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Hirschbeck A, Schwegler H, Solujanova L, Kossmann D, Hasan A, Röh A. [Sports Programs for Mental Illness: How Mental Health Professionales Can Provide Effective Support]. PSYCHIATRISCHE PRAXIS 2025; 52:166-170. [PMID: 39832769 DOI: 10.1055/a-2506-9431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2025]
Abstract
Despite the positive effects of physical activity, people with mental illness often remain inactive. Exercise recommendations are inconsistent and challenging to follow.This study assessed exercise behavior and the need for programs during and after inpatient treatment to develop clinical recommendations.Patients from the psychiatric clinic at the University of Augsburg were recruited via flyer/QR-Code.A total of 47 patients participated in this survey. Over 70% exercise regularly, and over 70% are interested in peer-sports-groups with low-threshold conditions (e.g. no prior registration required). Strength training and moderate intensity training were favored over endurance sports.Our findings complement the World Health Organization's exercise recommendations. Strength training programs and accessible options may promote physical activity in this population.
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Affiliation(s)
- Anna Hirschbeck
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Medizinische Fakultät, Universität Augsburg, Bezirkskrankenhaus Augsburg
| | - Hannah Schwegler
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Medizinische Fakultät, Universität Augsburg, Bezirkskrankenhaus Augsburg
| | - Ludmila Solujanova
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Medizinische Fakultät, Universität Augsburg, Bezirkskrankenhaus Augsburg
| | - David Kossmann
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Medizinische Fakultät, Universität Augsburg, Bezirkskrankenhaus Augsburg
| | - Alkomiet Hasan
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Medizinische Fakultät, Universität Augsburg, Bezirkskrankenhaus Augsburg
- Deutsches Zentrum für Psychische Gesundheit (DZPG), Standort München/Augsburg
| | - Astrid Röh
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Medizinische Fakultät, Universität Augsburg, Bezirkskrankenhaus Augsburg
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Chaves AR, Cuda J, Shim S, Drodge J, Nasr Y, Brender R, Antochi R, McMurray L, Pilutti LA, Tremblay S. Optimizing antidepressant benefits: Effect of theta burst stimulation treatment in physically active people with treatment-resistant depression. J Affect Disord 2024; 367:876-885. [PMID: 39260582 DOI: 10.1016/j.jad.2024.09.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 07/16/2024] [Accepted: 09/08/2024] [Indexed: 09/13/2024]
Abstract
Theta burst stimulation (TBS) is a promising therapy for treatment-resistant major depressive disorder (MDD), but a significant proportion of individuals do not respond adequately, necessitating alternative approaches. This study explores whether individuals meeting minimum recommended physical activity levels demonstrate better responses to TBS compared to physically inactive individuals. Using data from a randomized controlled trial (n = 43), participants were categorized as physically active or inactive based on baseline International Physical Activity Questionnaire (IPAQ) scores. Depression scores (Hamilton Rating Scale for Depression, 17-item; HRSD-17) were assessed at baseline, 4, and 6 weeks of TBS treatment. A significant Time X Group effect adjusted for age and baseline depression was observed. Physically active individuals consistently exhibited lower depression scores across time points. At 4 and 6 weeks, there was a significant increase in between-group differences, indicating that the physically active group derived greater benefits from treatment. At 6 weeks, a significantly higher proportion of responders (≥50 % HRSD-17 reduction) were observed in the physically active compared to inactive group. Physical activity significantly contributed to regression and logistic models predicting treatment response. These findings support the potential role of baseline physical activity in enhancing TBS therapy for MDD.
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Affiliation(s)
- Arthur R Chaves
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, 200 Lees Ave Building FHS, Ottawa, ON K1S 5S9, Canada; The Royal's Institute of Mental Health Research, 1145 Carling Ave, Ottawa, ON K1Z 7K4, Canada
| | - Jennifer Cuda
- The Royal's Institute of Mental Health Research, 1145 Carling Ave, Ottawa, ON K1Z 7K4, Canada
| | - Stacey Shim
- The Royal's Institute of Mental Health Research, 1145 Carling Ave, Ottawa, ON K1Z 7K4, Canada
| | - Jessica Drodge
- The Royal's Institute of Mental Health Research, 1145 Carling Ave, Ottawa, ON K1Z 7K4, Canada
| | - Youssef Nasr
- The Royal's Institute of Mental Health Research, 1145 Carling Ave, Ottawa, ON K1Z 7K4, Canada
| | - Ram Brender
- Department of Psychiatry, University of Ottawa, Roger Guindon Hall, 451 Smyth Rd #2044, Ottawa, ON K1H 8M5, Canada; Royal Ottawa Mental Health Centre, 1145 Carling Ave, Ottawa, ON K1Z 7K4, Canada
| | - Ruxandra Antochi
- Department of Psychiatry, University of Ottawa, Roger Guindon Hall, 451 Smyth Rd #2044, Ottawa, ON K1H 8M5, Canada; Royal Ottawa Mental Health Centre, 1145 Carling Ave, Ottawa, ON K1Z 7K4, Canada
| | - Lisa McMurray
- Department of Psychiatry, University of Ottawa, Roger Guindon Hall, 451 Smyth Rd #2044, Ottawa, ON K1H 8M5, Canada; Royal Ottawa Mental Health Centre, 1145 Carling Ave, Ottawa, ON K1Z 7K4, Canada
| | - Lara A Pilutti
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, 200 Lees Ave Building FHS, Ottawa, ON K1S 5S9, Canada; The University of Ottawa Brain and Mind Research Institute, Roger Guindon Hall, 451 Smyth Rd #2044, Ottawa, ON K1H 8M5, Canada
| | - Sara Tremblay
- The Royal's Institute of Mental Health Research, 1145 Carling Ave, Ottawa, ON K1Z 7K4, Canada; The University of Ottawa Brain and Mind Research Institute, Roger Guindon Hall, 451 Smyth Rd #2044, Ottawa, ON K1H 8M5, Canada; Département de psychoéducation et de psychologie, Université du Québec en Outaouais, 283 Alexandre-Taché Boul, Gatineau, QC J8X 3X7, Canada; Department of Neuroscience, Carleton University, 1125 Colonel By Dr, Ottawa, ON K1S 5B6, Canada; Department of Cellular and Molecular Medicine, University of Ottawa, Roger Guindon Hall, 451 Smyth Rd #2044, Ottawa, ON K1H 8M5, Canada.
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Rethorst CD, Trombello JM, Chen PM, Carmody TJ, Goodman LC, Lazalde A, Trivedi MH. Pilot evaluation on an adapted tele-behavioral activation to increase physical activity in persons with depression: a single-arm pilot study. BMC Psychol 2024; 12:643. [PMID: 39522018 PMCID: PMC11549759 DOI: 10.1186/s40359-024-02053-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 10/01/2024] [Indexed: 11/16/2024] Open
Abstract
BACKGROUND Physical activity has the potential to improve physical and mental health outcomes of persons with depression. However, feasible and acceptable strategies to integrate physical activity interventions into real-world settings are needed. OBJECTIVE To assess the feasibility and acceptability of a manualized Behavioral Activation intervention aimed to increase physical activity in persons with depression (defined as a PHQ-9 score ≥ 10). METHODS A single-arm pilot study was conducted. The intervention consisted of 8 tele-therapy sessions delivered over a 10-week period. Measures of feasibility included screening, enrollment, intervention adherence, outcome data availability, and intervention fidelity. Acceptability was assessed with a post-intervention survey and qualitatively through focus groups and interviews. Preliminary efficacy of the intervention was assessed by evaluating pre-to-post changes in physical activity and depressive symptoms. RESULTS All feasibility metrics exceeded predetermined feasibility goal metrics with the exception of Fitbit wear and screening rate, which was due to a greater than anticipated enrollment rate. Participants (n = 15) reported perceived benefits from the intervention and convenience in attending tele-therapy sessions. Depressive symptoms, as measured by the PHQ-9 improved (16.8 at enrollment to 10.1 post intervention, Cohen's d = 1.13). Self-reported moderate-to-vigorous physical activity (MVPA) increased from 22.0 min/week at baseline to 36.67 min/week post-intervention (d = 0.58). Physical activity as measured by the Fitbit showed little change (daily step 5543.29 during Week 1 to 6177.48 during Week 10, (d = 0.14); MVPA 21.23 min/week during Week 1 to 19.22 at Week 10 (d = 0.0.06). CONCLUSIONS Results of the pilot study suggest the intervention is feasible to deliver and acceptable to participants. Preliminary results suggest the intervention may be effective in improving depressive symptoms and increasing self-reported physical activity. TRIAL REGISTRATION ClinicalTrials.gov NCT04990401, Registered July 21, 2021.
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Affiliation(s)
- Chad D Rethorst
- Institute for Advancing Health Through Agriculture, Texas A&M University System, Dallas, TX, USA.
- Texas A&M Agrilife Research and Extension Center - Dallas, 17360 Coit Rd, Dallas, TX, 75252, USA.
| | - Joseph M Trombello
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Patricia M Chen
- O'Donnell School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Thomas J Carmody
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Lynnel C Goodman
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Madhukar H Trivedi
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Fairag M, Alzahrani SA, Alshehri N, Alamoudi AO, Alkheriji Y, Alzahrani OA, Alomari AM, Alzahrani YA, Alghamdi SM, Fayraq A. Exercise as a Therapeutic Intervention for Chronic Disease Management: A Comprehensive Review. Cureus 2024; 16:e74165. [PMID: 39712722 PMCID: PMC11662992 DOI: 10.7759/cureus.74165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2024] [Indexed: 12/24/2024] Open
Abstract
This comprehensive review examines exercise as a therapeutic intervention for managing chronic diseases. It explores the physiological mechanisms behind physical activity's beneficial effects and its impact on various conditions, including cardiovascular disease, diabetes mellitus, obesity, and mental health disorders. Drawing from current literature and research findings, this review highlights how regular exercise significantly reduces mortality rates, improves disease outcomes, and enhances the overall quality of life for those with chronic illnesses. It discusses specific exercise recommendations for different conditions, emphasizing the importance of tailored physical activity programs. The review also addresses exercise's potential as a cost-effective and accessible treatment option, which may complement or, in some cases, reduce the need for pharmacological interventions. Ultimately, this review aims to equip healthcare professionals with a thorough understanding of exercise's therapeutic potential in chronic disease management, supporting the integration of physical activity into comprehensive treatment plans.
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Affiliation(s)
- Maryam Fairag
- Family Medicine, Makkah Healthcare Cluster, Makkah, SAU
| | - Saif A Alzahrani
- Preventive Medicine, King Abdulaziz Medical City, Jeddah, SAU
- Public Health, Ministry of Health, Riyadh, SAU
| | | | - Arjwan O Alamoudi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Yazeed Alkheriji
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Omar A Alzahrani
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Abdulrahman M Alomari
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | | | | | - Amer Fayraq
- Preventive Medicine, King Abdullah International Medical Research Center, Jeddah, SAU
- Preventive Medicine, King Abdulaziz Medical City, Jeddah, SAU
- Public Health, Ministry of Health, Riyadh, SAU
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Schilling R, Cody R, Kreppke JN, Faude O, Beck J, Brand S, Donath L, Hatzinger M, Imboden C, Lang U, Mans S, Mikoteit T, Oswald A, Schweinfurth-Keck N, Gerber M. Correspondence between the Simple Physical Activity Questionnaire (SIMPAQ) and accelerometer-based physical activity in inpatients treated for major depressive disorders in comparison to non-depressed controls. Front Sports Act Living 2024; 6:1447821. [PMID: 39308892 PMCID: PMC11412836 DOI: 10.3389/fspor.2024.1447821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Accepted: 08/07/2024] [Indexed: 09/25/2024] Open
Abstract
Introduction Major depressive disorders (MDD) are a leading health concern worldwide. While first line medication treatments may fall short of desired therapeutic outcomes, physical activity (PA) interventions appear to be a promising and cost-effective add-on to improve symptoms of depression. This study aimed to address challenges in the assessment of PA in inpatients treated for MDD by examining the correspondence of self-reported and accelerometer-based PA. Methods In 178 inpatients treated for MDD (mean age: M = 41.11 years, SD = 12.84; 45.5% female) and 97 non-depressed controls (mean age: M = 35.24 years, SD = 13.40; 36.1% female), we assessed self-reported PA via the Simple Physical Activity Questionnaire (SIMPAQ) for one week, followed by a week where PA was monitored using an accelerometer device (Actigraph wGT3x-BT). Additionally, we examined correlations between PA levels assessed with the SIMPAQ and exercise determinants in both groups. Results Descriptively, inpatients treated for MDD showed lower levels of light PA on accelerometer-based measures, whereas they self-reported increased levels of certain types of PA on the SIMPAQ. More importantly, there was only a small degree of correspondence between self-reported and actigraphy-based PA levels in both in patients (r = 0.15, p < 0.05) and controls (r = 0.03, ns). Only few significant correlations were found for self-reported PA (SIMPAQ subscores) and perceived fitness, whereas self-reported PA and estimated VO2max were unrelated. Furthermore, only weak (and mostly statistically non-significant) correlations were found between exercise determinants and SIMPAQ-based exercise behavior in both populations. Discussion Our findings emphasize the intricate challenges in the assessment of PA, not only in inpatients treated for MDD, but also in non-depressed controls. Our findings also underline the necessity for a diversified data assessment. Further efforts are needed to refine and improve PA questionnaires for a more accurate data assessment in psychiatric patients and healthy controls.
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Affiliation(s)
- René Schilling
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Robyn Cody
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Jan-Niklas Kreppke
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Oliver Faude
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | | | - Serge Brand
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital of the University of Basel, Basel, Switzerland
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
- Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Lars Donath
- Department of Training Intervention Research, German Sport University Cologne, Cologne, Germany
| | - Martin Hatzinger
- Psychiatric Services Solothurn and Faculty of Medicine, University of Basel, Solothurn, Switzerland
| | - Christian Imboden
- Private Clinic Wyss, Münchenbuchsee, Switzerland
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Undine Lang
- Adult Psychiatric Clinics (UPKE), University of Basel, Basel, Switzerland
| | - Sarah Mans
- Private Clinic Wyss, Münchenbuchsee, Switzerland
| | - Thorsten Mikoteit
- Psychiatric Services Solothurn and Faculty of Medicine, University of Basel, Solothurn, Switzerland
| | - Anja Oswald
- Psychiatric Clinic Sonnenhalde, Riehen, Switzerland
| | - Nina Schweinfurth-Keck
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital of the University of Basel, Basel, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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Sauer F, Schmitz-Buhl M, Gouzoulis-Mayfrank E. [Effects of a Motivational Intervention on the Effectiveness and Sustainability of Sports and Exercise Therapy in Inpatient Psychiatric Care]. Psychother Psychosom Med Psychol 2024; 74:323-330. [PMID: 38710216 DOI: 10.1055/a-2298-8510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
OBJECTIVE Reinforcement and sustainability of sports and exercise therapy in inpatient depression treatment. METHODS Randomized controlled study with 3 measurement times: t0 admission to the study, t1 after four weeks, t2 two months after discharge. 96 inpatients with depressive disorders (ICD-10 F32, F33) were randomly assigned to an intervention group (IG) or a control group (KG). In addition to sports and exercise therapy (KG), the IG received an educational and motivational session on the importance of sports and exercise, as well as a motivational final discussion. RESULTS Endurance performance and physical fitness improved more significantly in the IG than in the CG over the 3 measurement times. The motivational final discussion was rated as more helpful. DISCUSSION The intervention was well accepted by the patients and partially increased the effects of sports and exercise therapy. Not only psychological aspects of depression treatment were influenced, but also measurable physical effects. CONCLUSION The practical and time-efficient motivational intervention in inpatient psychiatric care can complement sports and exercise therapy for depressive patients.
