Does cognitive behavioral therapy change the daily activity patterns of adults with depression? A secondary analysis of the CBT+ trial

This secondary analysis explored pre- to post-intervention changes in accelerometer-derived activity and sleep data from adults with major depressive disorder (MDD). The CBT+ trial comprised two 8-week Cognitive Behavioral Therapy (CBT) arms: ActiveCBT (n = 13; 30 min of moderate-intensity exercise before each CBT session) and CalmCBT (n = 12; 30 min of quiet rest before each session). Pre- and post-intervention acceleromtetry data were included in mean-centered linear models for sleep (time in bed; TIB), activity and sedentary time. There were no significant between-group effects, but there was a significant average within-person decrease of 47.2 mins/day of sedentary time across all participants (95% CI: −82.0 to −14.4 min/day; p = .007), a significant increase of 36.5 mins/day of sleep duration-TIB (4.2 to 68.8 min/day; p = .028), and a non-significant increase of 12.3 mins/day of total physical activity (−34.5 to 59.1 min/day; p = .589). Overall, CBT was associated with beneficial changes in daily activity patterns. The findings of reduced sedentary time and increased TIB indicate possible additional health benefits of CBT for adults with depression, although replication in larger sample sizes is needed. Future work should explore whether these behavioral improvements can be sustained beyond the intervention period.