Sree Sucharitha Tirukkovalluri, Pradeep Rangasamy, Vijaya Lakshmi Ravi, Angeline Julius, Chakrapani Chatla, Balaji Sivaram Mahendiran, Aravind Manoharan
Health care professional's perceived stress levels and novel brief COPE-4 factor structure-based assessment of coping methods during COVID-19 pandemic in India: A multi-modal cross-sectional study
Journal of family medicine and primary care
globally mental health conditions pose substantial burden disease despite availability evidencebased pharmacological psychological treatments symptoms substantial subgroup patients respond interventions minority patients access study aimed assess efficacy impuls 6month transdiagnostic group exercise intervention plus treatmentasusual compared treatmentasusual alone outpatients various mental disorders pragmatic twoarm multisite randomised controlled trial germany ten outpatient rehabilitative medical care facilities involved study sites participants outpatients diagnosed according icd10 one following disorders based structured clinical interviews moderate severe depression primary insomnia posttraumatic stress disorder ptsd panic disorder agoraphobia participants required aged 18 years 65 years insured health insurers allgemeine ortskrankenkasse badenwrttemberg techniker krankenkasse fluent german without medical contraindications exercise blocks six participants randomly allocated impuls plus treatmentasusual treatmentasusual alone allocation ratio 11 stratified study site randomisation sequence generated external data manager team responsible data collection management masked randomisation sequence impuls intervention comprised evidencebased outdoor exercises lasting 30 min aimed achieving least moderate intensity also incorporated behavioural change techniques targeting motivational volitional determinants exercise behaviour treatmentasusual representative typical outpatient health care germany allowing patients access standard treatments primary outcome global symptom severity 6 months randomisation measured using selfreport brief symptom inventory bsi18 analysed intentiontotreat sample individuals lived experience mental illness involved conducting study writing final publication safety assessed participants trial registered german clinical trials register drks00024152 completion date june 30 2024 600 patients provided informed consent recruited study underwent diagnostic interview jan 1 2021 may 31 2022 following 199 excluded basis inclusion exclusion criteria one withdrew consent baseline assessment 400 eligible participants 284 71 selfidentified female 106 27 selfidentified male nine 2 selfidentified mean age 4220 years sd 1323 range 1965 ethnicity data assessed 287 72 participants met criteria moderate severe depression 81 20 primary insomnia 37 9 agoraphobia 46 12 panic disorder 72 18 ptsd 199 participants allocated intervention group impuls plus treatmentasusual 201 control group treatmentasusual alone 38 19 participants receive minimum impuls intervention dose impuls plus treatmentasusual demonstrated superior efficacy treatmentasusual alone reducing global symptom severity adjusted difference bsi18 411 95 ci 174648 d035 95 ci 014056 p00007 6 months significant differences total number adverse events serious adverse events two groups one serious adverse event male torn ligament related intervention impuls efficacious transdiagnostic adjunctive treatment outpatient mental health care findings suggest exercise therapy implemented outpatient mental health care adjunctive transdiagnostic treatment mental disorders depression insomnia panic disorder agoraphobia ptsd transdiagnostic group exercise interventions might ameliorate existing disparity care provision many individuals need evidencebased treatment receiving german innovation fund federal joint committee germany