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Affiliation(s)
- Frank Sauer
- LVR-Klinik Köln, Akademisches Lehrkrankenhaus der Universität zu Köln, Köln, Germany
| | - Mario Schmitz-Buhl
- LVR-Klinik Köln, Akademisches Lehrkrankenhaus der Universität zu Köln, Köln, Germany
| | - Euphrosyne Gouzoulis-Mayfrank
- LVR-Klinik Köln, Akademisches Lehrkrankenhaus der Universität zu Köln, Köln, Germany
- Fachliche Direktorin Forschung, LVR-Institut für Forschung und Bildung, Köln, Germany
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Wolf S, Seiffer B, Zeibig JM, Frei AK, Studnitz T, Welkerling J, Meinzinger E, Bauer LL, Baur J, Rosenstiel S, Fiedler DV, Helmhold F, Ray A, Herzog E, Takano K, Nakagawa T, Günak MM, Kropp S, Peters S, Flagmeier AL, Zwanzleitner L, Sundmacher L, Ramos-Murguialday A, Hautzinger M, Sudeck G, Ehring T. A transdiagnostic group exercise intervention for mental health outpatients in Germany (ImPuls): results of a pragmatic, multisite, block-randomised, phase 3 controlled trial. Lancet Psychiatry 2024; 11:417-430. [PMID: 38670127 DOI: 10.1016/s2215-0366(24)00069-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 02/23/2024] [Accepted: 02/29/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Globally, mental health conditions pose a substantial burden of disease. Despite the availability of evidence-based pharmacological and psychological treatments, the symptoms of a substantial subgroup of patients do not respond to these interventions, and only a minority of patients have access to them. This study aimed to assess the efficacy of ImPuls, a 6-month transdiagnostic group exercise intervention, plus treatment-as-usual, compared with treatment-as-usual alone in outpatients with various mental disorders. METHODS In this pragmatic, two-arm, multisite, randomised controlled trial in Germany, ten outpatient rehabilitative and medical care facilities were involved as study sites. Participants were outpatients diagnosed according to ICD-10 with one or more of the following disorders based on structured clinical interviews: moderate or severe depression, primary insomnia, post-traumatic stress disorder (PTSD), panic disorder, or agoraphobia. Participants were required to be aged between 18 years and 65 years, insured by the health insurers Allgemeine Ortskrankenkasse Baden-Württemberg or Techniker Krankenkasse, fluent in German, and without medical contraindications for exercise. Blocks of six participants were randomly allocated to ImPuls plus treatment-as-usual or treatment-as-usual alone (allocation ratio: 1:1), stratified by study site. The randomisation sequence was generated by an external data manager. The team responsible for data collection and management was masked to the randomisation sequence. The ImPuls intervention comprised evidence-based outdoor exercises lasting 30 min, and aimed at achieving at least moderate intensity. It also incorporated behavioural change techniques targeting motivational and volitional determinants of exercise behaviour. Treatment-as-usual was representative of typical outpatient health care in Germany, allowing patients access to any standard treatments. The primary outcome was global symptom severity at 6 months after randomisation, measured using self-report on the Brief Symptom Inventory (BSI-18) and analysed in the intention-to-treat sample. No individuals with lived experience of mental illness were involved in conducting the study or writing the final publication. Safety was assessed in all participants. The trial was registered with the German Clinical Trials Register (DRKS00024152) with a completion date of June 30, 2024. FINDINGS 600 patients provided informed consent, were recruited to the study, and underwent a diagnostic interview between Jan 1, 2021, and May 31, 2022. Following this, 199 were excluded on the basis of inclusion and exclusion criteria and one withdrew consent during the baseline assessment. Of the 400 eligible participants, 284 (71%) self-identified as female, 106 (27%) self-identified as male, and nine (2%) self-identified as other. The mean age was 42·20 years (SD 13·23; range 19-65). Ethnicity data were not assessed. 287 (72%) participants met the criteria for moderate or severe depression, 81 (20%) for primary insomnia, 37 (9%) for agoraphobia, 46 (12%) for panic disorder, and 72 (18%) for PTSD. 199 participants were allocated to the intervention group of ImPuls plus treatment-as-usual and 201 to the control group of treatment-as-usual alone. 38 (19%) participants did not receive the minimum ImPuls intervention dose. ImPuls plus treatment-as-usual demonstrated superior efficacy to treatment-as-usual alone in reducing global symptom severity, with an adjusted difference on BSI-18 of 4·11 (95% CI 1·74-6·48; d=0·35 [95% CI 0·14-0·56]; p=0·0007) at 6 months. There were no significant differences in the total number of adverse events or serious adverse events between the two groups. There was one serious adverse event (male, torn ligament) related to the intervention. INTERPRETATION ImPuls is an efficacious transdiagnostic adjunctive treatment in outpatient mental health care. Our findings suggest that exercise therapy should be implemented in outpatient mental health care as an adjunctive transdiagnostic treatment for mental disorders such as depression, insomnia, panic disorder, agoraphobia, and PTSD. Transdiagnostic group exercise interventions might ameliorate the existing disparity in care provision between the many individuals in need of evidence-based treatment and the few who are receiving it. FUNDING The German Innovation Fund of the Federal Joint Committee of Germany.
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Affiliation(s)
- Sebastian Wolf
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany.
| | - Britta Seiffer
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
| | - Johanna-Marie Zeibig
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
| | - Anna Katharina Frei
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
| | - Thomas Studnitz
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
| | - Jana Welkerling
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
| | - Edith Meinzinger
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
| | - Leonie Louisa Bauer
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
| | - Julia Baur
- Faculty of Science, Psychological Institute, Department of Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Stephanie Rosenstiel
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
| | - David Victor Fiedler
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
| | - Florian Helmhold
- Medical Faculty, Institute of Medical Psychology and Behavioural Neurobiology, University of Tübingen, Tübingen, Germany; International Max Planck Research School for Cognitive and Systems Neuroscience, Tübingen, Germany
| | - Andreas Ray
- Medical Faculty, Institute of Medical Psychology and Behavioural Neurobiology, University of Tübingen, Tübingen, Germany
| | - Eva Herzog
- Department of Psychology, Division of Clinical Psychology and Psychological Treatment, LMU Munich, Munich, Germany
| | - Keisuke Takano
- Department of Psychology, Division of Clinical Psychology and Psychological Treatment, LMU Munich, Munich, Germany; Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, Japan
| | - Tristan Nakagawa
- Department of Psychology, Division of Clinical Psychology and Psychological Treatment, LMU Munich, Munich, Germany
| | - Mia Maria Günak
- Department of Psychology, Division of Clinical Psychology and Psychological Treatment, LMU Munich, Munich, Germany
| | - Saskia Kropp
- Chair of Health Economics, Technical University Munich, Munich, Germany
| | - Stefan Peters
- German Association for Health-Enhancing Physical Activity and Exercise Therapy, Hürth-Efferen, Germany; Department of Human Sciences, Institute of Sport Science, Bundeswehr University Munich, Munich, Germany
| | | | | | - Leonie Sundmacher
- Chair of Health Economics, Technical University Munich, Munich, Germany
| | - Ander Ramos-Murguialday
- Medical Faculty, Institute of Medical Psychology and Behavioural Neurobiology, University of Tübingen, Tübingen, Germany; Department of Neurology & Stroke, University of Tübingen, Tübingen, Germany; Tecnalia, Basque Research and Technology Alliance, San Sebastián, Spain; Athenea Neuroclinics, San Sebastián, Spain
| | - Martin Hautzinger
- Faculty of Science, Psychological Institute, Department of Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Gorden Sudeck
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
| | - Thomas Ehring
- Department of Psychology, Division of Clinical Psychology and Psychological Treatment, LMU Munich, Munich, Germany; German Center for Mental Health, Munich, Germany
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Yu L, Zhang X, Li W. Causal effects of various types of physical activities on psychiatric disorders: a Mendelian randomization study. Front Sports Act Living 2024; 6:1331586. [PMID: 38500549 PMCID: PMC10944951 DOI: 10.3389/fspor.2024.1331586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 02/21/2024] [Indexed: 03/20/2024] Open
Abstract
Background Psychiatric disorders (PD) pose a significant burden, with vast prevalence and mortality, inflicting substantial costs on individuals and society. Despite its widespread prevalence, the complex pathogenesis of PD remains elusive, leading to limited and challenging therapeutic development. An emerging risk factor for chronic diseases, prolonged sedentary behavior, contrasts with the therapeutic potential of exercise, regardless of its intensity, for various ailments, including PD. Yet, the diversity in exercise modalities and intensities may offer varied impacts on health. This study, leveraging Mendelian Randomization (MR), seeks to investigate the causal relationship between exercise and PD, aiming to elucidate the optimal exercise modality and intensity for PD mitigation while addressing potential confounders. Methods This study employed a Mendelian randomization analysis using the genome-wide association study (GWAS) database to investigate the causal relationship between types of physical activity and psychiatric disorders. Sensitivity analysis was conducted to demonstrate the reliability and robustness of the results. Results In the past 4 weeks, engaging in a substantial amount of DIY physical activity was found to have a causal relationship with psychiatric disorders (IVW: OR = 0.228, 95% CI: 0.113-0.461, P = 0.000038). As for the types of exercises, there may be a potential causal association between aerobic training (including swimming, cycling, fitness, and bowling) and psychiatric disorders (IVW: OR = 0.322, 95% CI = 0.148-0.704, P = 0.004). However, there was no causal relationship found between mild DIY physical activity and psychiatric disorders (IVW: OR = 0.918, 95% CI = 0.417-2.021, P = 0.831). Furthermore, it seems that there is no causal relationship between vigorous exercise and psychiatric disorders (IVW: OR = 2.705, 95% CI = 0.081-3.419, P = 0.578). Conclusion Our study confirms that only a certain level of training activity can have a protective effect on psychiatric disorders, while mild physical activity or vigorous training does not have an impact on psychiatric disorders.
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Affiliation(s)
- Lan Yu
- Department of Gynaecology, Dalian Women and Children’s Medical Center (Group), Dalian, Liaoning, China
| | - Xu Zhang
- Department of Clinical Medicine, Harbin Medical University, Harbin, Heilongjiang, China
- Department of Clinical Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Wangshu Li
- Department of Gynaecology, Dalian Women and Children’s Medical Center (Group), Dalian, Liaoning, China
- Department of Key Laboratory for Early Diagnosis and Biotherapy of Malignant Tumors in Children and Women in Liaoning Province, Dalian, Liaoning, China
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9
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Sun S, Armada-da-Silva PAS, Shao Y. Editorial: Exercise and diet: strategies and prescriptions to improve mental and cognitive health. Front Psychiatry 2024; 14:1347233. [PMID: 38239904 PMCID: PMC10794546 DOI: 10.3389/fpsyt.2023.1347233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 12/01/2023] [Indexed: 01/22/2024] Open
Affiliation(s)
- Shengyan Sun
- School of Physical Education, Huzhou University, Huzhou, China
| | - Paulo A. S. Armada-da-Silva
- Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
| | - Yongcong Shao
- School of Psychology, Beijing Sport University, Beijing, China
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10
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Li FB, Lu P, Wu HT, Wang MH, Wang JD. Effects of Music, Massage, Exercise, or Acupuncture in the Treatment of Depression Among College Students: A Network Meta-Analysis. Neuropsychiatr Dis Treat 2023; 19:1725-1739. [PMID: 37546518 PMCID: PMC10404055 DOI: 10.2147/ndt.s416643] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/24/2023] [Indexed: 08/08/2023] Open
Abstract
Objective To assess the therapeutic impacts of exercise, massage, and music interventions on college students experiencing depression by employing a mesh meta-analysis approach. This research intends to offer valuable insights to aid in the development of non-pharmaceutical treatment strategies for depression. Methods We conducted a thorough search across various databases including Cochrane, PubMed, Embase, Web of Science, CNKI, and Wanfang to explore the effects of music, massage, aerobic exercise, fitness Qigong, yoga, tai chi, ball games, strength training, dance, whole body vibration training, and high-intensity interval training on the treatment of depression in college students. The search period was from January 1, 2023, which marks the establishment of each database. Subsequently, a mesh meta-analysis was performed using the "Stata 15.1" software, incorporating outcome indicators from 24 included literature comprising a total of 1458 patients. Results Based on the ranking of the optimal intervention effects of various non-pharmaceutical methods, the order, from highest to lowest probability, was as follows: high-intensity interval training (96%), yoga (94.90%), dance (78.30%), music (73.30%), ball games (62.50%), strength training (51.70%), aerobic training (45.30%), tai chi (35.40%), vibration training (27.30%), massage (20.10%), qigong (14.30%), and no intervention (1.00%). This ranking aligns closely with the findings obtained from pairwise comparisons between different interventions. Conclusion High-intensity interval training is likely to yield the most effective therapeutic results for college students with depression. In the pairwise comparison of different interventions, High-intensity interval training is also better than most interventions. However, to establish its intervention effect more conclusively, further validation through additional high-quality randomized controlled trials is necessary.
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Affiliation(s)
- Fang-bo Li
- Graduate School, Guangzhou Sport University, Guangzhou, Guangdong, 510500, People’s Republic of China
| | - Ping Lu
- School of PE and Health, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510006, People’s Republic of China
| | - Hai-tao Wu
- Graduate School, Guangzhou Sport University, Guangzhou, Guangdong, 510500, People’s Republic of China
| | - Ming-han Wang
- Graduate School, Guangzhou Sport University, Guangzhou, Guangdong, 510500, People’s Republic of China
| | - Jing-dong Wang
- Graduate School, Guangzhou Sport University, Guangzhou, Guangdong, 510500, People’s Republic of China
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11
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Rethorst CD, Trombello JM, Chen P, Carmody TJ, Lazalde A, Trivedi MH. Adaption of tele-behavioral activation to increase physical activity in depression: Protocol for iterative development and evaluation. Contemp Clin Trials Commun 2023; 33:101103. [PMID: 37128575 PMCID: PMC10147965 DOI: 10.1016/j.conctc.2023.101103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/13/2023] [Accepted: 03/10/2023] [Indexed: 05/03/2023] Open
Abstract
Background Poor treatment outcomes, disease recurrence, and medical co-morbidities contribute to the significant burden caused by depressive disorders. Increasing physical activity in persons with depression has the potential to improve both depression treatment outcomes and physical health. However, evidence for physical activity interventions that can be delivered as part of depression treatment remains limited. This study will examine a Behavioral Activation teletherapy intervention adapted to include a specific focus on increasing physical activity. Methods The two-phase study will include a preliminary pilot study (n = 15) to evaluate and refine the manualized intervention using a mixed-methods approach followed by a single-arm study to evaluate feasibility and preliminary efficacy of the adapted BA teletherapy. Participants will be adults, age 18-64, with moderate to severe depressive symptoms (defined as a PHQ-9 score ≥10) and who currently engage in 90 min or less of moderate-to-vigorous physical activity. Individuals will be excluded if they have a current or past manic or hypomanic episode, psychosis, schizophrenia or schizophreniform disorder, or active suicidal ideation, or if not medically-cleared to exercise. The BA intervention will consist of 8 weekly sessions, followed by 2 bi-weekly booster sessions. Feasibility outcomes will include metrics of screening, enrollment, intervention adherence and fidelity, and participant retention. Intervention preliminary efficacy will be evaluated through assessment of changes in depressive symptoms and moderate-to-vigorous physical activity. Conclusion Data from this trial will be used to support the conduct of a randomized controlled trial to evaluate the efficacy of the adapted BA intervention.
