Comparing a body-oriented and a cognitive online intervention for adults with depressive symptoms: A three-arm randomized controlled trial

Based on findings from basic and clinical research indicating that the motor system can causally influence emotional processes, Body, Breath and Mind (BBM) was developed as a minimally guided online intervention. BBM combines body-oriented Qi Gong practice with elements of behavioral activation and aims to target embodied aspects of depression. In a pre-registered three-arm randomized controlled trial, the effects of BBM were compared with MoodGym (MG), an established online intervention based on cognitive behavioral therapy, and with a waitlist control group (WL). A total of 303 participants with negative and depressive mood were randomized to BBM, MG, or WL. The primary outcome was depressive symptom severity, assessed with the Patient Health Questionnaire-9 (PHQ-9). Quality of life, measured with the Short Form Health Survey (SF-36), served as a secondary outcome. Both BBM and MG showed greater reductions in somatic depressive symptoms of the PHQ-9 compared to WL. For the affective component of the PHQ-9, only MG demonstrated significantly greater reductions than WL. No significant differences between conditions were observed for changes in quality of life. The results do not provide evidence that adding body-oriented components yields specific benefits in the online treatment of depressive symptoms. However, overall, BBM showed largely comparable effects to those of MoodGym, although the findings were less consistent for affective depressive symptoms. BBM may therefore provide an additional minimally guided online intervention option for addressing negative and depressed mood, which may be of particular interest to individuals who prefer a body-oriented approach.