Background: Morbid thoughts are a dangerous cognitive problem that can lead to suicide. It has been documented that educational lifestyle programs can improve metabolic markers, we study the effect in the psychological realm. This study documents the response of an 8-week lifestyle program on depression levels and morbid thoughts.
Methods: Participants from 5 continents who finished a depression program were studied. Those who chose to participate met once a week for 8 weeks for a 2 hour program. It consisted of a 45 minute DVD presentation followed by a small group discussion, work assignments were given at every session. This program focused on educating participants on healthy behaviors such as exercise, plant-based diets, sleep hygiene, thought control and others. Cooking classes and practical exercises helped teach the principles. Each participant answered at the beginning of the program and at the end of the program the Depression and Anxiety Assessment Test. It assessed depression level based on DSM-5 [The Diagnostic and Statistical Manual of Mental Disorders Volume 5]. No questions were asked about individuals' treatment of depression. The depression was classified according to DSM-5 into 4 categories as none (0-6), mild (7-10), moderate (11-19) or severe (20 or more). The test also inquired the frequency of morbid thoughts, which were defined as thinking about death often, considering harming yourself or others. The degree of morbid thoughts were ranked from A-D ([A] having none or rare; [B] having them 1/4 of the days; [C] being 1/2 of the days; [D] being almost every day in a period of 2 weeks).
Results: From 5997 participants that finished the 8 week program the mean age was 52.3, SD 15.1, and n= 4209 (70.1%) were female. From this group, n=1924 (32%) participants reported some level of morbid thoughts. Of the morbid thought group, the depression average before the program was 17.7, SD 6.2, median 19, mode 22. At the end of the 8 week program, the depression average of the same group was 9.6, SD 6.5, median 9, mode 5. The pair t-test of depression scores was significant with a t=50.26, p<.001. The levels of morbid thoughts at the beginning was A n=4073, B n=919, C n=587, D=418, and by the end A n=5180, B n=478, C n=236 and D n=103.
Conclusion: The educational intervention effectively improves this worrisome symptom decreasing even the everyday morbid thoughts therefore decreasing the risk of suicide. The emphasis of the program is to make the lifestyle changes permanent. A long term study is being planned to investigate how the changes continue on the long term.