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Affiliation(s)
- Chad D. Rethorst
- Institute for Advancing Health through Agriculture, Texas A&M Agrilife Research, Dallas, TX, USA
- Corresponding author. Texas A&M Agrilife Research and Extension Center, Dallas 17360 Coit Rd, Dallas, TX, 75252.
| | - Joseph M. Trombello
- Janssen Research and Development, Titusville, NJ, USA
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Patricia Chen
- Peter O'Donnell Jr. School of Public Health, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Thomas J. Carmody
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Madhukar H. Trivedi
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
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12
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Gerber M, Cody R, Beck J, Brand S, Donath L, Eckert A, Faude O, Hatzinger M, Imboden C, Kreppke JN, Lang UE, Mans S, Mikoteit T, Oswald A, Schweinfurth-Keck N, Zahner L, Ludyga S. Differences in Selective Attention and Inhibitory Control in Patients with Major Depressive Disorder and Healthy Controls Who Do Not Engage in Sufficient Physical Activity. J Clin Med 2023; 12:jcm12103370. [PMID: 37240475 DOI: 10.3390/jcm12103370] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/03/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Patients with major depressive disorder (MDD) are characterized by neurocognitive impairments and show deficits in various cognitive performance indicators, including executive function. We examined whether sustained attention and inhibitory control differ between patients with MDD and healthy controls, and whether differences exist between patients with mild, moderate, and severe depression. METHODS Clinical in-patients (N = 212) aged 18-65 years with a current diagnosis of MDD and 128 healthy controls were recruited. Depression severity was assessed using the Beck Depression Inventory, and sustained attention and inhibitory control were assessed using the oddball and flanker tasks. The use of these tasks promises insights into executive function in depressive patients that are not biased by verbal skills. Group differences were tested via analyses of covariance. RESULTS Patients with MDD showed slower reaction times in both the oddball and flanker task, independent of the executive demands of the trial types. Younger participants achieved shorter reaction times in both inhibitory control tasks. After correcting for age, education, smoking, BMI, and nationality, only differences in reaction times in the oddball task were statistically significant. In contrast, reaction times were not sensitive to the symptom severity of depression. CONCLUSION Our results corroborate deficits in basic information processing and specific impairments in higher-order cognitive processes in MDD patients. As difficulties in executive function underlie problems in planning, initiating, and completing goal-directed activities, they may jeopardize in-patient treatment and contribute to the recurrent nature of depression.
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Affiliation(s)
- Markus Gerber
- Department for Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland
| | - Robyn Cody
- Department for Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland
| | - Johannes Beck
- Psychiatric Clinic Sonnenhalde, 4125 Riehen, Switzerland
| | - Serge Brand
- Department for Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland
- Adult Psychiatric Clinics (UPKE), University of Basel, 4002 Basel, Switzerland
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6719851115, Iran
- Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
- School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran 1419733141, Iran
| | - Lars Donath
- Department of Intervention Research in Exercise Training, German Sport University Cologne, 50933 Cologne, Germany
| | - Anne Eckert
- Adult Psychiatric Clinics (UPKE), University of Basel, 4002 Basel, Switzerland
| | - Oliver Faude
- Department for Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland
| | - Martin Hatzinger
- Psychiatric Services Solothurn, University of Basel, 4503 Solothurn, Switzerland
| | | | - Jan-Niklas Kreppke
- Department for Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland
| | - Undine E Lang
- Adult Psychiatric Clinics (UPKE), University of Basel, 4002 Basel, Switzerland
| | - Sarah Mans
- Private Clinic Wyss, 3053 Münchenbuchsee, Switzerland
| | - Thorsten Mikoteit
- Psychiatric Services Solothurn, University of Basel, 4503 Solothurn, Switzerland
| | - Anja Oswald
- Psychiatric Clinic Sonnenhalde, 4125 Riehen, Switzerland
| | | | - Lukas Zahner
- Department for Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland
| | - Sebastian Ludyga
- Department for Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland
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13
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Uebelacker LA, Epstein-Lubow G, Sillice MA, O'Keeffe B, Kraines M, Battle CL, Anderson B, Miller IW, Abrantes AM. Project MOVE: A randomized controlled trial of Interventions for initiating and maintaining physical activity in depressed individuals. Ment Health Phys Act 2023; 24:100508. [PMID: 36967813 PMCID: PMC10032365 DOI: 10.1016/j.mhpa.2023.100508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Objective To test interventions for increasing aerobic exercise in depressed individuals. Methods We conducted a 3-arm randomized controlled trial aimed at increasing minutes of moderate-to-vigorous physical activity (MVPA) in depressed adults (N = 242). Each successive arm included an added component that might serve to increase and maintain physical activity. Arms were: 1) Brief advice (BA) to aerobic exercise; 2) BA + supervised and home-based aerobic exercise (SHE) + health education (HE); and 3) BA + SHE +cognitive-behavioral sessions focused on increasing and maintaining aerobic exercise (CBEX). HE was intended to serve as a control for CBEX. Assessments were conducted at baseline, Month 1.5, end of intervention (Month 3), Month 6, and Month 9. The primary outcome of MVPA was assessed via accelerometry. Secondary outcomes included self-reported MVPA, depression severity, and other aspects of mood and affect. Results At 3 months (the pre-designated primary outcome timepoint), the simple effect of treatment was statistically significant (F2, 569.0 = 4.17, p = .016), with BA+SHE+CBEX being superior to BA. We did not observe differences between BA+SHE+HE and either of the other arms. There were no statistically significant differences between treatment groups at 6- or 9-months. Treatment effects were not statistically significant for secondary outcomes. Conclusions Supervised and home-based exercise, when combined with a cognitive-behavioral exercise intervention, is effective in increasing aerobic exercise in depressed adults in the short-term, although the impact diminishes post-intervention period.
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Affiliation(s)
- Lisa A Uebelacker
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University Providence RI, USA
- Butler Hospital, Providence RI, USA
| | - Gary Epstein-Lubow
- Butler Hospital, Providence RI, USA
- Department of Health Services, Policy and Practice of Brown University, Providence RI, USA
| | - Marie A Sillice
- City University of New York School of Public & Health Policy, Department of Health Policy and Management, New York, NY, 10027
| | | | - Morganne Kraines
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University Providence RI, USA
- Butler Hospital, Providence RI, USA
| | - Cynthia L Battle
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University Providence RI, USA
- Butler Hospital, Providence RI, USA
- Center for Women's Behavioral Health, Women & Infants' Hospital of Rhode Island, Providence RI, USA
| | | | - Ivan W Miller
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University Providence RI, USA
- Butler Hospital, Providence RI, USA
| | - Ana M Abrantes
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University Providence RI, USA
- Butler Hospital, Providence RI, USA
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14
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Zhang CS, Cheng L, Chen X, Wang Y, Wei S, Sun J. The strategies of exercise intervention for adolescent depression: A meta-analysis of randomized controlled trials. Front Psychol 2023; 13:974382. [PMID: 36687827 PMCID: PMC9846179 DOI: 10.3389/fpsyg.2022.974382] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 11/25/2022] [Indexed: 01/06/2023] Open
Abstract
Purpose This study aimed to investigate the effect of exercise intervention, and analyze exercise intervention strategies for adolescent depression through a meta-analysis of RCTs. Methods Accordance to PRISMA guidelines, PubMed, Medline, EBSCO, Web of Science, SPORTDiscus, PsycINFO, ProQuest, and CNKI were searched for eligible records. Peer-reviewed studies were included if they met the following criteria: population (mean age of 10-18 years), intervention (physical activity, sport, or exercise), and outcomes (depression, adherence, ITT, dropout, adverse events, follow-up report). The protocol of this systematic review was registered in PROSPERO (CRD42022321683). Effect sizes calculations and methodological quality of exercise intervention (TESTEX scale) were carried out. The certainty of evidence was assessed by GRADE framework. Results Thirteen randomized controlled trials were eligible for this review, which comprised a total of 433 adolescents. Compared with the control treatment, the effect of exercise on adolescent depression was moderate (SMD = -0.65, 95%CI: -1.03 to -0.27, p < 0.01). Heterogeneity was substantial (T 2 = 0.30, I 2 = 67%, p < 0.01). The moderating effect analysis showed that exercise intervention characteristics (organization form, exercise frequency, exercise intensity, exercise type, and single exercise session duration) of included studies varied greatly revealing multiple factors that may impact the antidepressant effect of exercise on adolescent depression (I 2 > 50%, p < 0.05). Three studies show that the positive effect of exercise on reducing depression in adolescents remained 40 weeks after the intervention. Moreover, owing to the included studies contained methodological limitations, the certainty of evidence was reduced to moderate level. Conclusion This study shows that exercise intervention has a moderate and sustained positive effect on adolescent depression. Our results recommended that adolescents with depression undertake moderate to high intensity group mixed exercise for more than 12 weeks, 20 to 60 min/time, more than 3 times/week. Additionally, our study also shows that the antidepressant effects remained for a long time after the end of exercise interventions. However, following the GRADE framework, we rated the certainty of evidence the primary meta-analysis as moderate evidence due to some limitations of included studies. Therefore, rigorous studies are still needed to verify the results. Systematic review registration [https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=321683], identifier [CRD42022321683].
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Affiliation(s)
- Chang Sheng Zhang
- School of Physical Education, Chengdu Sport University, Chengdu, China
| | - Liang Cheng
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu, China
| | - Xiaoan Chen
- School of Sports Science, Jishou University, Jishou, Hunan, China
| | - Yi Wang
- School of Sports Science, Jishou University, Jishou, Hunan, China
| | - Shuguang Wei
- Department of Psychology, College of Education, Hebei Normal University, Hebei, China
| | - Jinxiu Sun
- School of Sports Science, Jishou University, Jishou, Hunan, China
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15
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Zeibig JM, Seiffer B, Frei AK, Takano K, Sudeck G, Rösel I, Hautzinger M, Wolf S. Long-term efficacy of exercise across diagnostically heterogenous mental disorders and the mediating role of affect regulation skills. PSYCHOLOGY OF SPORT AND EXERCISE 2023; 64:102340. [PMID: 37665821 DOI: 10.1016/j.psychsport.2022.102340] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 10/14/2022] [Accepted: 11/17/2022] [Indexed: 09/06/2023]
Abstract
BACKGROUND Exercise interventions are efficacious in reducing disorder-specific symptoms in various mental disorders. However, little is known about long-term transdiagnostic efficacy of exercise across heterogenous mental disorders and the potential mechanisms underlying treatment effects. METHODS Physically inactive outpatients, with depressive disorders, anxiety disorders, insomnia or attention deficit hyperactivity disorder were randomized to a standardized 12-week exercise intervention, combining moderate exercise with behavior change techniques (BCTs) (n = 38), or a passive control group (n = 36). Primary outcome was global symptom severity (Symptom Checklist-90, SCL-90-R) and secondary outcomes were self-reported exercise (Physical Activity, Exercise, and Sport Questionnaire), exercise-specific affect regulation (Physical Activity-related Health Competence Questionnaire) and depression (SCL-90-R) assessed at baseline (T1), post-treatment (T2) and one year after post-treatment (T3). Intention-to-treat analyses were conducted using linear mixed models and structural equations modeling. RESULTS From T1 to T3, the intervention group significantly improved on global symptom severity (d = -0.43, p = .031), depression among a depressed subsample (d = -0.62, p = .014), exercise (d = 0.45, p = .011) and exercise-specific affect regulation (d = 0.44, p = .028) relative to the control group. The intervention group was more likely to reveal clinically significant changes from T1 to T3 (p = .033). Increases in exercise-specific affect regulation mediated intervention effects on global symptom severity (ß = -0.28, p = .037) and clinically significant changes (ß = -0.24, p = .042). CONCLUSIONS The exercise intervention showed long-term efficacy among a diagnostically heterogeneous outpatient sample and led to long-lasting exercise behavior change. Long-term increases in exercise-specific affect regulation within exercise interventions seem to be essential for long-lasting symptom reduction.
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Affiliation(s)
- Johanna-Marie Zeibig
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tuebingen, 72074, Tuebingen, Germany.
| | - Britta Seiffer
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tuebingen, 72074, Tuebingen, Germany
| | - Anna Katharina Frei
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tuebingen, 72074, Tuebingen, Germany
| | - Keisuke Takano
- Human Informatics and Interaction Research Institute (HIIRI), National Institute of Advanced Industrial Science and Technology (AIST), 1-1-1 Umezono, Tsukuba, Ibaraki, 305-8560, Japan
| | - Gorden Sudeck
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tuebingen, 72074, Tuebingen, Germany
| | - Inka Rösel
- Faculty of Medicine, Institute for Clinical Epidemiology and Applied Biostatistics, University of Tuebingen, 72074, Tuebingen, Germany
| | - Martin Hautzinger
- Faculty of Science, Psychological Institute, Department of Clinical Psychology and Psychotherapy, University of Tuebingen, 72074, Tuebingen, Germany
| | - Sebastian Wolf
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tuebingen, 72074, Tuebingen, Germany
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16
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Ketelhut S, Wehlan E, Bayer G, Ketelhut RG. Influence of Initial Severity of Depression on the Effectiveness of a Multimodal Therapy on Depressive Score, Heart Rate Variability, and Hemodynamic Parameters. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9836. [PMID: 36011470 PMCID: PMC9407770 DOI: 10.3390/ijerph19169836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 08/04/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
Depression is a major cause of disability among populations worldwide. Apart from primary symptoms, depressed patients often have a higher cardiovascular risk profile. Multimodal therapy concepts, including exercise, have emerged as promising approaches that not only improve depressive symptoms but also have a positive impact on cardiovascular risk profile. However, controversies have arisen concerning the influence of baseline severity on the effects of therapy concepts for this demographic. This study assessed whether pretreatment severity moderates psychological and physiological treatment outcomes of a multimodal therapy. A total of 16 patients diagnosed with mild depression (MD) and 14 patients diagnosed with severe depression (SD) took part in a 3-month outpatient multimodal treatment therapy. Before and after the treatment, depression score (Beck Depression Inventory (BDI)), peripheral systolic (pSBP) and diastolic (pDBP) blood pressure, central systolic (cSBP) and diastolic (cDBP) blood pressure, pulse wave velocity (PWV), heart rate (HR), and parasympathetic parameters of heart rate variability (RMSSD) were assessed. Significant time effects were detected for BDI (−20.0 ± 11.6, p > 0.001, η2 = 0.871), pSBP (−4.7 ± 6.8 mmHg, p < 0.001, η2 = 0.322), pDBP (−3.5 ± 6.9 mmHg, p = 0.01, η2 = 0.209), cSBP (−4.8 ± 6.5 mmHg, p < 0.001, η2 = 0.355), cDBP (−3.6 ± 6.8 mmHg, p = 0.008, η2 = 0.226), PWV (−0.13 ± 0.23 m/s, p = 0.008, η2 = 0.229), HR (4.3 ± 8.8 min−1, p = 0.015, η2 = 0.193), RMSSD (−12.2 ± 23.9 ms, p = 0.017, η2 = 0.251), and and SDNN (10.5 ± 17.8 ms, p = 0.005, η2 = 0.330). Significant time × group interaction could be revealed for BDI (p < 0.001, η2 = 0.543), with patients suffering from SD showing stronger reductions. Pretreatment severity of depression has an impact on the effectiveness of a multimodal therapy regarding psychological but not physiological outcomes.
