The Combined Treatment of Foot Bath and Antidepressant Reduces the Depressive Symptoms and Suicidal Ideation

合併足浴與抗憂鬱劑可快速降低憂鬱以及自殺意念

許崇智(Chung-Chih Hsu)；戴月明(Yueh-Ming Tai)；楊立光(Li-Kung Yang)；楊斯年(Szu-Nian Yang)

warm-water foot-bath ； depression ； anxiety ； suicidal ideation ； 溫水足浴 ； 憂鬱 ； 焦慮自殺意念

台灣精神醫學

32卷3期（2018 / 09 / 01）

217 - 224+iv

英文

Background: The current main treatment of depression and suicidal ideation is to use the antidepressant and psychotherapy. But, it takes two to four weeks to show clinical responses. The warm-water foot-bath is an adjuvant treatment to choose. The effects to lower depression severity and suicidal ideation have been demonstrated before. Methods: We used 40°C warm water foot bath, 3 times a week, to explore the effect on depression, anxiety, and the suicidal ideation. Furthermore, we also monitored the heart rate as the physiological parameters during the intervention. Results: This study revealed that the foot bath significantly improved the severity of depression and suicidal ideation (p ＜ 0.05), which measured by Beck’s Depressive Inventory and Brief Suicidal Rating Scale. The lowering of the anxiety severity, measured by Beck's anxiety inventory, was found to be correlated to the times of the foot bath (p ＜ 0.05). Conclusion: In line with other studies, this study confirmed the improved effects of warm-water foot-bath on depression, anxiety and suicidal ideation. But increasing the study sample size in the future is warranted.

目的：目前臨床對於憂鬱合併焦慮疾患以抗憂鬱劑為主要治療方式，但其需2-4週時間出現治療反應，而其他輔助療法仍少。利用溫度改變改善憂鬱狀況已在過去被證實。方法：本文收案14年輕男性，分A、B兩組以交叉研究方式(cross-over)，利用攝氏40度水溫足浴介入，一週三次，以探討對於憂鬱、焦慮以及自殺意念嚴重程度變化。另以心跳監測足浴過程中生理狀況改變，探討適當足浴時間設定。結果：研究發現溫水足浴介入在以貝氏憂鬱量表及簡式自殺量表所量測的憂鬱及自殺意念均有顯著的改善效果(p ＜ 0.05)，對於焦慮方面則是隨著介入次數本身增加而有顯著改善(p ＜ 0.05)。討論：本研究證實溫水足浴可佐助抗鬱劑在短期減少憂鬱症狀及自殺意念。但未來仍需收集更多病人受試者證實此一論述。

1. Chou, HY,Tai, YM,Hung, HT(2015).Comparing the effects of clozapine with non-clozapine on heart rate variability in patients with schizophrenia.Taiwanese Journal of Psychiatry,29,253-261.
   連結：
2. Agudelo, LZ,Femenía, T,Orhan, F(2014).Skeletal muscle PGC-1alpha1 modulates kynurenine metabolism and mediates resilience to stress-induced depression.Cell,159,33-45.
3. Becker, BE(2009).Aquatic therapy: scientific foundations and clinical rehabilitation applications.PM R,1,859-872.
4. Blumenthal, JA,Babyak, MA,Moore, KA(1999).Effects of exercise training on older patients with major depression.Arch Intern Med,159,2349-2356.
5. Bruce, E,Becker, KH,Rebekah, K(2009).Biophysiologic effects of warm water immersion.Int J Aquatic Res Edu,3,14-15.
6. Clarke, DM,Currie, KC(2009).Depression, anxiety and their relationship with chronic diseases: a review of the epidemiology, risk and treatment evidence.Med J Aust,190,54-60.
7. Coryell, W(2000).Augmentation strategies for inadequate antidepressant response: a review of placebo-controlled studies.Ann Clin Psychiatry,12,141-146.
8. Craft, LL,Perna, FM(2004).The benefits of exercise for the clinically depressed.Prim Care Companion J Clin Psychiatry,6,104-111.
9. Guest, S,Grabenhorst, F,Essick, G(2007).Human cor tical representation of oral temperature.Physiol Behav,92,975-984.
10. Gusi, N,Tomas-Carus, P,Häkkinen, A(2006).Exercise in waist-high warm water decreases pain and improves health-related quality of life and strength in the lower extremities in women with fibromyalgia.Arthritis Rheum,55,66-73.
11. Haddad, PM,Talbot, PS,Anderson, IM(2015).Managing inadequate antidepressant response in depressive illness.Br Med Bull,115,183-201.
12. Janssen, CW,Lowry, CA,Mehl, MR(2016).Wholebody hyperthermia for the treatment of major depressive disorder: a randomized clinical trial.JAMA Psychiatry,73,789-795.
13. Lang, M,Krátký, J,Shaver, JH(2015).Effects of anxiety on spontaneous ritualized behavior.Curr Biol,25,1892-1897.
14. Mehdi Naseri, AR,Batool, N,Mehdi, S,Maryam, MF(2012).Effects of foot baths on sleep in ICU patients.J Crit Care Nurs,88,59-64.
15. Mooventhan, A,Nivethitha, L(2014).Scientific evidence-based effects of hydrotherapy on various systems of the body.N Am J Med Sci,6,199-209.
16. Naumann, J,Grebe, J,Kaifel, S(2017).Effects of hyperthermic baths on depression, sleep and heart rate variability in patients with depressive disorder: a randomized clinical pilot trial.BMC Complement Altern Med,17,172.
17. Quello, SB,Brady, KT,Sonne, S(2005).Mood disorders and substance use disorder: a complex comorbidity.Sci Pract Perspect,3,13-21.
18. Rolls, ET(2010).The affective and cognitive processing of touch, oral texture, and temperature in the brain.Neurosci Biobehav Rev,34,237-245.
19. Saeki, Y(2000).The effect of foot-bath with or without the essential oil of lavender on the autonomic nervous system: a randomized trial.Complement Ther Med,8,2-7.
20. Shevchuk, NA(2008).Adapted cold shower as a potential treatment for depression.Med Hypotheses,70,995-1001.
21. Spalding, NJ(2003).Reducing anxiety by pre-operative education: make the future familiar.Occup Ther Int,10,278-293.
22. Sullivan, PF,Neale, MC,Kendler, KS(2000).Genetic epidemiology of major depression: review and meta-analysis.Am J Psychiatry,157,1552-1562.
23. Sung, EJ,Tochihara, Y(2000).Effects of bathing and hot footbath on sleep in winter.J Physiol Anthropol Appl Human Sci,19,21-27.
24. Trivedi, MH,Rush, AJ,Wisniewski, SR(2006).Evaluation of outcomes with citalopram for depression using measurement-based care in STAR*D: implications for clinical practice.Am J Psychiatry,163,28-40.
25. van Praag, HM(2005).Can stress cause depression?.World J Biol Psychiatry,6,5-22.

1. 蔡培癸、蔡文鐘、劉雪娥、谷大為、李婉菁(2019)。溫水足浴對中風病患疲憊與睡眠品質之成效探討。長庚護理，30(4)，445-458。
2. (2024)。Analysis of Heart Rate Variability in Young Male Adults with Depression and Anxiety during Warm-water Footbath。臺灣精神醫學，38(1)，25-30。