavior during aging, and the role of serotonin and serotonin 1A receptors in this process. Both 24-month-old (aged) and 6-month-old (adult) female rats were divided into five groups; aged control, adult control, aged + serotonin re-uptake inhibitors (SSRIs), aged + exercise, and aged + SSRIs + exercise. After exercise, all groups were evaluated using the open field arena, elevated plus maze and forced swim tests. We assessed serum corticosterone levels; number of amygdala, hippocampus and prefrontal cortex cells; tissue serotonin and serotonin 1A (5-HT1A) levels. In the open field test, aged rats exhibited a significant increase in locomotor activity compared to the SSRIs and SSRIs + exercise groups. During the elevated plus maze test, aged rats were observed less frequently in the open arms of assembly compared to adults. The duration increased in the exercise group and remained unchanged in the SSRIs group. In the forced swim test, the aged rats were more immobile compared to adults; no change was observed in the immobility time between these groups. The tissue serotonin levels in amygdala and hippocampus were higher in SSRIs + exercise group compared to the aged, exercised and SSRIs groups. The number of cells in the hippocampus, prefrontal cortex and amygdala decreased in the aged group compared to adult rats; increased numbers of cell were observed in exercise, SSRIs and SSRIs + exercise groups compared to aged rats. Exercise in multiple sessions may increase the number of cells in the hippocampus, prefrontal cortex and amygdala, which may reduce senile anxiety and depression. Also, serotonin and serotonin 1A receptors may play role in depression-like behavior.

OBJECTIVE:This study was carried out in an effort to determine the effect of music therapy on depression and physiological parameters in elderly people who were living in a nursing home.

METHOD:The study was a randomized controlled trial. The study sample consisted of 64 elderly people who complied with the criteria of inclusion for the study. The data were collected using the 'Elderly Information Form' and 'Geriatric Depression Scale'. The music group listened to music three days in a week during 8 weeks. The depression levels were assessed at baseline (week 0) and follow-up in the eight week.

RESULTS:It was found that the difference between post-test depression scores of the two groups was found to be statistically significant (t = -2.86, p<.01). The mean scores of post-test systolic blood pressure in the music group were found to be significantly lower than those of the control group (t = -3.11, p<.05).

CONCLUSION:It was concluded that music therapy decreased the depression level and systolic blood pressure in elderly people. The study results implies that music therapy can be an effective practice for public health and home care nurses attempting to reduce depression and control physiological parameters of elderly people.

BACKGROUND:Previous studies have acknowledged Tai Chi and Qigong exercise could be potential effective treatments for reducing depression and anxiety in both healthy and clinical populations. However, there is a scarcity of systematic reviews summarizing the clinical evidence conducted among individuals with substance use disorders. This study tries to fill up this gap.

METHODS:A systematic search using Medline, EMbase, PsychINFO, Eric, SPORTDiscus, CINAHL, the Cochrane Central Register of Controlled Trials (CENTRAL), the Chinese National Knowledge Infrastructure (CNKI), Wanfang, and the Chinese Scientific Journal (VIP) databases was initiated to identify randomized controlled trials (RCTs) and non-randomized comparison studies (NRS) assessing the effect of Tai Chi and Qigong versus various comparison groups on depression and anxiety related outcomes. Study quality was evaluated using a Checklist to Evaluate a Report of a Nonpharmacological Trial (CLEAR-NPT) designed for nonpharmacological trial.

RESULTS:One RCT and six NRS with a total of 772 participants were identified. Some of them were meta-analyzed to examine the pooled effects based on different types of intervention and controls. The results of meta-analyses suggested the effect of Tai Chi was comparable to treatment as usual (TAU) on depression (standardized mean difference (SMD) = - 0.17[- 0.52, 0.17]). Qigong exercise appears to result in improvement on anxiety compared to that of medication (SMD = -1.12[- 1.47, - 0.78]), and no treatment control (SMD = -0.52[- 0.77, - 0.27]).