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Affiliation(s)
- Sascha Ketelhut
- Institute of Sport Science, University of Bern, 3012 Bern, Switzerland
- Cardiology and Sports Medicine, Medical Center Berlin (MCB), 10559 Berlin, Germany
| | - Emanuel Wehlan
- Cardiology and Sports Medicine, Medical Center Berlin (MCB), 10559 Berlin, Germany
- Institute of Sport Science, Humboldt University of Berlin, 10115 Berlin, Germany
| | - Gerhart Bayer
- Institute of Sport Science, Humboldt University of Berlin, 10115 Berlin, Germany
| | - Reinhard G. Ketelhut
- Cardiology and Sports Medicine, Medical Center Berlin (MCB), 10559 Berlin, Germany
- Institute of Sport Science, Humboldt University of Berlin, 10115 Berlin, Germany
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17
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Thaller L, Frühauf A, Heimbeck A, Voderholzer U, Kopp M. A Comparison of Acute Effects of Climbing Therapy with Nordic Walking for Inpatient Adults with Mental Health Disorder: A Clinical Pilot Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116767. [PMID: 35682348 PMCID: PMC9180369 DOI: 10.3390/ijerph19116767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/18/2022] [Accepted: 05/27/2022] [Indexed: 11/18/2022]
Abstract
As climbing therapy is increasingly used for mental health disorders, the present study aimed to compare acute effects of a therapeutic climbing intervention (CT) on affective responses, anxiety, and self-efficacy with those of Nordic walking (NW) and a sedentary control condition (SC) in an inpatient setting with persons with depression, anxiety, or obsessive−compulsive disorders. A total of 21 inpatients (32 ± 12.2 years) participated in a clinical trial in all interventions using an experimental within-subject design. Anxiety and self-efficacy were assessed preintervention (t0) and postintervention (t2) using the State-Trait Anxiety Inventory and the General Self-Efficacy Scale, and affective responses were additionally evaluated during (t1) and 180 min after the intervention (t3) using the Feeling Scale, Felt Arousal Scale, and Positive and Negative Affect Schedule. Statistical evaluation was performed with a 3 × 2 or 3 × 4 repeated measures ANOVA. Significant interaction effects were found for affective responses regarding positive affect, affective valence, and perceived activation (p < 0.015) favoring CT over NW and SC. For anxiety, a significant interaction effect was found (F(2.40) = 6.603; p = 0.003; η2 = 0.248), and also perceived self-efficacy increased significantly (F(2.40) = 6.046; p = 0.005; η2 = 0.232). Single CT sessions may enhance affective responses and self-efficacy and reduce anxiety in inpatients with mental health disorders to a higher extent than NW. CT as part of an inpatient therapy program may help to improve key affective mechanisms and should be further studied in comparison with other exercise interventions with comparable intensity.
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Affiliation(s)
- Lisa Thaller
- Department of Sports Science, University of Innsbruck, 6020 Innsbruck, Austria; (A.F.); (M.K.)
- Schoen Clinic Roseneck, 83209 Prien am Chiemsee, Germany; (A.H.); (U.V.)
- Correspondence: ; Tel.: +49-151-20702742
| | - Anika Frühauf
- Department of Sports Science, University of Innsbruck, 6020 Innsbruck, Austria; (A.F.); (M.K.)
| | - Alexander Heimbeck
- Schoen Clinic Roseneck, 83209 Prien am Chiemsee, Germany; (A.H.); (U.V.)
| | - Ulrich Voderholzer
- Schoen Clinic Roseneck, 83209 Prien am Chiemsee, Germany; (A.H.); (U.V.)
- Department of Psychiatry and Psychotherapy, University Hospital of Munich (LMU), 80336 Munich, Germany
| | - Martin Kopp
- Department of Sports Science, University of Innsbruck, 6020 Innsbruck, Austria; (A.F.); (M.K.)
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18
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Ramsey CM, Lynch KG, Gehrman PR, Vairavan S, Narayan VA, Li QS, Oslin DW. Daily steps and depressive symptoms: A longitudinal evaluation of patients with major depressive disorder in the precision medicine in mental health care study. J Affect Disord 2022; 300:334-340. [PMID: 34979178 DOI: 10.1016/j.jad.2021.12.116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 12/12/2021] [Accepted: 12/30/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Although the benefits of exercise on Major Depressive Disorder (MDD) are well established, longitudinal studies of objectively measured activity in clinical populations are needed to establish specific guidelines for exercise by persons with moderate-to-severe depression. This study examines the association between objectively assessed daily step count and depressive symptoms over a 24-week follow- up period in outpatients receiving treatment for moderate-to-severe depression. METHODS Participants were US Veterans with MDD enrolled in the Precision Medicine in Mental Health Care study (PRIME Care), a pragmatic, multi-site, randomized, controlled trial that examines the utility of genetic testing in the context of pharmacotherapy for MDD. Participants were a subset (N = 66) enrolled in actigraphy (using GT9X ActiGraph) monitoring component of the trial. Daily steps were examined as a predictor of depressive symptoms over 4-, 8-, 12-, 18-, and 24-weeks. RESULTS On average, participants took 3,460 (±1,768) steps per day. In generalized linear mixed models, an increase in 1,000 steps per day was associated with a 0.6-point decrease in depressive symptom severity at the subsequent follow-up assessment. LIMITATIONS Activity monitoring was observational and causal inferences cannot be made between daily steps and subsequent depressive symptom severity. Results may not generalize to non-treatment-seeking populations. CONCLUSIONS Study findings provide an initial metric for persons with clinically significant MDD, of whom most do not get sufficient daily activity. The findings can inform future trials aimed at determining how much daily activity is needed to improve symptoms in individuals with MDD.
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Affiliation(s)
- Christine M Ramsey
- VISN 4 Mental Illness, Research, Education, and Clinical Center, Corporal Michael J. Crescenz VA Medical Center, 5800 Woodland Ave, Philadelphia, PA 19130, United States; Yale School of Medicine, New Haven, CT, United States.
| | - Kevin G Lynch
- VISN 4 Mental Illness, Research, Education, and Clinical Center, Corporal Michael J. Crescenz VA Medical Center, 5800 Woodland Ave, Philadelphia, PA 19130, United States; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Philip R Gehrman
- VISN 4 Mental Illness, Research, Education, and Clinical Center, Corporal Michael J. Crescenz VA Medical Center, 5800 Woodland Ave, Philadelphia, PA 19130, United States; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Srinivasan Vairavan
- Neuroscience Data Science, Janssen Research & Development, LLC, Titusville, NJ, United States
| | - Vaibhav A Narayan
- Neuroscience Data Science, Janssen Research & Development, LLC, Titusville, NJ, United States; Science for Minds, Janssen Research & Development, LLC, Titusville, NJ, United States
| | - Qingqin S Li
- Neuroscience Data Science, Janssen Research & Development, LLC, Titusville, NJ, United States
| | - David W Oslin
- VISN 4 Mental Illness, Research, Education, and Clinical Center, Corporal Michael J. Crescenz VA Medical Center, 5800 Woodland Ave, Philadelphia, PA 19130, United States; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
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19
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Zhao Y, Wang W, Wang M, Gao F, Hu C, Cui B, Yu W, Ren H. Personalized individual-based exercise prescriptions are effective in treating depressive symptoms of college students during the COVID-19: A randomized controlled trial in China. Front Psychiatry 2022; 13:1015725. [PMID: 36699477 PMCID: PMC9869038 DOI: 10.3389/fpsyt.2022.1015725] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 12/19/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has seriously increased depression prevalence among the public, including Chinese college students. However, many exercise cannot be performed as usual under the stay-at-home order. This study was a 12-week three-arm randomized controlled trial using the intention-to-treat principle, aiming to explore and compare the feasibility and effect of individual-based personalized aerobic-exercise and resistance-training prescriptions on depressive symptoms in college students, and conclude with some recommendations for individual-based exercise prescriptions. METHODS Eighty-six college students with depressive symptoms were randomized into aerobic-exercise (AE), resistance-training (RT), and wait-list control (WLC) groups. Participants in two experimental groups received 12-week personalized AE and RT prescriptions on their individual situations, respectively. No intervention was implemented on participants in the WLC group. Depressive symptoms and physical activity (PA) were measured by Zung Self-Rating Depression Scale (SDS) and International Physical Activity Questionnaire-Short Form (IPAQ-SF), respectively. All data were collected at the baseline, 4, 8, and 12 weeks, and 4-week post-intervention. RESULTS At 12 weeks, 72.09% of depressive participants improved to "normal." Participants exhibited a statistical reduction in SDS in all 3 groups (p < 0.05) at 12 weeks compared to baseline. Follow-up assessments showed no significant increase in SDS at 4-week post-intervention compared to 12 weeks (p > 0.05). The independent t-test revealed significantly lower SDS in AE and RT group than in WLC group (p AE < 0.001 and p RT < 0.05) at 4, 8, and 12 weeks, and 4-week post-intervention. Furthermore, the PA of participants (including total PA and intensities) in both experimental groups represented a significant improvement at 4-week post-intervention compared to baseline (p < 0.05), while no differences were observed in the PA of participants in the WLC group (p > 0.05). CONCLUSION Personalized exercise prescriptions have good feasibility as they can increase adherence to intervention and reduce serious adverse events. Besides, individual-based personalized aerobic-exercise and resistance-training prescriptions result in a similar effect in relieving depressive symptoms and improving physical activity in college students. The individual-based exercise programs performed in 45- to 60- min with progressive moderate-to-vigorous intensity, 3 times/week for at least 12 weeks, may reduce depressive symptoms in college students during the COVID-19.
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Affiliation(s)
- Yuanhui Zhao
- School of Sport Science, Beijing Sport University, Beijing, China.,Key Laboratory of the Ministry of Education of Exercise and Physical Fitness, Beijing Sport University, Beijing, China
| | - Wenxing Wang
- School of Sport Science, Beijing Sport University, Beijing, China.,Key Laboratory of the Ministry of Education of Exercise and Physical Fitness, Beijing Sport University, Beijing, China
| | - Mengdie Wang
- China Institute of Sport Science, Beijing, China
| | - Fang Gao
- School of Sport Science, Beijing Sport University, Beijing, China.,Key Laboratory of the Ministry of Education of Exercise and Physical Fitness, Beijing Sport University, Beijing, China
| | - Chun Hu
- School of Sport Science, Beijing Sport University, Beijing, China.,Key Laboratory of the Ministry of Education of Exercise and Physical Fitness, Beijing Sport University, Beijing, China
| | - Bowen Cui
- School of Sport Science, Beijing Sport University, Beijing, China.,Key Laboratory of the Ministry of Education of Exercise and Physical Fitness, Beijing Sport University, Beijing, China
| | - Wenlang Yu
- School of Sport Science, Beijing Sport University, Beijing, China.,Key Laboratory of the Ministry of Education of Exercise and Physical Fitness, Beijing Sport University, Beijing, China
| | - Hong Ren
- School of Sport Science, Beijing Sport University, Beijing, China.,Key Laboratory of the Ministry of Education of Exercise and Physical Fitness, Beijing Sport University, Beijing, China
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20
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Imboden C, Claussen MC, Seifritz E, Gerber M. [The Importance of Physical Activity for Mental Health]. PRAXIS 2022; 110:186-191. [PMID: 35291871 DOI: 10.1024/1661-8157/a003831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The Importance of Physical Activity for Mental Health Abstract. Due to the worldwide high prevalence of psychiatric disorders and its association with sedentary behavior and comorbid physical diseases, increasing physical activity in psychiatric populations is of high importance. Regular physical activity is associated with increased mental wellbeing and has shown to have preventive effects on depression, anxiety disorders and probably sleep disorders. Additionally, positive effects on comorbid chronic physical diseases have been found. Exercise as treatment for several weeks has shown to have an antidepressant effect. Similar positive effects on symptoms have been found in anxiety disorders and schizophrenia. Therefore, assessing and promoting physical activity is advisable in clinical psychiatric practice. Patients should be coached to reach at least a weekly average of 150 minutes of moderate and/or 75 minutes of vigorous physical activity. Establishing physical activity and exercise groups is of utmost importance for psychiatric outpatients.
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Affiliation(s)
| | - Malte Christian Claussen
- Privatklinik Wyss AG, Münchenbuchsee
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Psychiatrische Universitätsklinik Zürich, Universität Zürich, Zürich
- Erwachsenenpsychiatrie, Psychiatrische Dienste Graubünden, Chur
| | - Erich Seifritz
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Psychiatrische Universitätsklinik Zürich, Universität Zürich, Zürich
| | - Markus Gerber
- Departement für Sport, Bewegung und Gesundheit, Universität Basel, Basel
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21
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Abstract
Physical Activity and Mental Health in the Elderly Abstract. The aging process is closely linked to physiological changes. These physiological changes may lead to an increased vulnerability for developing somatic and mental disorders. Reduced physical activity/sedentary behaviour can enhance this process. In contrast, physical training and sports counteract this process, in particular in the elderly, who may thus gain or maintain a younger biological age. Physical fitness is associated with better mental health in the elderly. Sports and physical activity over the course of life have shown to be of preventive value concerning the development of depression and dementia in old age. Also late-life depression and cognitive impairment (MCI, mild cognitive impairment) can be improved by regular, continuous physical exercise. Some data furthermore suggest that even patients with dementia benefit from physical exercise, especially on behalf of the behavioural and psychic symptoms of dementia (BPSD).
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22
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Imboden C, Claussen MC, Seifritz E, Gerber M. The Importance of Physical Activityfor Mental Health. PRAXIS 2022; 110:e186-e190. [PMID: 35291869 DOI: 10.1024/1661-8157/a003820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Due to the worldwide high prevalence of psychiatric disorders and its association with sedentary behavior and comorbid physical diseases, increasing physical activity in psychiatric populations is of high importance. Regular physical activity is associated with increased mental wellbeing and has shown to have preventive effects on depression, anxiety disorders and probably sleep disorders. Additionally, positive effects on comorbid chronic physical diseases have been found. Exercise as treatment for several weeks has shown to have an antidepressant effect. Similar positive effects on symptoms have been found in anxiety disorders and schizophrenia. Therefore, assessing and promoting physical activity is advisable in clinical psychiatric practice. Patients should be coached to reach at least a weekly average of 150 minutes of moderate and/or 75 minutes of vigorous physical activity. Establishing physical activity and exercise groups is of utmost importance for psychiatric outpatients.
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Affiliation(s)
| | - Malte Christian Claussen
- Private Clinic Wyss, Münchenbuchsee, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
- Department of Adult Psychiatry, Psychiatric Services Grisons, Chur, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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23
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Kreppke JN, Cody R, Faude O, Gerber M. [Enjoying Sports and Movement in Mental Illness]. PRAXIS 2022; 110:200-204. [PMID: 35291865 DOI: 10.1024/1661-8157/a003830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Enjoying Sports and Movement in Mental Illness Abstract. Sports and exercise therapy is an effective complemant in the treatment of major depression. The recommendations of at least 150 minutes of moderate or 75 minutes of intensive physical activity per week should be met to achieve positive effects of physical activity. In addition, individual needs and the physical health conditions must be considered in the planning and implementation, so that exercise will be enjoyed in the long term.
