Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-18T08:49:46.777Z Has data issue: false hasContentIssue false

The use of biofeedback intervention in the improvement of depression levels: a randomised trial

Published online by Cambridge University Press:  11 January 2021

Willams Henrique da Costa Maynart*
Affiliation:
School of Nursing. Federal University of Alagoas, Maceió, Alagoas, Brazil
Maria Cicera dos Santos de Albuquerque
Affiliation:
School of Nursing. Federal University of Alagoas, Maceió, Alagoas, Brazil
Regina Célia Sales Santos
Affiliation:
School of Nursing. Federal University of Alagoas, Maceió, Alagoas, Brazil
Patrícia de Albuquerque Sarmento
Affiliation:
School of Nursing. Federal University of Alagoas, Maceió, Alagoas, Brazil
Jadelson Júnior da Silva
Affiliation:
School of Nursing. Federal University of Alagoas, Maceió, Alagoas, Brazil
Christine de Sousa Gomes Costa
Affiliation:
School of Nursing. Federal University of Alagoas, Maceió, Alagoas, Brazil
Jessica Diodino da Silva Santos
Affiliation:
School of Nursing. Federal University of Alagoas, Maceió, Alagoas, Brazil
Crislane de Oliveira Pontes
Affiliation:
School of Nursing. Federal University of Alagoas, Maceió, Alagoas, Brazil
Marcela Cristina dos Santos Barros
Affiliation:
School of Nursing. Federal University of Alagoas, Maceió, Alagoas, Brazil
Flaviane Maria Pereira Belo
Affiliation:
School of Nursing. Federal University of Alagoas, Maceió, Alagoas, Brazil
Christefany Régia Braz Costa
Affiliation:
Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
Cyro Rego Cabral Júnior
Affiliation:
School of Nutrition. Federal University of Alagoas, Maceió, Alagoas, Brazil
*
Author for correspondence: Willams Henrique da Costa Maynart, Email: willamshcmaynart@hotmail.com

Abstract

Objective:

To evaluate the use of biofeedback intervention in the levels of depression. The main hypothesis tested if the use of biofeedback improves depression levels compared to the control group.

Methods:

A randomised clinical trial. The final sample was composed of 36 participants (18 in the experimental group, receiving 6 training, once a week, with biofeedback; and 18 in the control group, who received conventional treatment in the service).Outcome measures were assessed in two stages: pre-test and post-test. The research used the following instruments: demographic survey data, Mini International Neuropsychiatric Interview 5.0.0 and Beck Depression Inventory (BDI). The factors and variables were presented in terms of descriptive and inferential statistics. Fisher’s exact test (p < 0.05) was used to verify the existence of an association between the counting variables. The multinomial logistic regression model was adopted, and the Logit link function was used, as the software RStudio version 3.6.2.

Results:

The factors that remained in the final model were group, sex, partner, atypical antidepressant, benzodiazepines, mood stabiliser, antiepileptic and antihistamine, according to the levels of depression based on the BDI. The group that did not receive biofeedback intervention had 16 times more chances of increasing the depression levels compared to participants in the experimental group.

Conclusion:

The use of biofeedback reduces depression, thus, representing a complementary alternative for the treatment of moderate and severe depression, and dysthymia.