CONCLUSION:The findings suggest potentially beneficial effect of Qigong exercise on symptoms of anxiety among individuals with drug abuse. Considering the small number and overall methodological weakness of included studies and lack of RCTs, results should be interpreted with caution and future rigorously designed RCTs are warranted to provide more reliable evidence.

Background:In recent decades, several medical and scientific studies on yoga proved it to be very useful in the treatment of some diseases. This study was conducted to investigate the effects of yoga on stress, anxiety, and depression in women living in Ilam, Iran.

Methods:This study is a quasi-experimental study with pre-post test. To collect data, the questionnaire of DASS-21 (Depression Anxiety Stress Scale-21) was used. For eligible samples, hatha yoga exercises and training sessions were held for 4 weeks (3 time/weeks; 60-70 min each) by a specialist. Data were analyzed using SPSS version 20.

Results:52 women with a mean age of 33.5± 6.5 were included for analysis. Depression, anxiety, and stress decreased significantly in women after 12 sessions of regular hatha yoga practice (<0.001).

Conclusions:Yoga has an effective role in reducing stress, anxiety, and depression. Thus, it can be used as complementary medicine.

Art therapy has often been applied in the treatment of traumatized adults, and good results in clinical practice have been reported. However, although art therapy experts underline these benefits, the effectiveness of art therapy in trauma treatment has not been established by systematic review. The aim of this systematic review is to identify and evaluate empirical evidence of the effectiveness of art therapy for trauma treatment. As a result of the systematic review, six controlled, comparative studies on art therapy for trauma in adult patients were found. In half of the included studies, a significant decrease in psychological trauma symptoms was found in the treatment groups, and one study reported a significant decrease in depression. Although there are limitations in the number of included studies, the number of participants, the heterogeneity of included studies, and their methodological quality, the results contribute to insight into the effectiveness of art therapy in trauma treatment and form an evidence base for the urgent need for further research on art therapy and trauma treatment.

CONTEXT:The World Health Organization (WHO) places major depressive disorder (MDD), or depression, as the fourth leading cause of disability worldwide. Some studies have found that cognitive behavioral therapy (CBT) represents the most superior approach in treating mild to severe symptoms. Recent literature has indicated a number of limitations to this therapeutic approach. An approach that has received increasing attention within the literature is the emotional freedom technique (EFT).

OBJECTIVE:The current pilot study aimed to evaluate the effectiveness of CBT and EFT in the treatment of depression and comorbid anxiety.

DESIGN:The research team designed a pilot study structured as a randomized, controlled trial with 2 intervention arms.

SETTING:The study took place at Bond University in Gold Coast, Queensland, Australia.

PARTICIPANTS:Participants (n = 10) were local community members who had screened positive for a primary diagnosis of MDD.

INTERVENTION:Participants were randomly assigned to an 8-wk CBT or EFT treatment program, the intervention groups. A sample of individuals from the community was assessed for comparative purposes (control group) (n = 57).

OUTCOME MEASURES:Pre- and postintervention, all participants were interviewed using the Mini-International Neuropsychiatric Interview (MINI) 6.0, and they completed the following validated questionnaires: (1) the Beck Depression Inventory, second edition (BDI-2) and (2) the Depression, Anxiety, and Stress Scales (DASS-21).

RESULTS:Findings revealed that both treatment approaches produced significant reductions in depressive symptoms, with the CBT group reporting a significant reduction postintervention, which was not maintained with time. The EFT group reported a delayed effect involving a significant reduction in symptoms at the 3- and 6-mo follow-ups only. Examination of the individual cases revealed clinically significant improvements in anxiety across both interventions.

CONCLUSIONS:Overall, the findings provide evidence to suggest that EFT might be an effective treatment strategy worthy of further investigation.

OBJECTIVES:We aim to review trials of the effectiveness of music listening in reducing depressive symptoms in adults, and identify areas requiring further study.

BACKGROUND:Little is known about the efficacy of music listening in the mediation of depressive symptoms.

METHODS:We systematically search 9 databases and reviewed 17 studies included randomized controlled and quasi-experimental trails of music listening in reducing depressive symptoms in adults. The Joanna Briggs Institute-Meta Analysis of Statistics Assessment and Review Instrument was used for quality assessment of included studies.