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Affiliation(s)
- Jan-Niklas Kreppke
- Abteilung Bewegungs- und Trainingswissenschaften, Departement für Sport, Bewegung und Gesundheit, Universität Basel, Basel
| | - Robyn Cody
- Abteilung Sport und psychische Gesundheit, Departement für Sport, Bewegung und Gesundheit, Universität Basel, Basel
| | - Oliver Faude
- Abteilung Bewegungs- und Trainingswissenschaften, Departement für Sport, Bewegung und Gesundheit, Universität Basel, Basel
| | - Markus Gerber
- Abteilung Sport und psychische Gesundheit, Departement für Sport, Bewegung und Gesundheit, Universität Basel, Basel
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24
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Zeibig JM, Seiffer B, Sudeck G, Rösel I, Hautzinger M, Wolf S. Transdiagnostic efficacy of a group exercise intervention for outpatients with heterogenous psychiatric disorders: a randomized controlled trial. BMC Psychiatry 2021; 21:313. [PMID: 34158000 PMCID: PMC8218400 DOI: 10.1186/s12888-021-03307-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 05/20/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Exercise efficaciously reduces disorder-specific symptoms of psychiatric disorders. The current study aimed to examine the efficacy of a group exercise intervention on global symptom severity and disorder-specific symptoms among a mixed outpatient sample. METHODS Groups of inactive outpatients, waiting for psychotherapy, with depressive disorders, anxiety disorders, insomnia, and attention-deficit/hyperactivity disorders were randomized to a manualized 12-week exercise intervention, combining moderate to vigorous aerobic exercise with techniques for sustainable exercise behaviour change (n = 38, female = 71.1% (n = 27), Mage = 36.66), or a passive control group (n = 36, female = 75.0% (n = 27), Mage = 34.33). Primary outcomes were global symptom severity and disorder-specific symptoms, measured with the Symptom Checklist-90-Revised and Pittsburgh Sleep Quality Index pre- and post-treatment. Secondary outcome was the self-reported amount of exercise (Physical Activity, Exercise, and Sport Questionnaire), measured pre-treatment, intermediate-, and post-treatment. Intention-to-treat analyses were conducted using linear mixed models. Linear regressions were conducted to examine the effect of the change of exercise behaviour on the change of symptoms. RESULTS The intervention significantly improved global symptom severity (d = 0.77, p = .007), depression (d = 0.68, p = .015), anxiety (d = 0.87, p = .002), sleep quality (d = 0.88, p = .001), and increased the amount of exercise (d = 0.82, p < .001), compared to the control group. Post-treatment differences between groups were significant for depression (d = 0.63, p = .031), sleep quality (d = 0.61, p = .035) and the amount of exercise (d = 1.45, p < .001). Across both groups, the reduction of global symptom severity was significantly predicted by an increase of exercise (b = .35, p = .012). CONCLUSIONS The exercise intervention showed transdiagnostic efficacy among a heterogeneous clinical sample in a realistic outpatient setting and led to sustained exercise behaviour change. Exercise may serve as an efficacious and feasible transdiagnostic treatment option improving the existing treatment gap within outpatient mental health care settings. TRIAL REGISTRATION The study was registered on ClinicalTrials.gov (ID: NCT03542396 , 25/04/2018).
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Affiliation(s)
- Johanna-Marie Zeibig
- Department of Education & Health Research, Faculty of Economics and Social Sciences, Institute of Sports Science, University of Tuebingen, 72074, Tuebingen, Germany.
| | - Britta Seiffer
- Department of Education & Health Research, Faculty of Economics and Social Sciences, Institute of Sports Science, University of Tuebingen, 72074, Tuebingen, Germany
| | - Gorden Sudeck
- Department of Education & Health Research, Faculty of Economics and Social Sciences, Institute of Sports Science, University of Tuebingen, 72074, Tuebingen, Germany
| | - Inka Rösel
- Faculty of Medicine, Institute for Clinical Epidemiology and Applied Biostatistics, University of Tuebingen, 72074, Tuebingen, Germany
| | - Martin Hautzinger
- Department of Clinical Psychology and Psychotherapy, Faculty of Science, Psychological Institute, University of Tuebingen, 72074, Tuebingen, Germany
| | - Sebastian Wolf
- Department of Education & Health Research, Faculty of Economics and Social Sciences, Institute of Sports Science, University of Tuebingen, 72074, Tuebingen, Germany.,Department of Clinical Psychology and Psychotherapy, Faculty of Science, Psychological Institute, University of Tuebingen, 72074, Tuebingen, Germany
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25
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Zhang J, He ZX, Qu YS, Li LF, Wang LM, Yuan W, Hou WJ, Zhu YQ, Cai WQ, Zhang XN, Guo QQ, An SC, Jia R, Tai FD. Different baseline physical activity predicts susceptibility and resilience to chronic social defeat stress in mice: Involvement of dopamine neurons. Eur Neuropsychopharmacol 2021; 45:15-28. [PMID: 33730683 DOI: 10.1016/j.euroneuro.2021.02.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 02/10/2021] [Accepted: 02/15/2021] [Indexed: 02/07/2023]
Abstract
Physical inactivity, the fourth leading mortality risk factor worldwide, is associated with chronic mental illness. Identifying the mechanisms underlying different levels of baseline physical activity and the effects of these levels on the susceptibility to stress is very important. However, whether different levels of baseline physical activity influence the susceptibility and resilience to chronic social defeat stress (CSDS), and the underlying mechanisms in the brain remain unclear. The present study segregated wild-type mice into low baseline physical activity (LBPA) and high baseline physical activity (HBPA) groups based on short term voluntary wheel running (VWR). LBPA mice showed obvious susceptibility to CSDS, while HBPA mice were resilient to CSDS. In addition, the expression of tyrosine hydroxylase (TH) in the ventral tegmental area (VTA) was lower in LBPA mice than in HBPA mice. Furthermore, activation of TH neurons in the VTA of LBPA mice by chemogenetic methods increased the levels of VWR and resilience to CSDS. In contrast, inhibiting TH neurons in the VTA of HBPA mice lowered the levels of VWR and increased their susceptibility to CSDS. Thus, this study suggests that different baseline physical activities might be mediated by the dopamine system. This system also affects the susceptibility and resilience to CSDS, possibly via alteration of the baseline physical activity. This perspective on the neural control and impacts on VWR may aid the development of strategies to motivate and sustain voluntary physical activity. Furthermore, this can maximize the impacts of regular physical activity toward stress-reduction and health promotion.
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Affiliation(s)
- Jing Zhang
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an 710062, China; School of Physical Education & Health, Nanning Normal University, Nanning 530100, China
| | - Zhi-Xiong He
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an 710062, China
| | - Yi-Shan Qu
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an 710062, China
| | - Lai-Fu Li
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an 710062, China
| | - Li-Min Wang
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an 710062, China
| | - Wei Yuan
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an 710062, China
| | - Wen-Juan Hou
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an 710062, China
| | - Ying-Qi Zhu
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an 710062, China
| | - Wen-Qi Cai
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an 710062, China
| | - Xue-Ni Zhang
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an 710062, China
| | - Qian-Qian Guo
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an 710062, China
| | - Shu-Cheng An
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an 710062, China
| | - Rui Jia
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an 710062, China; Cognition Neuroscience and Learning Division, Key Laboratory of Modern Teaching Technology, Ministry of Education, Shaanxi Normal University, Xi'an 710062, China.
| | - Fa-Dao Tai
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an 710062, China; Cognition Neuroscience and Learning Division, Key Laboratory of Modern Teaching Technology, Ministry of Education, Shaanxi Normal University, Xi'an 710062, China.
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26
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Jones CD, Motl R, Sandroff BM. Depression in multiple sclerosis: Is one approach for its management enough? Mult Scler Relat Disord 2021; 51:102904. [PMID: 33780807 DOI: 10.1016/j.msard.2021.102904] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/18/2021] [Accepted: 03/15/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND Major depression disorder (MDD) and severe depression symptoms are highly prevalent in multiple sclerosis (MS). Depression can worsen symptoms of MS and is associated with significantly reduced quality of life and increased risk of suicide. Currently, there is no gold-standard, single treatment available for depression in MS. Pharmacotherapy, cognitive behavior therapy (CBT), and exercise training individually are moderately, yet incompletely, efficacious for managing depression in the general population and MS. PURPOSE This review provides an overview of evidence from meta-analyses and systematic reviews for current treatments of depression in persons with MS. This review further develops the rationale for using a combinatory treatment approach in persons with MS. METHODS We performed a narrative review of meta-analyses and systematic reviews regarding the current state of evidence for the three most common treatments of depression in persons with MS (i.e., antidepressant medication, cognitive-behavior therapy, and exercise training). We provide a concise assessment of the overall effect of these treatments on depression in the general population and then persons with MS. We further note short-comings of research on these treatments for depression. CONCLUSION There is no single, gold-standard treatment for depression in MS, and we proposed that combinatory treatments should be considered for the management of depression in MS. However, there is a paucity of evidence for the use of combinatory therapy on depression and its outcomes in persons with MS, and this supports direct examination of the feasibility and efficacy of such combinatory approaches for MDD in MS.
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Affiliation(s)
- C Danielle Jones
- University of Alabama at Birmingham, Department of Physical Therapy, Birmingham, AL, United States.
| | - Robert Motl
- University of Alabama at Birmingham, Department of Physical Therapy, Birmingham, AL, United States
| | - Brian M Sandroff
- Kessler Foundation, Center for Neuropsychology and Neuroscience, West Orange, NJ, United States
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27
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Xie Y, Wu Z, Sun L, Zhou L, Wang G, Xiao L, Wang H. The Effects and Mechanisms of Exercise on the Treatment of Depression. Front Psychiatry 2021; 12:705559. [PMID: 34803752 PMCID: PMC8602192 DOI: 10.3389/fpsyt.2021.705559] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 10/05/2021] [Indexed: 12/12/2022] Open
Abstract
Background: It is necessary to seek alternative therapies for depression, because side effects of medications lead to poor adherence and some patients do not achieve a clinical treatment effect. Recently the role of exercise as a low-cost and easy-to-use treatment for depression has gained attention with a number of studies showing that exercise is effective at reducing depressive symptoms and improving body functions such as cardiorespiratory system and cognitive function. Because of the heterogeneity of exercise therapy programs, there is no standardized and unified program. Few studies have summarized the specific properties of exercise programs (type, intensity, duration, and frequency) and clinical prescriptions for exercise are not mentioned in most articles. Aims: This study aimed to investigate the feasibility and efficacy of exercise therapy for patients with depression, in order to appraise the evidence and outline accepted guidelines to direct individualized treatment plans for patients with depression based on their individual situations. Methods: A systematic review of English language literature including papers published from 2010 to present in PubMed was performed. Given the feasibility of prescribing exercise therapy for patients with depression, nearly 3 years of clinical studies on the treatments of depressive symptoms with exercise were first reviewed, comparing the exercise programs utilized. Conclusions: Exercise has therapeutic effects on depression in all age groups (mostly 18-65 years old), as a single therapy, an adjuvant therapy, or a combination therapy, and the benefits of exercise therapy are comparable to traditional treatments for depression. Moderate intensity exercise is enough to reduce depressive symptoms, but higher-dose exercise is better for overall functioning. Exercise therapy has become more widely used because of its benefits to the cardiovascular system, emotional state, and systemic functions. Recommendations: Aerobic exercise/mind-body exercise (3-5 sessions per week with moderate intensity lasting for 4-16 weeks) is recommended. Individualized protocols in the form of group exercise with supervision are effective at increasing adherence to treatment.
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Affiliation(s)
- Yumeng Xie
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zuotian Wu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Limin Sun
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Lin Zhou
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Gaohua Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ling Xiao
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Huiling Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
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28
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Smith PJ, Merwin RM. The Role of Exercise in Management of Mental Health Disorders: An Integrative Review. Annu Rev Med 2020; 72:45-62. [PMID: 33256493 DOI: 10.1146/annurev-med-060619-022943] [Citation(s) in RCA: 129] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
A large and growing body of evidence suggests that physical activity (PA) may hold therapeutic promise in the management of mental health disorders. Most evidence linking PA to mental health outcomes has focused on the effects of aerobic exercise training on depression, although a growing body of work supports the efficacy of both aerobic and resistance exercise paradigms in the treatment of anxiety and post-traumatic stress disorder. Despite abundant evidence linking PA and mental health, use of exercise training as a mental health treatment remains limited due to three important sources of uncertainty: (a) large individual differences in response to exercise treatment within multiple mental health domains; (b) the critical importance of sustained PA engagement, not always achieved, for therapeutic benefit; and (c) disagreement regarding the relative importance of putative therapeutic mechanisms. Our review of treatment data on exercise interventions and mental health outcomes focuses primarily on depression and anxiety within a health neuroscience framework. Within this conceptual framework, neurobiological and behavioral mechanisms may have additiveor synergistic influences on key cognitive and behavioral processes that influence mental health outcomes. We therefore highlight sources of treatment heterogeneity by integrating the critical influences of (a) neurobiological mechanisms enhancing neuroplasticity and (b) behavioral learning of self-regulatory skills. Understanding the interrelationships between dynamic neurobiological and behavioral mechanisms may help inform personalized mental health treatments and clarify why, and for whom, exercise improves mental health outcomes. The review concludes with recommendations for future studies leveraging individual differences to refine treatment approaches to optimize mental health benefits.
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Affiliation(s)
- Patrick J Smith
- Department of Psychiatry and Behavioral Sciences.,Department of Medicine, and.,Department of Population Health Sciences, Duke University Medical Center, Durham, North Carolina 27708, USA;
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Imboden C, Gerber M, Beck J, Holsboer-Trachsler E, Pühse U, Hatzinger M. Aerobic exercise or stretching as add-on to inpatient treatment of depression: Similar antidepressant effects on depressive symptoms and larger effects on working memory for aerobic exercise alone. J Affect Disord 2020; 276:866-876. [PMID: 32739704 DOI: 10.1016/j.jad.2020.07.052] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 05/19/2020] [Accepted: 07/05/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Aerobic exercise (AE) has positive effects on symptom severity and cognitive symptoms of depression. Since data on AE as add-on to inpatient treatment in depression is still scarce, we conducted this double-blind randomized controlled study. METHODS Patients aged between 18 and 60 years were recruited into the study if Hamilton Depression Rating Scale 17 (HDRS-17) score was >16. Participants were randomly assigned to either AE or basic stretching activities (control), which took place 3x/week for 6 weeks. Primary outcome was depression severity as assessed with the HDRS-17 and the Beck Depression Inventory (BDI). Further physiological and psychological variables and cognitive performance were assessed as secondary outcomes. RESULTS Forty-two patients were included in the analysis (exercise: n = 22; control: n = 20). Regardless of group allocation, we found a significant short-term time effect for symptom-severity (HDRS17: p<0.001, η²=0.70; BDI: p<0.001, η²=0.51), mental toughness (p<0.001, η²=0.32), physical self-description endurance score (p = 0.013, η²=0.16), cognitive flexibility (p = 0.013, η²=0.14), and body mass index (BMI) (p = 0.006, η²=0.19). Working memory showed a significant time by group interaction in favor of AE (p = 0.043, η²=0.10). Short-term effects on symptom severity, mental toughness and BMI remained stable across the 6-month follow-up period. Finally, self-reported physical activity increased significantly from baseline to follow-up (p = 0.014, η²=0.15). LIMITATIONS The sample-size is rather small. The control intervention might have been too active as to find a time by group interaction for symptom severity. CONCLUSIONS AE was associated with comparably large depression alleviation vs. stretching and with add-on benefits on working memory.
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Affiliation(s)
- Christian Imboden
- Psychiatric Services Solothurn, Solothurn, Switzerland, and University of Basel, Basel, Switzerland; Private Clinic Wyss, Muenchenbuchsee, Switzerland.
