Tai Chi Intervention for Chinese Americans With Depression
Tai Chi Intervention for Chinese Americans With Depression
The purpose of this study is to conduct a pilot randomized controlled trial (RCT) that
 provides the feasibility, safety, and preliminary efficacy data required to design a large
 scale trial evaluating Tai Chi for Chinese Americans with major depressive disorder (MDD) who
 are not on antidepressant medications.
Aim #1: To evaluate the feasibility and safety of conducting a RCT of Tai Chi for Chinese
 American adults with MDD who are not on antidepressant medications. The investigators
 hypothesize that: a) the investigators can develop a Tai Chi intervention and
 depression-related measurement protocol for Chinese Americans with MDD; b) the investigators
 will be able to recruit non-pharmacologically treated Chinese Americans with MDD to
 participate in a randomized controlled Tai Chi study; c) participants will be compliant with
 the Tai Chi intervention and all testing protocols; d) the Tai Chi intervention will be safe
 and study staff will be able to effectively monitor participants' depressive symptoms and
 assure their safety during the study.

 Aim #2: To collect preliminary data on the efficacy of a 12-week Tai Chi group intervention
 for Chinese Americans with MDD who are not on antidepressant medications to determine the
 effect size needed for a definitive RCT. The investigators hypothesize that at the conclusion
 of 12-weeks, Tai Chi participants, as compared to control subjects, will demonstrate a)
 greater improvement in depressive symptoms (Hamilton Depression Severity Index-17, Beck
 Depression Inventory), b) greater improvement in functional status, general health, and well
 being (Clinical Global Impressions Scale, The SF-36 Health Survey (SF-36®) for social
 functioning, Exercise Self-Efficacy, Mindfulness), and c) greater social support
 (Multidimensional Scale of Perceived Social Support).

 Aim #3: To characterize participants' experience in a trial of Tai Chi for Chinese Americans
 with MDD in order to optimally design a subsequent, more definitive study. Using mixed
 methods (qualitative and quantitative analyses), the investigators will identify the
 ethnocultural experience of Tai Chi among Chinese Americans with MDD, assess whether they
 view Tai Chi a more culturally acceptable alternative to conventional antidepressant therapy,
 explore the facilitators and barriers to adherence to the Tai Chi training protocol, identify
 characteristics of responders and non-responders to the Tai Chi intervention, and assess
 participants' willingness/intention to continue practice of Tai Chi beyond the study period.
 The investigators hypothesize that a) characteristics such as severity of illness, age,
 co-morbidities, and education level may distinguish responders from non-responders; b)
 participants with greater levels of class attendance and home practice will exhibit greater
 improvements in depressive symptoms; and c) participants who continue to practice Tai Chi
 after the 12-week training will maintain clinical improvements in depressive symptoms and a
 lower rate of relapse at the end of 3 additional months of follow-up compared to those who do
 not continue Tai Chi practice.
Inclusion Criteria:

 -  Self-identified as being of Chinese ethnicity and fluent in Mandarin and/or Cantonese

 -  18-80 years of age

 -  Satisfy DSM-IV criteria for MDD

 -  Baseline score of 14-20 on the 17-item Hamilton Rating Scale for Depression (HAM-D-17)

 -  No regular (≥ 3 times/week for ≥ 2 months) Tai Chi training/practice or other forms of
 mind-body intervention in the past 6 months

 Exclusion Criteria:

 -  Primary psychiatric diagnosis other than MDD

 -  History of psychosis, mania, or severe cluster B personality disorder, active ETOH or
 substance abuse/dependency disorder in the past 6 months

 -  Unstable medical conditions as judged by investigators

 -  Use or plan to use confounding treatments, including antidepressants and CAM
 treatments thought to have beneficial effects on mood, such as St. John's Wort,
 S-Adenosyl methionine (SAMe), omega-3 fatty acids, light therapy, conventional
 psychotherapy, mind-body interventions (e.g. Qigong, mindfulness training, muscle
 relaxation training, etc.)

 -  Current active suicidal or self-injurious potential necessitating immediate treatment

 -  Women who are pregnant