Type
Original Article
Copyright
© The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association, DSM-5 Task Force (2013) Diagnostic and Statistical Manual of Mental Disorders: DSM-5™, 5th Edn. USA: American Psychiatric Publishing.Google Scholar
Amorim, P (2000 ) Mini International Neuropsychiatric Interview (MINI): validação de entrevista breve para diagnóstico de transtornos mentais [Mini International Neuropsychiatric Interview (MINI): validation of a brief interview for the diagnosis of mental disorders]. Brazilian Journal of Psychiatry 22(3), 106115.CrossRefGoogle Scholar
Beck, AT and Steer, RA (1993) Beck Depression Inventory Manual. San Antonio: Psychological Corporation.Google Scholar
Benasi, G, Guidi, J, Offidani, E, Balon, R, Rickels, K and Fava, GA (2018) Benzodiazepines as a monotherapy in depressive disorders: a systematic review. Psychotherapy and Psychosomatics 87, 6574. doi: 10.1159/000486696 CrossRefGoogle ScholarPubMed
Brazil (2016) Saúde mental no SUS: Cuidado em liberdade, defesa de direitos e Rede de Atenção Psicossocial [Mental health in Brazilian Public Health System: Care in freedom, advocacy and Network of Psychosocial Attention]. Available at http://portalarquivos2.saude.gov.br/images/pdf/2016/junho/27/Relat--rio-Gest--o-2011-2015---.pdf (accessed 7 March 2020).Google Scholar
Brazil (2004) Saúde mental no SUS: os centros de atenção psicossocial [Mental health in Brazilian Public Health System: the psychosocial care center. Available at http://www.ccs.saude.gov.br/saude_mental/pdf/SM_Sus.pdf (accessed 22 February 2020).Google Scholar
Buehler, AM, Cavalcanti, AB, Suzumura, EA, Carballo, MT and Berwanger, O (2009) How to assess intensive care randomized trials. Revista Brasileira de Terapia Intensiva, 21(2), 219225.CrossRefGoogle ScholarPubMed
Canadian Agency for Drugs and Technologies in Health (2014) Neurofeedback and Biofeedback for Mood and Anxiety Disorders: A Review of the Clinical Evidence and Guidelines – An Update. Rapid Response Report: Summary with Critical Appraisal. Available at https://www.ncbi.nlm.nih.gov/books/NBK253820/pdf/Bookshelf_NBK253820.pdf (accessed 15 March 2020).Google Scholar
Caldwell, HW (2015) Impact of Heart-Rate Variability Biofeedback on Major Depression Disorder in Resting-State fMRI. Thesis (Doctorate) – Department of Psychology, Brigham Young University. Available at https://scholarsarchive.byu.edu/etd/5633/ (accessed 15 March 2020).Google Scholar
Caldwell, YT and Steffen, PR (2018) Adding HRV biofeedback to psychotherapy increases heart rate variability and improves the treatment of major depressive disorder. International Journal of Psychophysiology 131, 96101.CrossRefGoogle ScholarPubMed
Cheng, HC, Lin, KC, Huang, CJ, Tang, TC, Lee, LL and Lai, CY (2014) The effect of biofeedback therapy on depression and anxiety levels in depressive outpatients. Journal of Nursing and Healthcare Research, 10(4), 103112. http://dx.doi.org/10.6225/JNHR.10.4.295.Google Scholar
Cunha, JA (2001) Manual da versão em português das Escalas Beck [Portuguese version of the Beck Scales]. São Paulo: Casa do Psicólogo.Google Scholar
Fletcher, RH and Fletcher, SW (2006) Epidemiologia clínica: elementos essenciais [Clinical Epidemiology: Essential Elements]. 4th Edn.. Porto Alegre: Artmed.Google Scholar
Guyatt, G, Rennie, D, Meade, MO and Cook, DJ (2008) Users’ Guide to the MEDICAL LITERATURE. A Manual for Evidence-Based Clinical Practice. 2nd Edn. New York: American Medical Association.Google Scholar
Hartogs, BMA, Bartels-Velthuis, AA, Ploeg, KVD and Bos, EH (2017) Heart rate variability biofeedback stress relief program for depression. A replicated single-subject design. Methods of Information in Medicine 56(6), 419426.Google ScholarPubMed
Jester, DJ, Rozek, EK and Mckelley, RA (2018) Heart rate variability biofeedback: implications for cognitive and psychiatric effects in older adults. Aging & Mental Health, 17.Google ScholarPubMed