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Johannes Beck
- Psychiatric University Hospital, University of Basel, Basel, Switzerland; Private Clinic Sonnenhalde, Riehen, Switzerland
| | | | - Uwe Pühse
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Martin Hatzinger
- Psychiatric Services Solothurn, Solothurn, Switzerland, and University of Basel, Basel, Switzerland
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The emotional dance with depression: A longitudinal investigation of OULA® for depression in women. J Bodyw Mov Ther 2020; 24:413-422. [PMID: 33218542 DOI: 10.1016/j.jbmt.2020.05.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 06/05/2019] [Accepted: 05/01/2020] [Indexed: 12/27/2022]
Abstract
The primary purpose of this pilot study was to evaluate OULA®, a dance fitness program with a strong emphasis on processing emotions through dance, as an intervention for depression in women diagnosed with major or persistent depressive disorders. 53 women were eligible for participation. Women attended OULA® for 12 weeks and then abstained from OULA® during week 13. For the primary outcome, depression severity was measured using the Hamilton Depression Rating Scale (HAM-D), and secondary outcomes were measured using the Beck Anxiety Index (BAI) and the Subjective Happiness Scale (SHS). After the abstinence week, women were offered 3-months of optional additional OULA®. HAM-D, BAI and SHS scores were collected at weeks 2, 4, 5-14 and at the end of the 3-month optional OULA® phase. Results from linear mixed effects repeated models show that during the 12-week intervention period and at week 26, HAM-D scores significantly decrease each week compared to baseline. Further, BAI scores significantly decrease starting at week 5 and through the end of the intervention period and at week 26. Moreover, SHS scores increased significantly for four of the weeks during the intervention period and at week 26. The results from this study suggest that OULA® may be a useful intervention for decreasing depression and anxiety severity in women with depression but may not be helpful for improving subjective happiness.
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Brinsley J, Schuch F, Lederman O, Girard D, Smout M, Immink MA, Stubbs B, Firth J, Davison K, Rosenbaum S. Effects of yoga on depressive symptoms in people with mental disorders: a systematic review and meta-analysis. Br J Sports Med 2020; 55:992-1000. [PMID: 32423912 DOI: 10.1136/bjsports-2019-101242] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To assess whether physically active yoga is superior to waitlist control, treatment as usual and attention control in alleviating depressive symptoms in people with a diagnosed mental disorder recognised by the Diagnostic and Statistical Manual of Mental Disorders (DSM). DESIGN Systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. DATA SOURCES Data were obtained from online databases (MEDLINE, EMBASE, PsychINFO, CENTRAL, EMCARE, PEDro). The search and collection of eligible studies was conducted up to 14 May 2019 (PROSPERO registration No CRD42018090441). ELIGIBILITY CRITERIA FOR SELECTING STUDIES We included randomised controlled trials with a yoga intervention comprising ≥50% physical activity in adults with a recognised diagnosed mental disorder according to DSM-3, 4 or 5. RESULTS 19 studies were included in the review (1080 participants) and 13 studies were included in the meta-analysis (632 participants). Disorders of depression, post-traumatic stress, schizophrenia, anxiety, alcohol dependence and bipolar were included. Yoga showed greater reductions in depressive symptoms than waitlist, treatment as usual and attention control (standardised mean difference=0.41; 95% CI -0.65 to -0.17; p<0.001). Greater reductions in depressive symptoms were associated with higher frequency of yoga sessions per week (β=-0.44, p<0.01).
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Affiliation(s)
- Jacinta Brinsley
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia: Allied Health and Human Performance, Adelaide, South Australia, Australia
| | - Felipe Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - Oscar Lederman
- Keeping the Body In Mind, South Eastern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Danielle Girard
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia: Allied Health and Human Performance, Adelaide, South Australia, Australia
| | - Matthew Smout
- School of Psychology, Social Work and Social Policy, University of South Australia, Adelaide, South Australia, Australia
| | - Maarten A Immink
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia: Allied Health and Human Performance, Adelaide, South Australia, Australia
| | - Brendon Stubbs
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
| | - Kade Davison
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia: Allied Health and Human Performance, Adelaide, South Australia, Australia
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.,Black Dog Institute, Randwick, New South Wales, Australia
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Gerber M, Imboden C, Beck J, Brand S, Colledge F, Eckert A, Holsboer-Trachsler E, Pühse U, Hatzinger M. Effects of Aerobic Exercise on Cortisol Stress Reactivity in Response to the Trier Social Stress Test in Inpatients with Major Depressive Disorders: A Randomized Controlled Trial. J Clin Med 2020; 9:E1419. [PMID: 32403243 PMCID: PMC7291068 DOI: 10.3390/jcm9051419] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/30/2020] [Accepted: 05/05/2020] [Indexed: 12/01/2022] Open
Abstract
Physical activity is associated with a favourable (blunted) cortisol stress reactivity in healthy people. However, evidence from experimental study and with psychiatric patients is missing. This study examines whether exercise training impacts on cortisol stress reactivity in inpatients with major depressive disorder (MDD). These new insights are important because the stress reactivity of healthy people and patients with severe symptoms of depression might differ. Methods: The study was designed as a randomized controlled trial (trial registration number: NCT02679053). In total, 25 patients (13 women, 12 men, mean age: 38.1 12.0 years) completed a laboratory stressor task before and after a six-week intervention period. Nine samples of salivary free cortisol were taken before and after the Trier social stress test (TSST). Fourteen participants took part in six weeks of aerobic exercise training, while 11 patients were allocated to the control condition. While the primary outcome of the study was depressive symptom severity, the focus of this paper is on one of the secondary outcomes (cortisol reactivity during the TSST). The impact of aerobic exercise training was examined with a repeated-measures analysis of variance. We also examined the association between change in depression and cortisol response via correlational analysis. Cortisol reactivity did not change from baseline to post-intervention, either in the intervention or the control group. Participation in six weeks of aerobic exercise training was not associated with participants' cortisol reactivity. Moreover, depressive symptom change was not associated with change in cortisol response. Aerobic exercise training was not associated with patients' stress reactivity in this study. Because many patients initially showed a relatively flat/blunted cortisol response curve, efforts might be needed to find out which treatments are most efficient to promote a normalization of HPA axis reactivity.
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Affiliation(s)
- Markus Gerber
- Sport Science Section, Department of Sport, Exercise and Health, University of Basel, CH-4052 Basel, Switzerland; (S.B.); (F.C.); (U.P.)
| | - Christian Imboden
- Psychiatric Services Solothurn, 4503 Solothurn, Switzerland; (C.I.); (M.H.)
- Private Clinic Wyss, 3053 Muenchenbuchsee, Switzerland
| | | | - Serge Brand
- Sport Science Section, Department of Sport, Exercise and Health, University of Basel, CH-4052 Basel, Switzerland; (S.B.); (F.C.); (U.P.)
- University Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders, University of Basel, 4002 Basel, Switzerland;
- Substance Abuse Prevention Research Center and Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
| | - Flora Colledge
- Sport Science Section, Department of Sport, Exercise and Health, University of Basel, CH-4052 Basel, Switzerland; (S.B.); (F.C.); (U.P.)
| | - Anne Eckert
- University Psychiatric Clinics (UPK), Neurobiology Laboratory for Brain Aging and Mental Health, University of Basel, 4002 Basel, Switzerland;
| | - Edith Holsboer-Trachsler
- University Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders, University of Basel, 4002 Basel, Switzerland;
| | - Uwe Pühse
- Sport Science Section, Department of Sport, Exercise and Health, University of Basel, CH-4052 Basel, Switzerland; (S.B.); (F.C.); (U.P.)
| | - Martin Hatzinger
- Psychiatric Services Solothurn, 4503 Solothurn, Switzerland; (C.I.); (M.H.)
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Uebelacker LA, Sillice MA, Epstein-Lubow G, Battle CL, Anderson B, Caviness C, Miller IW, Abrantes AM. Combined intervention approaches for initiating and maintaining physical activity in depressed individuals: design and rationale of the Project MOVE randomized clinical trial. Contemp Clin Trials 2020; 91:105974. [PMID: 32151752 PMCID: PMC8017446 DOI: 10.1016/j.cct.2020.105974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 02/25/2020] [Accepted: 03/02/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Regular engagement in physical activity decreases risks for many chronic conditions, and may also improve depression symptoms. However, rates of physical activity and adherence to exercise interventions remain low among depressed individuals relative to non-depressed individuals. METHODS This is a study protocol for Project MOVE. This study is a theoretically-driven, 3-arm randomized controlled trial for increasing physical activity with depressed adults. Each successive arm includes an added component that may serve to increase and maintain physical activity. The arms are: 1) Brief advice (BA) to exercise alone (minimal treatment control condition); 2) BA + supervised and home-based exercise (SHE) + health education (HE; serves as contact control for CBEX); and 3) BA + SHE +cognitive-behavioral sessions focused on increasing and maintaining exercise (CBEX). The target sample size is 240. Assessments are conducted at baseline, Month 1.5, end of intervention (month 3), and at 6 and 9 months. The primary outcome is minutes of moderate-to-vigorous physical activity, assessed via an accelerometer. Secondary outcomes include cardiorespiratory fitness, body composition, and depression, and maintenance of moderate-vigorous physical activity through 6 and 9 month follow-ups. Mediators and moderators derived from behavior change theories, including the Health Behavior Model, Self-Determination Theory, and Social Ecological Theory, will be examined. CONCLUSION Project MOVE is designed to test primarily whether both a structured exercise program (SHE) and a cognitive-behavioral group (CBEX) increase physical activity in depressed adults during both a 3-month intervention period, and during the 6-months that follow.
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Affiliation(s)
- Lisa A Uebelacker
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Psychosocial Research Program, Butler Hospital, Providence, RI, USA
| | - Marie A Sillice
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Psychosocial Research Program, Butler Hospital, Providence, RI, USA; Behavioral Medicine & Addiction Research, Butler Hospital, Providen,ce, RI, USA.
| | - Gary Epstein-Lubow
- Psychosocial Research Program, Butler Hospital, Providence, RI, USA; Department of Health Services, Policy and Practice of Brown University, Providence, RI, USA
| | - Cynthia L Battle
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Psychosocial Research Program, Butler Hospital, Providence, RI, USA; Center for Women's Behavioral Health, Women & Infants' Hospital of Rhode Island, Providence, RI, USA
| | - Bradley Anderson
- Behavioral Medicine & Addiction Research, Butler Hospital, Providen,ce, RI, USA
| | - Celeste Caviness
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Behavioral Medicine & Addiction Research, Butler Hospital, Providen,ce, RI, USA
| | - Ivan W Miller
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Psychosocial Research Program, Butler Hospital, Providence, RI, USA
| | - Ana M Abrantes
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Behavioral Medicine & Addiction Research, Butler Hospital, Providen,ce, RI, USA
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Patel N, Chakraborty S, Bandyopadhyay D, Amgai B, Hajra A, Atti V, Das A, Ghosh RK, Deedwania PC, Aronow WS, Lavie CJ, Di Tullio MR, Vaduganathan M, Fonarow GC. Association between depression and readmission of heart failure: A national representative database study. Prog Cardiovasc Dis 2020; 63:585-590. [PMID: 32224112 DOI: 10.1016/j.pcad.2020.03.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 03/22/2020] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Depression is a recognized predictor of adverse outcomes in patients with heart failure (HF) and is associated with poor quality of life, functional limitation, increased morbidity and mortality, decreased adherence to treatment, and increased rehospitalization. To understand the impact of depression on HF readmission, we conducted a retrospective cohort study using the Nationwide Readmission Database (NRD) 2010-2014. METHODS We identified all patients with the primary discharge diagnosis of HF by ICD-9-CM codes. The primary outcome of the study was to identify 30-day all-cause readmission and causes of readmission in patients with and without depression. Multivariate Cox regression analysis was used to estimate the adjusted hazard ratio for the primary and secondary outcomes. RESULTS Among, 3,500,570 patients admitted with HF, 9.7% had concomitant depression. Patients with depression were more likely to be readmitted within 30 days (19.7% vs. 18.5%; P < 0.001). Concomitant depression was associated with higher risk of all-cause readmissions within 30 days and 90 days [P < 0.001] but was not associated with increased readmissions due to cardiovascular (CV) cause at 30 days and 90 days. The hazard of psychiatric causes of readmission was higher in patients with depression, both at 30 days [P < 0.001], and 90 days [P < 0.001]. Most of the readmissions were due to CV causes, with HF being the most common cause. CONCLUSION Among patients hospitalized with HF, the presence of depression is associated with increased all-cause readmission driven mainly by psychiatric causes but not CV-related readmission. Standard interventions targeted toward HF are unlikely to modify this portion of all-cause readmission.
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Affiliation(s)
| | | | | | | | - Adrija Hajra
- Jacobi Medical Center/Albert Einstein College of Medicine, Bronx, New York, USA
| | | | - Avash Das
- University of Texas Southwestern Medical Center, TX, USA
| | - Raktim K Ghosh
- Case Western Reserve University, Heart and Vascular Institute, MetroHealth Medical Center, Cleveland, OH, USA
| | | | - Wilbert S Aronow
- Westchester Medical Center and New York Medical College, New York, USA
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the University of Queensland School of Medicine, New Orleans, LA, USA
| | | | - Muthiah Vaduganathan
- Brigham and Women's Hospital Heart and Vascular Center and Harvard Medical School, Boston, MA, USA
| | - Gregg C Fonarow
- Division of Cardiology, Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan-UCLA Medical Center, Los Angeles, California, USA
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Lindegård A, Wastensson G, Hadzibajramovic E, Grimby-Ekman A. Longitudinal associations between cardiorespiratory fitness and stress-related exhaustion, depression, anxiety and sleep disturbances. BMC Public Health 2019; 19:1726. [PMID: 31870352 PMCID: PMC6929432 DOI: 10.1186/s12889-019-8081-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 12/13/2019] [Indexed: 01/09/2023] Open
Abstract
Background In the last few years, so-called “common mental disorders”, including adjustment disorder and stress-related exhaustion, have outrivalled musculoskeletal disorders as being the leading cause of long-term sick leave in Sweden. Cardiorespiratory fitness level defined as “the maximal amount of physiological work that an individual can do as measured by oxygen consumption” has in many studies shown to reduce the risk of several life-style related diseases and moreover to improve mood, well-being and physical performance. The aim of the present study was to investigate, longitudinal associations between cardiorespiratory fitness and self-reported physical activity levels and the severity of symptoms connected to stress-related exhaustion, depression, anxiety, and sleep disturbances among women clinically diagnosed with stress-related exhaustion disorder (ED). Methods The study was that of a longitudinal cohort study consisting of women (n = 88) diagnosed with stress-related ED in a specialist clinic in Gothenburg, Sweden. Cardiorespiratory fitness was measured with the Åstrand indirect test of maximal oxygen uptake (VO2max) and subjective measures of physical activity levels were rated on 4-graded physical activity scale. To measure and follow symptoms of ED over time the SMBQ-questionnaire (Shirom Melamed Burnout Questionnaire) was used. The Hospital Anxiety and Depression Scale (HADS) was used to measure depression and anxiety. A proxy variable for capturing overall disturbed sleep used to measure sleep. Longitudinal associations for continuous outcome variables and the dichotomous variable sleep were analysed using mixed- effects regression models with random intercepts. Regression coefficients along with the 95% confidence interval (CI) are presented as measures of association. Both exposures and the outcome were measured simultaneously over six waves (T1–T6). Results The results showed statistically significant associations between level of fitness and reduced symptoms of stress-related exhaustion over time. Best improvements over time were seen in patients having a medium cardiorespiratory fitness level. No associations could be found between cardiorespiratory fitness level over time and anxiety, depression or sleep disturbances. Conclusion Having medium cardiorespiratory fitness was positivity associated with a more sustained reduction in symptoms of ED overtime compared to those having low or high cardiorespiratory fitness levels. The clinical implication following this result is that an individual recommendation based on a medium level of physical activity in line with the recommendations from ACSM (American College of Sports Medicine) is preferable compared to recommendations including more vigorous physical activity in order to restore and sustainably reduce symptoms of exhaustion disorder over time.