RESULTS:Music listening over a period of time helps to reduce depressive symptoms in the adult population. Daily intervention does not seem to be superior over weekly intervention and it is recommended that music listening session be conducted repeatedly over a time span of more than 3weeks to allow an accumulative effect to occur.

CONCLUSIONS:All types of music can be used as listening material, depending on the preferences of the listener. So, it is recommended that the listeners are given choices over the kind of music which they listen to. There is a need to conduct more studies, which replicate the designs used in the existing studies that met the inclusion criteria, on the level of efficacy of music listening on the reduction of depressive symptoms for a more accurate meta-analysis of the findings and reflect with greater accuracy the significant effects that music has on the level of depressive symptoms.

BACKGROUND:Due to the chronic character of multiple sclerosis (MS), non-pharmacological treatment can be applied. These therapies can be a good complementation to standard pharmacological treatment.

OBJECTIVES:The aim of the study was to evaluate the effectiveness of whole-body cryotherapy (WBC) and physical exercise training on the psychological and general well-being of patients with MS.

MATERIAL AND METHODS:The study was carried out on 60 patients, who were divided into 3 groups: cryotherapy (Cryo), physical exercise training (Gym) and cryotherapy with physical exercise training (CryoGym). The Psychological General Well-Being Index, the Hospital Anxiety and Depression Scale and the Rivermead Mobility Index were used at 2 points in time: T1 - before the first therapy session and T2 - after 14 days of therapy.

RESULTS:Statistically significant differences in the psychosocial well-being were found in the Gym and CryoGym group. Reduction of depressive symptoms and improved functional status was noted in Cryo group. The most significant improvement was observed in the group using WBC with exercise training (CryoGym).

CONCLUSIONS:Whole-body cryotherapy with physical exercise training was an effective therapy for patients with MS. The introduction of WBC into the standard physiotherapy protocol for patients with MS is fully justified.

PURPOSE:The purpose of this study was to investigate the effect of aromatherapy on pain, depression, and feelings of satisfaction in life of arthritis patients.

METHOD:This study used a quasi-experimental design with a non-equivalent control group, pre-and post-test. The sample consisted of 40 patients, enrolled in the Rheumatics Center, Kangnam St. Mary's Hospital, South Korea. The essential oils used were lavender, marjoram, eucalyptus, rosemary, and peppermint blended in proportions of 2:1:2:1:1. They were mixed with a carrier oil composed of almond (45%), apricot(45%), and jojoba oil(10%) and they were diluted to 1.5% after blending. The data were analyzed using an 2-test, Fisher's exact test, t-test and paired t-test.

RESULT:Aromatherapy significantly decreased both the pain score and the depression score of the experimental group compared with the control group. However, aromatherapy didn't increase the feeling of satisfaction in life of the experimental group compared with the control group.

CONCLUSION:The result of this study clearly shows that aromatherapy has major effects on decreasing pain and depression levels. Based on our experiment's findings, we suggest that aromatherapy can be a useful nursing intervention for arthritis patients.

This study aimed to investigate the effects of a two-day forest therapy program on individuals with chronic widespread pain. Sixty one employees of a public organization providing building and facilities management services within the Seoul Metropolitan area participated in the study. Participants were assigned to an experimental group (n = 33) who participated in a forest therapy program or a control group (n = 28) on a non-random basis. Pre- and post-measures of heart rate variability (HRV), Natural Killer cell (NK cell) activity, self-reported pain using the visual analog scale (VAS), depression level using the Beck Depression Inventory (BDI), and health-related quality of life measures using the EuroQol Visual Analog Scale (EQ-VAS) were collected in both groups. The results showed that participants in the forest therapy group, as compared to the control group, showed physiological improvement as indicated by a significant increase in some measures of HRV and an increase in immune competence as indicated by NK cell activity. Participants in the forest therapy group also reported significant decreases in pain and depression, and a significant improvement in health-related quality of life. These results support the hypothesis that forest therapy is an effective intervention to relieve pain and associated psychological and physiological symptoms in individuals with chronic widespread pain.

