Dance Movement Therapy in the Treatment of Depressed Patients: A Randomised Controlled Trial

Study Overview
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Brief Summary
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This multi-centre research investigates the effects of dance movement therapy (DMT) on participants diagnosed with depression. In total, 109 persons participated in the study in various locations in Finland. All participants received treatment as usual (TAU). They were randomised into DMT + TAU (n = 52) or TAU-only (n = 57). The participants in the DMT + TAU group were offered 20 DMT sessions twice a week for 10 weeks in addition to standard care. The measurement points included pre-treatment measurement at the baseline and post-treatment measurement at the end of the intervention, which was 10 weeks after the pre-treatment measurement. The follow-up measurement was 3 months after the post-treatment measurement. The effects of the intervention were assessed with a clinical measure of depression (BDI-I) and with indicators of physical and psychological distress (CORE-OM and SCL-90). The participants in the treatment group (DMT+TAU) were compared to the participants in the control group who received TAU-only.

Detailed Description
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This research investigates the outcomes of dance movement therapy (DMT) groups in the treatment of adults with depression. In total, 157 participants were involved. Of them, 109 were randomized into DMT group (n = 52) or control group (n = 57). The rest of the participants participated in non-randomized DMT groups. All participants met the criteria for the eligibility for rehabilitation psychotherapy, had depression diagnosed by a doctor, and the severity of depression threatened the ability to work/ study. All participants received treatment as usual during the research. DMT-intervention was facilitated by a dance movement therapist and included 20 x 75 mins sessions within 10 weeks. Depressive symptoms (BDI), physical and psychological distress (CORE-OM, SCL-90), ability to work/study, and body image were assessed at three measurement points: pre-measurement at the baseline, post-measurement 10 weeks after the pre-treatment measurement, and a follow-up measurement three months after the post-treatment measurement. This research includes a larger number of participants (N = 109) than have been involved in previous studies utilising randomised controlled trials in research designs. The research generates further information about the effectiveness of dance movement therapy groups in the rehabilitation of depression as it was conducted in five cities across Finland. This type of multi-centre research can provide a realistic picture of the typical practice of a range of dance movement therapists working with participants in various geographic locations.

Official Title
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Dance Movement Therapy in the Treatment of Depressed Patients: A Randomised Controlled Trial

Conditions
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Depression

Intervention / Treatment
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* Behavioral: Dance Movement Therapy group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: The participant needed to have a diagnoses of depression by a psychiatrist or general practitioner (ICD -diagnostic system). The researchers checked that the participants were working age (18-65 years of age) and fulfilled the criteria for rehabilitative psychotherapy in Finland: at least three months of relevant treatment since depression was diagnosed; the participants' ability to work or study is impaired by depression; a psychiatrist has determined that rehabilitative psychotherapy is necessary to improve or support the participant's ability to work or study. Exclusion Criteria: active suicidal ideation; psychotic symptoms; substance misuse that is on a critical level. Also, interviewees who had pain-related problems that restricted daily life or were pregnant were not admitted to the study.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Treatment group<br>The participants in the treatment group were offered 20 Dance movement therapy sessions in addition to standard care. | Behavioral: Dance Movement Therapy group<br>* DMT-intervention was facilitated by a dance movement therapist and included 20 x 75 mins sessions within 10 weeks.<br>|
| No Intervention: Control group<br>Participants in the control group continued treatment as usual in the health services. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline depressive symptoms (Beck Depression Inventory; BDI) at 10-week post-treatment measurement | BDI measures depressive symptoms with 21 items. Each item is scored 0-3 and sum scores are calculated on the basis of participants' responses. The total sum score can range from 0 to 63. | 10 weeks | 
| Change from post-treatment depressive symptoms (Beck Depression Inventory; BDI) at three-month follow-up measurement | The change in depressive symptoms between the post-treatment measurement at the end of the 10-week intervention and the 3-month follow-up. | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline psychological distress (Clinical Outcomes in Routine Evaluation - Outcome Measure; CORE-OM) at 10-week post-treatment measurement | The CORE-OM comprises 43 items and four dimensions of well-being, problems, life functioning, and risk for aggressive/suicidal behaviour. Each item is scored from 0 to 4. CORE-OM items are summed and then divided by the number of answered items, which is then multiplied by ten; that is, the total scores ranges from 0 to 40. | 10 weeks | 
| Change from post-treatment psychological distress (Clinical Outcomes in Routine Evaluation - Outcome Measure; CORE-OM) at three-month follow-up measurement | The change in psychological distress (CORE-OM) between the post-treatment measurement at the end of the 10-week intervention and the 3-month follow-up. | 3 months | 
| Change from baseline physiological and psychological symptoms (the Symptoms Check List-90; SCL-90) at 10-week post-treatment measurement | SCL-90 uses 90 items to measure nine primary symptomatic dimensions, including somatisation, obsessive-compulsiveness, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism. The level of distress is scored on a scale from 0 to 4. An average score of the 90 items is calculated, which represents the severity of the participant's symptoms, that is, the Global Severity Index (GSI). | 10 weeks | 
| Change from post-treatment physiological and psychological symptoms (the Symptoms Check List-90; SCL-90) at three-month follow-up measurement | The change in physiological and psychological symptoms (SCL-90) between the post-treatment measurement at the end of the 10-week intervention and the 3-month follow-up. | 3 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Dance Movement Therapy, Adults, Depression, Beck Depression Inventory, Clinical Outcomes in Routine Evaluation - Outcome Measure, The Symptoms Check List-90