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Affiliation(s)
- Agneta Lindegård
- Institute of Stress Medicine, Region Västra Götaland, Carl Skottsbergs gata 22 B, 413 19, Gothenburg, Sweden.
| | - Gunilla Wastensson
- Occupational and Environmental Medicine, Community Medicine and Public Health, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Emina Hadzibajramovic
- Institute of Stress Medicine, Region Västra Götaland, Carl Skottsbergs gata 22 B, 413 19, Gothenburg, Sweden.,Health Metrics, Community Medicine and Public Health, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Anna Grimby-Ekman
- Health Metrics, Community Medicine and Public Health, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
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Liang X, Tang J, Chao FL, Zhang Y, Chen LM, Wang FF, Tan CX, Luo YM, Xiao Q, Zhang L, Qi YQ, Jiang L, Huang CX, Gao Y, Tang Y. Exercise improves depressive symptoms by increasing the number of excitatory synapses in the hippocampus of CUS-Induced depression model rats. Behav Brain Res 2019; 374:112115. [DOI: 10.1016/j.bbr.2019.112115] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 07/08/2019] [Accepted: 07/26/2019] [Indexed: 01/28/2023]
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Keeler LA, Skidmore B, Leenstra T, MacDonald JR, Stewart D. Treating University Students’ Depression using Physical Activity with Peers: Two Field-Based Quasi-Experiments Grounded in the Self-Determination Theory. JOURNAL OF COLLEGE STUDENT PSYCHOTHERAPY 2019. [DOI: 10.1080/87568225.2019.1660293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- L. A. Keeler
- Department of Health and Human Development, Western Washington University, Bellingham, Washington, USA
| | - B. Skidmore
- Department of Health and Human Development, Western Washington University, Bellingham, Washington, USA
| | - T. Leenstra
- Department of Health and Human Development, Western Washington University, Bellingham, Washington, USA
| | - J. R. MacDonald
- Department of Health and Human Development, Western Washington University, Bellingham, Washington, USA
| | - D. Stewart
- Student Health Center, California State University, Chico, California, USA
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Buschert V, Prochazka D, Bartl H, Diemer J, Malchow B, Zwanzger P, Brunnauer A. Effects of physical activity on cognitive performance: a controlled clinical study in depressive patients. Eur Arch Psychiatry Clin Neurosci 2019; 269:555-563. [PMID: 29951850 DOI: 10.1007/s00406-018-0916-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 05/22/2018] [Indexed: 11/29/2022]
Abstract
Physical activity is a common adjunctive therapy in psychiatric and psychosomatic hospitals. In the present study, we assessed the effects of an exercise program, integrated into routine inpatient treatment, on cognitive performance and subjective severity of depression in a sample of patients suffering from major depression. We randomized n = 38 patients with unipolar depression to either physical exercise (n = 18) or occupational therapy as an active control treatment (n = 20). Both treatments were delivered in group format over a period of 3-4 weeks. Data indicate that there were significant improvements of cognitive functions and depressive symptoms in both groups, with specific treatment effects in reaction time and in short-term verbal memory favoring the physical activity group. In conclusion, we found physical exercise to be a feasible, easy-to-implement add-on therapy for depressive patients with promising effects on cognitive performance. However, these results need to be replicated in larger samples with an extended follow-up.
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Affiliation(s)
- V Buschert
- Department of Neuropsychology, kbo-Inn-Salzach-Klinikum, Psychiatric Hospital, Gabersee 13, 83512, Wasserburg am Inn, Germany
| | - D Prochazka
- Department of Neuropsychology, kbo-Inn-Salzach-Klinikum, Psychiatric Hospital, Gabersee 13, 83512, Wasserburg am Inn, Germany
| | - H Bartl
- Department of Neuropsychology, kbo-Inn-Salzach-Klinikum, Psychiatric Hospital, Gabersee 13, 83512, Wasserburg am Inn, Germany
| | - J Diemer
- Department of Neuropsychology, kbo-Inn-Salzach-Klinikum, Psychiatric Hospital, Gabersee 13, 83512, Wasserburg am Inn, Germany
| | - B Malchow
- Department of Psychiatry and Psychotherapy, University Hospital Jena, Jena, Germany.,Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University Munich, Munich, Germany
| | - P Zwanzger
- Department of Neuropsychology, kbo-Inn-Salzach-Klinikum, Psychiatric Hospital, Gabersee 13, 83512, Wasserburg am Inn, Germany.,Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University Munich, Munich, Germany
| | - A Brunnauer
- Department of Neuropsychology, kbo-Inn-Salzach-Klinikum, Psychiatric Hospital, Gabersee 13, 83512, Wasserburg am Inn, Germany. .,Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University Munich, Munich, Germany.
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Zhang YY, Lei YT, Song Y, Lu RR, Duan JL, Prochaska JJ. Gender differences in suicidal ideation and health-risk behaviors among high school students in Beijing, China. J Glob Health 2019; 9:010604. [PMID: 31217964 PMCID: PMC6571108 DOI: 10.7189/jogh.09.010604] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Suicide is still the leading cause of death in the 15 to 34-year age group, especially for girls aging 15 to 19-year old. In China particularly, the suicide rate of female is 60% higher than male. The gender difference on suicidal ideation and its patterns with academic, family, social and health-risk factors is unknown among adolescents in Beijing, China. Methods A total of 33 635 students in grades 7-12 in Beijing participated in the 2014 Chinese Youth Risk Behavior Surveillance. Data were stratified by gender and associations with suicidal ideation were analyzed using χ2 test and multivariate regression analyses. The interaction effects on suicidal ideation between gender and the related behaviors were also analyzed. Results The prevalence of suicidal ideation was significantly higher for girls (13.3%) than boys (10.7%). The multivariate regression analyses indicated that high academic pressure, running away from home, feeling lonely or sad/hopeless, being bullied, fighting, and binge drinking were significantly associated with suicidal ideation in boys and girls. Factors more strongly associated with suicidal ideation in girls than boys were being in junior vs senior high school (girl vs boys: 1.24 vs NA), high academic pressure (2.42 vs 1.55), ever smoking (1.52 vs NA), binge drinking (1.30 vs 1.17), fighting once (1.63 vs 1.06) and being sad/hopeless (2.39 vs 2.04) and their interaction with gender were all statistically significant (P < 0.05). A lower likelihood of suicidal ideation was found among boys, but not girls, who had PE class two or more days per week. Conclusions Girls showed more vulnerability to suicidal ideation than boys particularly among girls in junior school, reporting high academic pressure, smoking, binge drinking and fighting. The combinations of risk factors and differential patterns for boys and girls point to high-risk groups and potential targets for gender-specific suicide prevention.
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Affiliation(s)
- Yi-Yang Zhang
- Peking University Third Hospital, Peking University, Beijing, China
| | - Yuan-Ting Lei
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Yi Song
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China.,Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, California, USA
| | - Ruo-Ran Lu
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Jia-Li Duan
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Judith J Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, California, USA
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Gerber M, Beck J, Brand S, Cody R, Donath L, Eckert A, Faude O, Fischer X, Hatzinger M, Holsboer-Trachsler E, Imboden C, Lang U, Mans S, Mikoteit T, Oswald A, Pühse U, Rey S, Schreiner AK, Schweinfurth N, Spitzer U, Zahner L. The impact of lifestyle Physical Activity Counselling in IN-PATients with major depressive disorders on physical activity, cardiorespiratory fitness, depression, and cardiovascular health risk markers: study protocol for a randomized controlled trial. Trials 2019; 20:367. [PMID: 31221205 PMCID: PMC6585067 DOI: 10.1186/s13063-019-3468-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Accepted: 05/24/2019] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is a widespread and burdensome psychiatric issue. Physical activity counselling may increase lifestyle physical activity and cardiorespiratory fitness in this specific and particularly vulnerable population, which often suffers from both mental and physical health problems. Therefore, this study will examine the impact of a lifestyle physical activity counselling intervention on physical activity, cardiorespiratory fitness, depression, and cardiovascular health risk markers among in-patients diagnosed with MDD compared to controls. Secondary purposes are to examine the acceptability and perceived usefulness of the intervention among these patients, to find out whether the effectiveness of the intervention is moderated by genetic factors, and to compare baseline values with an age- and gender-matched group of healthy controls. METHODS The study is designed as a multi-centric two-arm randomized clinical trial including an intervention group and a placebo control group, allocation concealment, single-blinding, and intention-to-treat analysis. Participants (N = 334) will be continuously recruited from four clinics specialized in the treatment of MDD. The intervention builds on a standardized, theory-based, low-cost lifestyle physical activity counselling programme, which was specifically designed for an in-patient rehabilitation setting. The placebo control condition consists of general instructions about health-enhancing physical activity. Data assessments will take place 2-3 weeks after admission to in-patient treatment (baseline), and 6 weeks (post) and 12 months (follow-up) after discharge from in-patient treatment. The primary outcome is objectively assessed physical activity at follow-up. DISCUSSION Because regular physical activity has proven to be an important predictor of long-term response and remission in patients with major depression, we believe that our planned study may lay important groundwork by showing how individually tailored lifestyle physical activity counselling can be integrated into given clinical structures. Improving physical activity may have important implications for tackling metabolic and cardiovascular disease and increasing mood and cognitive functioning in this at-risk population, hence limiting the future burden of multiple chronic conditions. Increased physical activity may also reduce the likelihood of future depressive episodes. By moving towards the primary prevention of chronic physical conditions, much can be done to enhance the quality and quantity of life of people with MDD. TRIAL REGISTRATION ISRCTN, ISRCTN10469580 . Registered on 3 September 2018.
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Affiliation(s)
| | | | - Serge Brand
- University of Basel, Basel, Switzerland
- University of Basel, Adult Psychiatric Clinics (UPKE), Basel, Switzerland
- Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
| | | | - Lars Donath
- German Sport University Cologne, Cologne, Germany
| | - Anne Eckert
- University of Basel, Adult Psychiatric Clinics (UPKE), Basel, Switzerland
| | | | | | | | | | | | - Undine Lang
- University of Basel, Adult Psychiatric Clinics (UPKE), Basel, Switzerland
| | - Sarah Mans
- Private Clinic Wyss, Münchenbuchsee, Switzerland
| | | | - Anja Oswald
- Psychiatric Clinic Sonnenhalde, Riehen, Switzerland
| | - Uwe Pühse
- University of Basel, Basel, Switzerland
| | - Sofia Rey
- University of Basel, Basel, Switzerland
| | | | - Nina Schweinfurth
- University of Basel, Adult Psychiatric Clinics (UPKE), Basel, Switzerland
| | - Ursula Spitzer
- University of Basel, Adult Psychiatric Clinics (UPKE), Basel, Switzerland
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41
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Case AD, Keyes CLM, Huffman KF, Sittser K, Wallace A, Khatiwoda P, Parnell HE, Proeschold-Bell RJ. Attitudes and behaviors that differentiate clergy with positive mental health from those with burnout. J Prev Interv Community 2019; 48:94-112. [PMID: 31140956 DOI: 10.1080/10852352.2019.1617525] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Clergy provide significant support to their congregants, sometimes at a cost to their mental health. Identifying the factors that enable clergy to flourish in the face of such occupational stressors can inform prevention and intervention efforts to support their well-being. In particular, more research is needed on positive mental health and not only mental health problems. We conducted interviews with 52 clergy to understand the behaviors and attitudes associated with positive mental health in this population. Our consensual grounded theory analytic approach yielded five factors that appear to distinguish clergy with better versus worse mental health. They were: (1) being intentional about health; (2) a "participating in God's work" orientation to ministry; (3) boundary-setting; (4) lack of boundaries; and (5) ongoing stressors. These findings point to concrete steps that can be taken by clergy and those who care about them to promote their well-being.
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Affiliation(s)
- Andrew D Case
- Department of Psychological Science, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Corey L M Keyes
- Department of Sociology, Emory University, Atlanta, Georgia, USA
| | - Katie F Huffman
- Duke Divinity School, Duke University, Durham, North Carolina, USA
| | - Kelli Sittser
- Duke Divinity School, Duke University, Durham, North Carolina, USA
| | - Amanda Wallace
- Duke Divinity School, Duke University, Durham, North Carolina, USA
| | | | - Heather E Parnell
- Center for Health Policy and Inequalities Research, Duke University, Durham, North Carolina, USA
| | - Rae Jean Proeschold-Bell
- Duke Global Health Institute, Durham, North Carolina, USA.,Center for Health Policy and Inequalities Research, Duke University, Durham, North Carolina, USA
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42
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Zhang J, He ZX, Wang LM, Yuan W, Li LF, Hou WJ, Yang Y, Guo QQ, Zhang XN, Cai WQ, An SC, Tai FD. Voluntary Wheel Running Reverses Deficits in Social Behavior Induced by Chronic Social Defeat Stress in Mice: Involvement of the Dopamine System. Front Neurosci 2019; 13:256. [PMID: 31019446 PMCID: PMC6458241 DOI: 10.3389/fnins.2019.00256] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 03/05/2019] [Indexed: 01/04/2023] Open
Abstract
Voluntary exercise has been reported to have a therapeutic effect on many psychiatric disorders and social stress is known to impair social interaction. However, whether voluntary exercise could reverse deficits in social behaviors induced by chronic social defeat stress (CSDS) and the underlying mechanism remain unclear. The present study shows CSDS impaired social preference and induced social interaction deficiency in susceptible mice. Voluntary wheel running (VWR) reversed these effects. In addition, CSDS decreased the levels of tyrosine hydroxylase in the ventral tegmental area and the D2 receptor (D2R) in the nucleus accumbens (NAc) shell. These changes can be recovered by VWR. Furthermore, the recovery effect of VWR on deficits in social behaviors in CSDS mice was blocked by the microinjection of D2R antagonist raclopride into the NAc shell. Thus, these results suggest that the mechanism underlying CSDS-induced social interaction disorder might be caused by an alteration of the dopamine system. VWR may be a novel means to treat CSDS-induced deficits in social behaviors via modifying the dopamine system.
