Efficacy of Virtually-Delivered Qigong/Tai Chi for Depression in Middle- and Older-Age Adults with Bipolar Disorder (QT-BD): A Pilot Randomized Controlled Trial during the COVID-19 Pandemic

Background : Depressive symptoms in middle-aged and older age bipolar disorder (BD) are associated with decreased quality of life and premature mortality. Yet, currently available pharmacological treatments are limited in efficacy. Mind-body interventions have been shown to improve mood, quality of life, and cognition in other adult populations, and may thus provide a promising therapeutic alternative. Here we conduct the first randomized controlled trial (RCT) examining the efficacy of a group Qigong/Tai Chi intervention (QT-BD) for reducing depressive symptoms in middle-aged and older adults with BD. As a further innovation during the COVID pandemic, we used Zoom to deliver the group intervention and active control. Methods : We conducted a virtually-delivered 12-week pilot RCT with 23 patients with BD aged >= 40 comparing a QT-BD intervention versus an active control (light exercise). We assessed depressive symptoms (primary outcome), verbal fluency (secondary outcome), and functioning/quality of life (exploratory outcomes) at baseline and 12-weeks. Results : No statistically significant differences were observed between groups for all outcomes (all p's>0.05). However, non-significant decreases in depressive symptoms were found in the subgroup of participants with baseline MADRS scores ≥10 in the QT-BD intervention only (p=0.07). Limitations : Our sample size was limited and the virtually-delivered format may have limited the positive benefits of face-to-face interventions. Conclusions : This novel pilot study suggests that QT-BD may be a feasible and efficacious intervention for reducing depressive symptoms in middle- and older-aged BD, particularly when baseline MADRS is ≥10, warranting further investigation in larger-scale trials.

Isolating together during COVID-19: Results from the Telehealth Intervention Program for older adults.

Background: A pressing challenge during the COVID-19 pandemic and beyond is to provide accessible and scalable mental health support to isolated older adults in the community. The Telehealth Intervention Program for Older Adults (TIP-OA) is a large-scale, volunteer-based, friendly telephone support program designed to address this unmet need. Methods: A prospective cohort study of 112 TIP-OA participants aged ≥60 years old was conducted in Quebec, Canada (October 2020-June 2021). The intervention consisted of weekly friendly phone calls from trained volunteers. The primary outcome measures included changes in scores of stress, depression, anxiety, and fear surrounding COVID-19, assessed at baseline, 4 and 8-weeks. Additional subgroup analyses were performed with participants with higher baseline scores. Results: The subgroup of participants with higher baseline depression scores (PHQ9 ≥10) had significant improvements in depression scores over the 8-week period measured [mean change score = -2.27 (±4.76), 95%CI (-3.719, -0.827), p = 0.003]. Similarly, participants with higher baseline anxiety scores (GAD7 ≥10) had an improvement over the same period, which, approached significance (p = 0.06). Moreover, despite peaks in the pandemic and related stressors, our study found no significant (p ≥ 0.09) increase in stress, depression, anxiety or fear of COVID-19 scores. Discussion: This scalable, volunteer-based, friendly telephone intervention program was associated with decreased scores of depression and anxiety in older adults who reported higher scores at baseline (PHQ 9 ≥10 and GAD7 ≥10).