Assessing multi-site feasibility of an integrated whole-body hyperthermia and behavioral intervention for major depressive disorder
openNCCIH - National Center for Complementary and Integrative Health
PROJECT SUMMARY/ABSTRACT
Major Depressive Disorder (MDD) afflicts more than 280 million people worldwide and is the leading cause of
life years lost to disability. Current treatments have important limitations in efficacy and, in the case of
medication, substantial side effects. There is thus a compelling need for additional effective, well-tolerated
treatments. Body heating practices, such as saunas, sweat lodges, and hot yoga, have rich traditions across
cultures as healing practices. Additionally, recent basic and clinical research, as well as the investigative
team’s pilot data, suggest that whole-body hyperthermia (WBH) holds promise for depression treatment. The
investigative team therefore hypothesizes that WBH, a body-based heat treatment, may decrease depression
symptoms. Additionally, pilot data suggest benefit from combining WBH and cognitive behavioral therapy
(CBT), an established mind-based treatment for depression. The UCSF investigative team led an NCCIH-
funded project testing WBH and CBT in adults with major depressive disorder and have found the combined
treatment to be feasible and acceptable. Additionally, preliminary data from this project suggest a clinically
meaningful and statistically significant reduction in depression symptoms. Despite promising initial data from
such pilot studies, rigorous and well-designed clinical trials are required to evaluate the efficacy of depression
treatments that include WBH. Before the investigative team can conduct a definitive efficacy trial, they must
assess the feasibility of key study design components. This proposal will test the feasibility of a multi-site 2 x 2
factorial trial design that randomizes adults (N=60) with MDD to two treatment factors: WBH (yes/no) and CBT
(yes/no). The three-site investigative team (University of California San Francisco, Cleveland Clinic
Foundation, Massachusetts General Hospital) will capitalize on their established collaborative relationships to
assess the feasibility of recruitment, enrollment, randomization, and retention (Aim 1), intervention fidelity and
acceptability (Aim 2), and consistency of data collection (Aim 3). The study will include a 2-week screening
period, a 10-week intervention period, and a 12-week follow-up period. During the intervention period,
participants randomized to WBH will receive four biweekly sessions, and participants randomized to CBT will
receive eight weekly sessions. If successful, the proposed multi-site feasibility R01 trial will lay key groundwork
for a future multi-site 2 x 2 factorial efficacy trial that will test the effects of WBH, CBT, and their combination on
depression symptoms. If successful, this program of research may yield novel non-drug treatment options for
millions of individuals struggling with depression.
Up to $601K
health research