Abstract
New, effective biological interventions for treatment of depressive episodes and recurrent depression are still needed. Whole-body cryotherapy (WBC), which is a treatment using cryogenic temperature, is a novel therapeutic modality in neurology and rheumatology. The objective of this study was to determine the efficacy and safety of WBC as an add-on treatment for depressive episode. 30 adults diagnosed with depressive episode were recruited to an observational, prospective study. 21 participants (17 women, 81%), mean age 46.1 (±16.7), completed the whole study procedure. The Hamilton Depression Rating Scale and the Beck Depression Inventory were used to assess the severity of depressive symptoms. Additionally, quality of life and anhedonia were assessed with the WHOQoL-BREF and the SHAPS. Participants undertook 10, 2-minute (from - 110 C to - 135 degrees C) WBC sessions within two weeks. Patients after WBC sessions showed significant improvement in the form of a reduction in total scores in scales assessing depressive symptoms: the HDRS (p< 0.00001) between T1 (16.94±4.3) and T4 (4.50±4.2) and the BDI-II (T1: 13.48±4.6; T4: 6.14±6.7, p<0.03), lower anhedonialevelon SHAPS (p =0.011) and higher quality of lifein thefollowing domains: physical health (p =0.024), psychological health (p =0.016) and environmental domain (p =0.003). Pre/post comparison of self-report well-being measured by the VAS scale showed a significant increase (p< 0.00001). It was shown that WBC have no effect on the level of cytokines, NO, hsCRP, ESR and TAS in blood (p> 0.05). WBC proved to be an effective, safe, and tolerable add-on intervention in patients with depressive episode. Further randomized controlled trials should be conducted.
Highlights
According to the World Health Organization, over 300 million people around the world are affected by depression, which was the third leading cause of disability in 2015
It was shown that Whole-body cryotherapy (WBC) have no effect on the level of cytokines, nitric oxide (NO), hsCRP, ESR and total antioxidative status (TAS) in blood (p> 0.05)
In the midst of heterogeneous nature of depression, in the recent reviews of studies [5, 30] regarding the relationship between mood disorders and immune-related abnormalities, it has been found that in some patients with depression there is a correlation between depressive symptoms and high levels of pro-inflammatory cytokines, such as IL-1, IL-1β, IL-6, tumor necrosis factor alpha (TNF-α), interferon gamma (IFN-γ), and hypothalamic-pituitary-adrenal axis (HPA) hyperfunction
Summary
According to the World Health Organization, over 300 million people around the world are affected by depression, which was the third leading cause of disability in 2015. Overall mortality is two-time higher in people who suffer from depression. Published reviews and meta-analyses suggest that anti-inflammatory treatments could have a significant role in the treatment of depressive symptoms [5,6,7,8]. Meta-analysis of Więdłocha et al [9] showed that plasma levels of IL-4, IL-6 and IL-10 decreased in patients with major depressive disorder after antidepressant treatment. Depression is associated with high CRP level [10] and decreased NO level [11, 12] as well as higher activity level of antioxidant enzymes [13]. Further studies on the possible adjuvant treatment with anti-inflammatory activity in depression treatment are needed
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