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Affiliation(s)
- Jing Zhang
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, China
| | - Zhi-Xiong He
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, China
| | - Li-Min Wang
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, China
| | - Wei Yuan
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, China
| | - Lai-Fu Li
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, China
| | - Wen-Juan Hou
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, China
| | - Yang Yang
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, China
| | - Qian-Qian Guo
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, China
| | - Xue-Ni Zhang
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, China
| | - Wen-Qi Cai
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, China
| | - Shu-Cheng An
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, China
| | - Fa-Dao Tai
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, China
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Frodl T, Strehl K, Carballedo A, Tozzi L, Doyle M, Amico F, Gormley J, Lavelle G, O’Keane V. Aerobic exercise increases hippocampal subfield volumes in younger adults and prevents volume decline in the elderly. Brain Imaging Behav 2019; 14:1577-1587. [DOI: 10.1007/s11682-019-00088-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Jarcho MR, McNeal N, Colburn W, Normann MC, Watanasriyakul WT, Grippo AJ. Wheel access has opposing effects on stress physiology depending on social environment in female prairie voles (Microtus ochrogaster). Stress 2019; 22:265-275. [PMID: 30628521 PMCID: PMC6476667 DOI: 10.1080/10253890.2018.1553948] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 11/25/2018] [Indexed: 12/16/2022] Open
Abstract
Physical exercise and chronic social stress are both known to impact general health and hypothalamic-pituitary-adrenal (HPA) axis function, albeit typically in opposing directions. Therefore, the question we investigated in this study was how these two factors - physical exercise and chronic social isolation - would interact when presented simultaneously in a female rodent model. Adult female prairie voles were separated into four experimental groups: (1) isolated without wheel access, (2) isolated with wheel access, (3) paired without wheel access, and (4) paired with wheel access. Plasma, hair, and adrenal glands were sampled to investigate changes in stress physiology. Our results indicate that, when isolated, wheel access had a mitigating effect on HPA activity. However, in paired animals, wheel access had the opposite effect, as both adrenal mass and increase in hair corticosterone concentrations were greater in paired animals with wheel access. Strong correlations were detected between change in hair corticosterone and adrenal mass, while no correlations were found between plasma corticosterone and either of the other markers. These results imply that the HPA axis is highly sensitive to both the social environment and the physical demands placed on the individual, and that when investigating the effects of chronic isolation, both hair corticosterone and adrenal mass may be more reliable markers than a single plasma corticosterone sample.
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Affiliation(s)
| | - Neal McNeal
- Department of Psychology, Northern Illinois University, DeKalb, IL
| | - William Colburn
- Department of Psychology, Northern Illinois University, DeKalb, IL
| | | | | | - Angela J. Grippo
- Department of Psychology, Northern Illinois University, DeKalb, IL
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45
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Imboden C, Gerber M, Beck J, Eckert A, Pühse U, Holsboer-Trachsler E, Hatzinger M. Effects of Aerobic Exercise as Add-On Treatment for Inpatients With Moderate to Severe Depression on Depression Severity, Sleep, Cognition, Psychological Well-Being, and Biomarkers: Study Protocol, Description of Study Population, and Manipulation Check. Front Psychiatry 2019; 10:262. [PMID: 31073292 PMCID: PMC6497035 DOI: 10.3389/fpsyt.2019.00262] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 04/08/2019] [Indexed: 12/31/2022] Open
Abstract
Background: Aerobic exercise (AE) may be a non-pharmacological strategy to improve depression treatment and lessen the burden of somatic comorbidity of depression. Only few studies have examined the effect of AE as an add-on treatment for moderate to severe depression in an inpatient setting, and most studies have focused on depression severity and cardiovascular parameters. The purpose of the present article is to present the study protocol, to provide information about the assessed study population, and to perform a manipulation check in order to examine whether the intervention program was properly implemented. Methods: We conducted a randomized controlled trial in two centers comparing 6 weeks of AE to a placebo control intervention (stretching) as an add-on to standardized inpatient treatment of moderate to severe depression. Besides depression severity, several other psychological and biological variables were measured such as salivary cortisol, brain-derived neurotropic factor, cognitive tests, and polysomnography. To evaluate long-term effects of the intervention, we also scheduled a follow-up 6 months after completion of the study intervention. Results: Forty-five patients were randomized to either AE (n = 23) or the placebo intervention (n = 22); 36 patients completed the 6-week intervention. In the AE group, 65% completed all 18 training sessions. Patients who were less physically active prior to admission were less likely to complete the study. With regard to energy expenditure, mean kcal/kg/week was 16.4 kcal/kg/week (range: 13.8-17.7), coming close to the targeted dose of 17.5 kcal/kg/week. Conclusions: Overall, patients showed good adherence to the intervention protocol despite at least moderate depression severity. However, the dropout rate suggests that depressed inpatients may need special support to adhere to a structured exercise intervention program. This study will add evidence on the effects of AE as an add-on to inpatient treatment of moderate to severe depression. Besides antidepressant effects, potentially beneficial effects of AE on a broad array of further variables associated with depression will be evaluated. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT02679053.
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Affiliation(s)
- Christian Imboden
- Psychiatric Services Solothurn, Solothurn, Switzerland.,Medical Faculty, University of Basel, Basel, Switzerland.,Private Clinic Wyss, Münchenbuchsee, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Johannes Beck
- Psychiatric University Hospital, University of Basel, Basel, Switzerland.,Private Clinic Sonnenhalde, Riehen, Switzerland
| | - Anne Eckert
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Uwe Pühse
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | | | - Martin Hatzinger
- Psychiatric Services Solothurn, Solothurn, Switzerland.,Medical Faculty, University of Basel, Basel, Switzerland
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Danborg P, Valdersdorf M, Gøtzsche P. Long-term harms from previous use of selective serotonin reuptake inhibitors: A systematic review. INTERNATIONAL JOURNAL OF RISK & SAFETY IN MEDICINE 2019; 30:59-71. [PMID: 30714974 PMCID: PMC6839490 DOI: 10.3233/jrs-180046] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Millions of people are treated with antidepressants like selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs). This clinical practice is based on short-term trials that have exaggerated the benefits and underestimated the harms. We also know too little about long-term harms. AIM To assess harms of SSRIs and SNRIs that persist after end of drug intake. METHODS Systematic review of placebo-controlled randomised trials of any length in patients with a psychiatric diagnosis and a follow-up of at least six months. Our primary outcomes were mortality, functional outcomes, quality of life and core psychiatric events. We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials and checked the references for eligible articles. One researcher extracted data and another checked the data extraction. RESULTS Our searches returned 9,153 unique records. We included 22 papers for 12 trials on SSRIs. Median intervention and follow-up periods were 15 and 52 weeks, respectively. Median number of randomised participants was 51; only two trials had a drop-out rate below 20%.Outcome reporting was less thorough during follow-up than for the intervention period and only two trials maintained the blind during follow-up. All authors concluded that the drugs were not beneficial in the long term.All trials reported harms outcomes selectively or did not report any. Only two trials reported on any of our primary outcomes (school attendance and number of heavy drinking days). CONCLUSION The randomised trials currently available cannot be used to investigate persistent harms of antidepressants.
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Affiliation(s)
- P.B. Danborg
- Nordic Cochrane Centre, Rigshospitalet, Copenhagen, Denmark
| | - M. Valdersdorf
- Nordic Cochrane Centre, Rigshospitalet, Copenhagen, Denmark
| | - P.C. Gøtzsche
- Nordic Cochrane Centre, Rigshospitalet, Copenhagen, Denmark
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47
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Roeh A, Kirchner SK, Malchow B, Maurus I, Schmitt A, Falkai P, Hasan A. Depression in Somatic Disorders: Is There a Beneficial Effect of Exercise? Front Psychiatry 2019; 10:141. [PMID: 30949079 PMCID: PMC6435577 DOI: 10.3389/fpsyt.2019.00141] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 02/26/2019] [Indexed: 12/13/2022] Open
Abstract
Background: The beneficial effects of exercise training on depressive symptoms are well-established. In the past years, more research attention has been drawn to the specific effects of exercise training on depressive symptoms in somatically ill patients. This reviews aims at providing a comprehensive overview of the current findings and evidence of exercise interventions in somatic disorders to improve depressive symptoms. Methods: We systematically searched PubMed and Cochrane databases and extracted meta-analyses from somatically ill patients that underwent exercise interventions and provided information about the outcome of depressive symptoms. Results: Of the 4123 detected publications, 39 were selected for final analysis. Various diseases were included (breast-cancer, prostate cancer, mixed-cancer, cardiovascular disease, coronary heart disease, hemodialysis, fibromyalgia syndrome, acute leukemia, other hematological malignancies, heart failure, HIV, multiple sclerosis, mixed neurological disorders, Parkinson's disease, stroke, ankylosing spondylitis, traumatic brain injury, lupus erythematodes). Most meta-analyses (33/39) found beneficial effects on depressive symptoms, but quality of the included studies as well as duration, intensity, frequency, and type of exercise varied widely. Conclusion: Exercise training has the potential to improve depressive symptoms in patients with somatic disorders. For specific training recommendations, more high quality studies with structured exercise programs and better comparability are needed.
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Affiliation(s)
- Astrid Roeh
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Sophie K Kirchner
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Berend Malchow
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Jena, Jena, Germany
| | - Isabel Maurus
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Andrea Schmitt
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany.,Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Alkomiet Hasan
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
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48
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Haller N, Lorenz S, Pfirrmann D, Koch C, Lieb K, Dettweiler U, Simon P, Jung P. Individualized Web-Based Exercise for the Treatment of Depression: Randomized Controlled Trial. JMIR Ment Health 2018; 5:e10698. [PMID: 30314962 PMCID: PMC6234340 DOI: 10.2196/10698] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 06/13/2018] [Accepted: 06/28/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Due to the high prevalence of depressive disorders, it is mandatory to develop therapeutic strategies that provide universal access and require limited financial and human resources. Web-based therapeutic approaches fulfill these conditions. OBJECTIVE The objective of our study was to assess the feasibility, acceptability, and efficacy of a supervised, individualized 8-week Web-based exercise intervention conducted for patients with moderate to severe depression. METHODS We recruited 20 patients with unipolar depression and randomly assigned them into 2 groups (intervention, exercise program group, n=14, and control, treatment-as-usual group, n=6). At baseline, depressive symptoms were rated via the Quick Inventory of Depressive Symptomatology (QIDS) by patients themselves (QIDS-self-report, QIDS-SR) and by a blinded psychiatrist (QIDS-clinician rating, QIDS-C). In addition, performance diagnostics (lactate analysis, spiroergometry during a treadmill walking test) were conducted. Quality of life was assessed via the Short Form-36 questionnaire (SF-36) and self-efficacy via the General Self-Efficacy scale (GSE). In addition, habitual physical activity (HPA) was determined via the Baecke questionnaire. Participants of the intervention group received exercise schedules once weekly with endurance and strength training instructions. Rating of depressive symptoms was repeated after 6-12 days and 8 weeks; performance diagnostics and the completion of all the questionnaires were repeated after 8 weeks only. RESULTS The severity of depression subsided significantly in the intervention group after 8 weeks (median change in QIDS-SR: -5; interquartile range, IQR: -2 to -10), although it was already evident within the first 6-12 days (median change in QIDS-SR: -6; IQR: -2 to -8). During the intervention, participants undertook a median of 75 (IQR: 63 to 98) minutes of endurance training per week or 84% (16 [IQR: 9 to 19] of 19 [IQR: 15 to 21]) recommended endurance units in total. In addition, 9 (IQR: 4 to 12) of 10 (IQR: 8 to 13) recommended strength training exercise units were conducted during the 8 weeks. Performance diagnostics revealed a substantial increase in the maximum output in Watt for the intervention group after 8 weeks. Moreover, the intervention showed a favorable effect on SF-36 items "emotional well-being" and "social functioning" as well as on GSE and HPA scores. CONCLUSIONS Our individualized Web-based exercise intervention for moderate to severe depression was highly accepted by the patients and led to a significant and clinically relevant improvement of depressive symptoms. TRIAL REGISTRATION ClinicalTrials.gov NCT02874833; https://clinicaltrials.gov/ct2/show/NCT02874833 (Archived by WebCite at http://www.webcitation.org/72ZUUR4tE).
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Affiliation(s)
- Nils Haller
- Department of Sports Medicine, Rehabilitation and Disease Prevention, Johannes Gutenberg-University, Mainz, Germany.,Department of Psychiatry and Psychotherapy, University Medical Center, Mainz, Germany
| | - Sonja Lorenz
- Department of Psychiatry and Psychotherapy, University Medical Center, Mainz, Germany
| | - Daniel Pfirrmann
- Department of Sports Medicine, Rehabilitation and Disease Prevention, Johannes Gutenberg-University, Mainz, Germany
| | - Cora Koch
- Department of Psychiatry and Psychotherapy, University Medical Center, Mainz, Germany
| | - Klaus Lieb
- Department of Psychiatry and Psychotherapy, University Medical Center, Mainz, Germany
| | - Ulrich Dettweiler
- Faculty of Arts and Education, University of Stavanger, Stavanger, Norway
| | - Perikles Simon
- Department of Sports Medicine, Rehabilitation and Disease Prevention, Johannes Gutenberg-University, Mainz, Germany
| | - Patrick Jung
- Department of Psychiatry and Psychotherapy, University Medical Center, Mainz, Germany
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49
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Ledochowski L, Stark R, Ruedl G, Kopp M. [Physical activity as therapeutic intervention for depression]. DER NERVENARZT 2018; 88:765-778. [PMID: 27679515 DOI: 10.1007/s00115-016-0222-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
AIM This article gives a conspectus of the present state of research on the efficiency of exercise as a treatment for patients suffering from depression. METHODS A systematic review of articles published between December 1980 and March 2016 was carried out. The review focused on studies that examined the effects of exercise compared to control conditions in the treatment of depression. Extracted and analyzed information from the articles included details about participants, characteristics of exercise and control conditions, assessments, study design and outcomes. RESULTS A total of 34 of the 48 studies included in the literature search reported a significant reduction of depressive symptoms due to exercise interventions. There was a trend to reduced depressive symptoms following the exercise interventions in five studies. In nine studies no positive impact of exercise on depression and affective well-being could be detected. DISCUSSION This review article shows that physical activity decreases depressive symptoms and increases affective well-being in patients with depressive diseases; therefore, exercise should be recommended as a component of depression treatment within the framework of a multi-dimensional approach.
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Affiliation(s)
- L Ledochowski
- Institut für Sportwissenschaft, Universität Innsbruck, Fürstenweg 185, 6020, Innsbruck, Österreich.
| | - R Stark
- Kepler Universitätsklinikum, Neuromed Campus, Wagner-Jauregg-Weg 15, 4020, Linz, Österreich
| | - G Ruedl
- Institut für Sportwissenschaft, Universität Innsbruck, Fürstenweg 185, 6020, Innsbruck, Österreich
| | - M Kopp
- Institut für Sportwissenschaft, Universität Innsbruck, Fürstenweg 185, 6020, Innsbruck, Österreich
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50
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Ferioli M, Zauli G, Martelli AM, Vitale M, McCubrey JA, Ultimo S, Capitani S, Neri LM. Impact of physical exercise in cancer survivors during and after antineoplastic treatments. Oncotarget 2018; 9:14005-14034. [PMID: 29568412 PMCID: PMC5862633 DOI: 10.18632/oncotarget.24456] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Accepted: 01/23/2018] [Indexed: 12/12/2022] Open
Abstract
Cancer patients experience symptoms and adverse effects of treatments that may last even after the end of treatments. Exercise is a safe, non-pharmacological and cost-effective therapy that can provide several health benefits in cancer patient and survivors, reducing cancer symptoms and cancer treatment side effects. The purpose of this review is to describe how the physical exercise is capable to reduce cancer symptoms and cancer treatment side effects. We realized a pragmatic classification of symptoms, dividing them into physical, psychological and psycho-physical aspects. For each symptom we discuss causes, therapies, we analyse the effects of physical exercise and we summarize the most effective type of exercise to reduce the symptoms. This review also points out what are the difficulties that patients and survivors face during the practice of physical activity and provides some solutions to overcome these barriers. Related to each specific cancer, it emerges that type, frequency and intensity of physical exercise could be prescribed and supervised as a therapeutic program, like it occurs for the type, dose and duration of a drug treatment.
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Affiliation(s)
- Martina Ferioli
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Giorgio Zauli
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Alberto M. Martelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Marco Vitale
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- CoreLab, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - James A. McCubrey
- Department of Microbiology and Immunology, Brody School of Medicine, East Carolina University, Greenville, NC, USA
| | - Simona Ultimo
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Silvano Capitani
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Luca M. Neri
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
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