Objectives To determine the efficacy of Sahaja Yoga (SY) meditation on mental health among clinical and healthy populations. Methods All publications on SY were eligible. Databases were searched up to November 2017, namely PubMed, MEDLINE (NLM), PsychINFO, and Scopus. An internet search (Google Scholar) was also conducted. The quality of the randomized controlled trails was assessed using the Cochrane Risk Assessment for Bias. The quality of cross-sectional studies, a non-randomized controlled trial and a cohort study was assessed with the Newcastle-Ottawa Quality Assessment Scale. Results We included a total of eleven studies; four randomized controlled trials, one non-randomized controlled trial, five cross-sectional studies, and one prospective cohort study. The studies included a total of 910 participants. Significant findings were reported in relation to the following outcomes: anxiety, depression, stress, subjective well-being, and psychological well-being. Two randomized studies were rated as high quality studies, two randomized studies as low quality studies. The quality of the non-randomized trial, the cross-sectional studies and the cohort study was high. Effect sizes could not be calculated in five studies due to unclear or incomplete reporting. Conclusions After reviewing the articles and taking the quality of the studies into account, it appears that SY may reduce depression and possibly anxiety. In addition, the practice of SY is also associated with increased subjective wellbeing and psychological well-beng. However, due to the limited number of publications, definite conclusions on the effects of SY cannot be made and more high quality randomized studies are needed to justify any firm conclusions on the beneficial effects of SY on mental health.

PURPOSE:This study was performed to determine the physical and psychological effects of an urban forest-walking program for office workers. For many workers, sedentary lifestyles can lead to low levels of physical activity causing various health problems despite an increased interest in health promotion.

METHODS:Fifty four office workers participated in this study. They were assigned to two groups (experimental group and control group) in random order and the experimental group performed 5 weeks of walking exercise based on Information-Motivation-Behavioral skills Model. The data were collected from October to November 2014. SPSS 21.0 was used for the statistical analysis.

RESULTS:The results showed that the urban forest walking program had positive effects on the physical activity level (U=65.00, p<.001), health promotion behavior (t=-2.20, p=.033), and quality of life (t=-2.42, p=.020). However, there were no statistical differences in depression, waist size, body mass index, blood pressure, or bone density between the groups.

CONCLUSION:The current findings of the study suggest the forest-walking program may have positive effects on improving physical activity, health promotion behavior, and quality of life. The program can be used as an effective and efficient strategy for physical and psychological health promotion for office workers.

The purpose of this article was to systematically review yoga interventions aimed at improving depressive symptoms. A total of 23 interventions published between 2011 and May 2016 were evaluated in this review. Three study designs were used: randomized control trials, quasi-experimental, and pretest/posttest, with majority being randomized control trials. Most of the studies were in the United States. Various yoga schools were used, with the most common being Hatha yoga. The number of participants participating in the studies ranged from 14 to 136, implying that most studies had a small sample. The duration of the intervention period varied greatly, with the majority being 6 weeks or longer. Limitations of the interventions involved the small sample sizes used by the majority of the studies, most studies examining the short-term effect of yoga for depression, and the nonutilization of behavioral theories. Despite the limitations, it can be concluded that the yoga interventions were effective in reducing depression.

The Emotional Freedom Technique (EFT) is defined and described as a clinical procedure for the relief of psychological and physical distress that patients often bring to the attention of nurses. Frequently referred to as"tapping,"this technique combines the cognitive reprocessing benefits of exposure and acceptance therapy with the energetic disturbance releases associated with acupuncture and other energy therapies. More than 60 research articles in peer-reviewed journals report a staggering 98% efficacy rate with the use of this procedure from psychological distress (posttraumatic stress disorder, phobias, anxiety, depression, etc.) to physical conditions (asthma, fibromyalgia, pain, seizure disorders, etc.) to performance issues (athletic, academic). Perhaps because of this, this technique has encountered a fair degree of skepticism within the health care community. Easily taught as a self-help aid that patients can administer to themselves, EFT becomes an efficacious tool in the hands of nurses who are seeking whole person approaches for the healing of a wide variety of psychological and physical conditions. A conceptual framework, mechanisms of action, evidence of safety, literature review, and case studies are also included.

