doi:10.1016/j.psychres.2022.114975engGarcia, A.Yáñez, A. M.Bennasar-Veny, M.Navarro, C.Salva, J.Ibarra, O.Gómez-Juanes, R.Serrano-Ripoll, M. J.Oliván, B.Gili, M.Roca, M.Riera-Serra, P.Aguilar Latorre, A.Montero-Marin, J.García-Toro, M.Efficacy of an adjuvant non-face-to-face multimodal lifestyle modification program for patients with treatment-resistant major depression: A randomized controlled trialART-2023-132626Background: The high prevalence of depression is partly attributable to the poor response of patients to first-line antidepressants. Multimodal programs that promote a healthy lifestyle are successful in treating depression when used as a complementary therapy, but their medium- and long-term benefits have not been demonstrated for patients with treatment-resistant depression (TRD). The main aim of this study was to compare the effectiveness of a lifestyle modification program (LMP) with mindfulness-based cognitive therapy (MBCT) and a placebo-control (written suggestions for lifestyle changes) in Spanish patients with TRD. Methods: This controlled clinical trial randomized 94 patients with TRD into 3 arms. The primary outcome was the Beck Depression Inventory-II (BDI-II) score at baseline, 2, 6 and 12 months. The secondary outcomes were changes in scores that evaluated quality-of-life, adherence to the Mediterranean diet, physical activity, and social support. Results: Relative to the placebo group, the LMP and MBCT groups had significantly better quality of life (p = 0.017; p = 0.027), and the LMP group had significantly better adherence to the Mediterranean diet (p<0.001) and reduced use of antidepressants (p = 0.036). However, the three groups showed no significant differences in BDI-II score. Limitations: Only about half of the planned 180 patients were recruited, in part due to the COVID-19 pandemic. Conclusions: There was no evidence that the LMP treatment significantly reduced symptoms of depression relative to the other groups during the COVID-19 lockdown.2023http://zaguan.unizar.es/record/12400510.1016/j.psychres.2022.114975http://zaguan.unizar.es/record/124005oai:zaguan.unizar.es:124005info:eu-repo/grantAgreement/ES/ISCIII/CP21-00080info:eu-repo/grantAgreement/ES/MCINN/RTI2018-093590-B-I00PSYCHIATRY RESEARCH 319 (2023), 114975 [9 pp.]byhttp://creativecommons.org/licenses/by/3.0/es/info:eu-repo/semantics/openAccess