The impact of whole-body hyperthermia interventions on mood and depression - are we ready for recommendations for clinical application?
Level 2 - randomized trial
Systematic review of lower-tier clinical studies (pre/post designs, some uncontrolled)
PubMed 31159624 · doi:10.1080/02656736.2019.1612103
What was done
This systematic review examined the effects of whole-body hyperthermia (WBH) on mood and depressive symptoms. Authors searched online and offline databases (including PubMed, Web of Knowledge, and Cochrane) for clinical pre/post-intervention studies using depression or mood outcome measures recognized by German S-3 guidelines. Data on study characteristics, means, and standard deviations were extracted, and risk of bias and secondary effect size analyses were performed.
What was found
Seven studies comprising 148 participants (mean age 46 years, range 36–56) met inclusion criteria. Modalities included hot baths (3 studies) and infrared heating (4 studies) over 1 to 6 weeks, with average treatment session duration of 66.37 minutes (range 42.55–140 minutes). Of 21 extracted study endpoints, 19 yielded large effect sizes (Cohen's d ≥ 0.8). Larger effects occurred with target core body temperatures between 38 °C and 39 °C and with slower rates of core temperature elevation.
Why it matters
Thermal interventions such as whole-body hyperthermia show preliminary promise as rapid-acting adjunctive treatments for depression, but the data are not yet robust enough to support formal clinical recommendations.
Limits
The total evidence base is small (148 subjects across 7 trials), 3 of the 7 studies lacked control groups, and all studies were susceptible to small-sample bias. Long-term durability of response and optimal dosing protocols remain unclear.
Cited by
- context In a 2013 open-label study by Hanusch et al., the decrease in core body temperature measured over five days following whole-body hyperthermia was correlated with a reduction in depression scores.
- context In clinical trials of whole-body hyperthermia for depression, heating sessions lasted approximately 107 minutes on average in the Janssen protocol and two hours in the Hanusch protocol.