PURPOSE:This study aimed to evaluate the effectiveness of Baduanjin exercise, which is a traditional Chinese Qigong exercise, in breast cancer survivors to assess its efficacy for physical and psychological rehabilitation.

METHODS:The study was a single-blinded randomized controlled trial. Eighty-six subjects were randomly assigned to the intervention (n = 46) or control (n = 40) groups. The intervention group received Baduanjin exercise 3 days/week at hospital and another 4 days/week at home for 6 months, whereas the control group were requested to maintain their original physical activity. Outcomes included body mass index (BMI), heart rate variability, lung capacity, arm circumference, shoulder range of motion, step test index, anxiety, depression, and quality of life (QOL).

RESULTS:After 6 months of intervention, heart rate variability and shoulder range of motion were significantly improved in the Baduanjin group compared to the control group (P < 0.05). There were also significant improvements in depression, QOL, and four QOL dimension scores (physical well-being, social well-being, functional well-being, and breast cancer subscale) (P < 0.05). However, there were no differences in the BMI, lung capacity, arm circumference, step test index, anxiety, and the emotional well-being QOL dimension scores.

CONCLUSION:Our findings indicate that Baduanjin is an effective intervention for improving physical and psychological health outcomes among breast cancer survivors, which is worth recommending and implementing by oncology nurses for breast cancer survivors during their long rehabilitation journeys.

BACKGROUND:The effectiveness of pharmacological treatment may be limited in older persons. Several studies using Tai Chi or music therapy separately confirmed positive effects in the reduction of depressive symptoms. We conducted a cluster randomized controlled trial to evaluate the possible synergistic effect of combined music and Tai Chi on depressive symptoms.

METHODS:One hundred and seven older adults with mild to moderate depressive symptoms were recruited from Ya'an city. Fifty-five participants were cluster randomized to combined music and Tai Chi group for three months, while the other fifty-two individuals were randomized to the control group that entailed routine health education delivered monthly by community nurses. The primary outcome of depressive symptoms was measured with the Geriatric Depression Scale (GDS) at baseline and monthly for three months.

RESULTS:At three-month follow-up, a statistically significant improvement in depressive symptoms was found in the intervention group compared with control group (F(3,315) = 69.661, P<0.001). Following adjustments for socio-demographic data, the true effect of intervention on depressive symptoms was significant (F = 41.725, P<0.01,η= 0.574).

CONCLUSIONS:Combined music and Tai Chi reduced depressive symptoms among community-dwelling older persons. This represents an economically viable solution to the management of depression in highly populous developing nations.

BACKGROUND:The effectiveness of pharmacological treatment may be limited in older persons. Several studies using Tai Chi or music therapy separately confirmed positive effects in the reduction of depressive symptoms. We conducted a cluster randomized controlled trial to evaluate the possible synergistic effect of combined music and Tai Chi on depressive symptoms.

METHODS:One hundred and seven older adults with mild to moderate depressive symptoms were recruited from Ya'an city. Fifty-five participants were cluster randomized to combined music and Tai Chi group for three months, while the other fifty-two individuals were randomized to the control group that entailed routine health education delivered monthly by community nurses. The primary outcome of depressive symptoms was measured with the Geriatric Depression Scale (GDS) at baseline and monthly for three months.

RESULTS:At three-month follow-up, a statistically significant improvement in depressive symptoms was found in the intervention group compared with control group (F(3,315) = 69.661, P<0.001). Following adjustments for socio-demographic data, the true effect of intervention on depressive symptoms was significant (F = 41.725, P<0.01,η= 0.574).

CONCLUSIONS:Combined music and Tai Chi reduced depressive symptoms among community-dwelling older persons. This represents an economically viable solution to the management of depression in highly populous developing nations.