Karavidas, MK, Lehrer, PM, Vaschillo, E, Vaschillo, B, Marin, H, Buyske, S, Malinovsky, I, Radvanski, D and Hassett, A (2007) Preliminary results of an open label study of heart rate variability biofeedback for the treatment of Major Depression. Applied Psychophysiology and Biofeedback 32, 1930.CrossRefGoogle ScholarPubMed
Klijs, B, Kibele, EU, Ellwardt, L, Zuidersma, M, Stolk, RP, Wittek, RP, Mendes de Leon, CM and Smidt, N (2016) Neighborhood income and major depressive disorder in a large Dutch population: results from the LifeLines Cohort study. BMC public health, 16(1), 773. https://doi.org/10.1186/s12889-016-3332-2.CrossRefGoogle Scholar
Kotozaki, Y, Takeuchi, H, Sekiguchi, A, Yamamoto, Y, Shinada, T, Araki, T, Takahashi, K, Taki, Y, Ogino, T, Kiguchi, M and Kawashima, R (2014) Biofeedback-based training for stress management in daily hassles: an intervention study. Brain and Behavior 4(4), 566579. https://doi.org/10.1002/brb3.241.CrossRefGoogle ScholarPubMed
Lima, MS. (1999) Epidemiologia e impacto social [Epidemiology and social impact]. Revistra Brasileira de Psiquiatria 21(1), 015. http://dx.doi.org/10.1590/S1516-44461999000500002 CrossRefGoogle Scholar
Malhi, GS and Mann, JJ (2018) Depression. Lancet (London, England) 392(10161), 22992312. https://doi.org/10.1016/S0140-6736(18)31948-2 CrossRefGoogle ScholarPubMed
Moher, D, Hopewell, S, Schulz, KF, Montori, V, Gøtzsche, PC, Devereaux, PJ, Elbourne, D, Egger, M and Altman, DG (2010) CONSORT 2010 Explanation and Elaboration: updated guidelines for reporting parallel group randomised trials. BMJ 340, c869.CrossRefGoogle ScholarPubMed
RStudio Team (2019) RStudio: Integrated Development for R. Boston, MA: RStudio, PBC. Available at http://www.rstudio.com/ Google Scholar
Rush, AJ, Trivedi, MH, Stewart, JW, Nierenberg, AA, Fava, M, Kurian, BT, Warden, D, Morris, DW, Luther, JF, Husain, MM, Cook, IA, Shelton, RC, Lesser, IM, Kornstein, SG and Wisniewski, SR (2011) Combining Medications to Enhance Depression Outcomes (CO-MED): acute and long-term outcomes of a single-blind randomized study. The American Journal of Psychiatry 168(7), 689701.CrossRefGoogle Scholar
Sadock, BJ, Sadock, VA and Ruiz, P (2017) Compêndio de psiquiatria [Compendium of Psychiatry], 11th Edn. Porto Alegre: Artmed.Google Scholar
Sadock, BJ, Sadock, VA and Sussman, N (2013) Manual de farmacologia psiquiátrica de Kaplan & Sadock [Kaplan & Sadock’s Manual of Psychiatric Pharmacology]. 5th Edn. Porto Alegre: Artmed.Google Scholar
Schoenberg, P and David, AS (2014) Biofeedback for psychiatric disorders: a systematic review. Applied Psychophysiology and Biofeedback 39(2), 109135.CrossRefGoogle ScholarPubMed
Schwartz, MS, Collura, TF, Kamiya, J and Schwartz, NM (2016) The history and definitions of biofeedback and applied psychophysiology. In Schwartz, MS and Andrasik, F (eds), Biofeedback: A Practitioner’s Guide. New York: Guilford Press, pp. 323.Google Scholar
Siepmann, M, Aykac, V, Unterdörfer, J, Petrowski, K and Mueck-Weymann, M (2008) A pilot study on the effects of heart rate variability biofeedback in patients with depression and in healthy subjects. Applied Psychophysiology and Biofeedback 33(4), 195201. https://doi.org/10.1007/s10484-008-9064-z CrossRefGoogle ScholarPubMed
Souza, TR and Lacerda, ALT (2013) Depressão ao longo da história. In Quevedo, J and Silva, AG (eds), Depressão: Teoria e Clínica, 1st Edn. Artmed: Porto Alegre, pp. 1728.Google Scholar
Tan, G, Shaffer, F, Lyle, R and Teo, I (2016) Evidence-based Practice in Biofeedback & Neurofeedback, 3rd Edn. New York: Association for Applied Psychophysiology and Biofeedback.Google Scholar
World Health Organization (2020) Depression. Available at https://www.who.int/news-room/fact-sheets/detail/depression (accessed 2 February 2020).Google Scholar
Ziliotto, GC (2013) Transtornos de Humor. In Marcolan, JF and Castro, RCBR, Enfermagem em Saúde Mental e Psiquiátrica, 1st Edn. Rio de Janeiro: Elsevier, pp. 8191.Google Scholar