Effects of biofeedback and relaxation in patients with depression

• Main Authors: Pei-Li Lei, 雷蓓莉
• Other Authors: Mei-Chi Hsu
• Format: Others
• Language: zh-TW
• Published: 2015
• Online Access: http://ndltd.ncl.edu.tw/handle/7xx692

碩士 === 義守大學 === 管理碩博士班 === 104 === Depression has a high prevalence worldwide. It makes depression physical and mental health worse and suicide risk increased. Except pharmacotherapy, the complementary treatments such as biofeedback may be a promising intervention to alleviate depressive symptoms. Biofeedback uses a series of electronic devices to monitor normal or abnormal signals such as skin temperature, electromyogram (EMG), breathing rate, electroencephalography (EEG), blood pressure and heart rate and convert them into recognizable data to the test subject. Biofeedback can therefore help people having more control over these involuntary functions, and their emotional or anxious status. The main purpose of this study was to examine the effects of biofeedback and relaxation on depression. This study adopted a pre-post test experimental design using a convenience sampling from psychiatric wards. A total of 62 patients were randomly assigned to either control group (n=22), experimental group I (relaxation combined with biofeedback, n=20), and experimental group II (relaxation only, n=20). The control group received the standard routine care, whereas participants in the experimental groups (I and II) received 10 consecutive biofeedback and/ or relaxation sessions. Data were collected and assessed before intervention (T1), just finished the 10th (the final) intervention (T2), and one month after the intervention (T3). Data from the control group were also collected at the same time frame. Statistical analyses included descriptive statistical methods, One-Way ANOVA, chi-square test, Generalized Estimating Equation (GEE), and McNemar test. The GEE results based on the Hospital Anxiety and Depression Scale (HADS) scores, showed that anxiety score from T1 to T3 in the experimental group I was significantly different and decreased (p< 0.05). Depressive symptoms from T1 to T3 in both experimental groups (I and II) were also significantly improved (p< 0.05). ANOVA analyses showed that anxiety scores of the control group were significantly higher than the experimental group I. The depression scores in the control group were higher than those in both experimental groups. However, the experimental group I had even lower depression scores than the experimental group II. In physiology indices, GEE results showed that electromyography (EMG) and lower-frequency power (LF) were significantly different in the experimental group I when relax. The findings indicated that the experimental group I had more effective muscle relaxation effects compared with both control group and experimental group II. Concerning the sympathetic and parasympathetic activity, the sympathomimetic activity was increased in the control group, while decreased in the experimental group II, and more so in the experimental group. During the biofeedback sessions, skin conductance, finger temperature and HF in the experimental group I showed significant change. When sympathetic tone was increased, it caused vasoconstriction and subsequently decreased the skin temperature. However, this study found temperature increased in both experimental groups. The experimental group I showed significantly improved and effective in the HF changes, which reflected an improved parasympathetic activity. Overall, the experimental group I in comparison with the experimental II showed more effective in reducing depressive symptoms, anxiety and physiological parameters. This study demonstrates that relaxation in combination with biofeedback could effectively improve depressive symptoms, increased HF and skin temperature, and decreased EMG. As a result, sympathetic activity was decreased and parasympathetic activity was increased. Thus, depressive symptoms in patients with depression were improved, and better quality of life achieved. The results found in this study may be useful in improving physical and psychological health in patients with depression. Our evidence-based research findings that a combined use of pharmacotherapy and complementary therapies could effective decreased depressive symptoms and improved quality of life, could provide a useful reference to nurses and other health professionals when caring for depression patients.