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Patrick RE, Dickinson RA, Gentry MT, Kim JU, Oberlin LE, Park S, Principe JL, Teixeira AL, Weisenbach SL. Treatment resistant late-life depression: A narrative review of psychosocial risk factors, non-pharmacological interventions, and the role of clinical phenotyping. J Affect Disord 2024; 356:145-154. [PMID: 38593940 DOI: 10.1016/j.jad.2024.04.017] [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: 12/19/2023] [Revised: 03/30/2024] [Accepted: 04/03/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Treatment resistant depression (TRD) is a subset of major depressive disorder (MDD) in which symptoms do not respond to front line therapies. In older adults, the assessment and treatment of TRD is complicated by psychosocial risk factors unique to this population, as well as a relative paucity of research. METHODS Narrative review aimed at (1) defining TRLLD for clinical practice and research; (2) describing psychosocial risk factors; (3) reviewing psychological and non-pharmacological treatments; (4) discussing the role of clinical phenotyping for personalized treatment; and (5) outlining research priorities. RESULTS Our definition of TRLLD centers on response to medication and neuromodulation in primary depressive disorders. Psychosocial risk factors include trauma and early life adversity, chronic physical illness, social isolation, personality, and barriers to care. Promising non-pharmacological treatments include cognitive training, psychotherapy, and lifestyle interventions. The utility of clinical phenotyping is highlighted by studies examining the impact of comorbidities, symptom dimensions (e.g., apathy), and structural/functional brain changes. LIMITATIONS There is a relative paucity of TRLLD research. This limits the scope of empirical data from which to derive reliable patterns and complicates efforts to evaluate the literature quantitatively. CONCLUSIONS TRLLD is a complex disorder that demands further investigation given our aging population. While this review highlights the promising breadth of TRLLD research to date, more research is needed to help elucidate, for example, the optimal timing for implementing risk mitigation strategies, the value of collaborative care approaches, specific treatment components associated with more robust response, and phenotyping to help inform treatment decisions.
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Affiliation(s)
- Regan E Patrick
- Department of Neuropsychology, McLean Hospital, Belmont, MA, United States of America; Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA, United States of America; Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America.
| | - Rebecca A Dickinson
- Department of Neuropsychology, McLean Hospital, Belmont, MA, United States of America; Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA, United States of America
| | - Melanie T Gentry
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States of America
| | - Joseph U Kim
- Department of Neurology, Brigham and Women's Hospital, Boston, MA, United States of America
| | - Lauren E Oberlin
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, United States of America; AdventHealth Research Institute, Neuroscience, Orlando, FL, United States of America
| | - Soohyun Park
- Department of Psychiatry, Tufts Medical Center, Boston, MA, United States of America
| | - Jessica L Principe
- Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA, United States of America; Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States of America; Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, United States of America
| | - Antonio L Teixeira
- Department of Psychiatry & Behavioral Sciences, UT Health Houston, Houston, TX, United States of America
| | - Sara L Weisenbach
- Department of Neuropsychology, McLean Hospital, Belmont, MA, United States of America; Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA, United States of America; Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America
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Ha WS, Chu MK. Advances in Exercise in the Clinical Trials of Migraine: A Scoping Review. Curr Pain Headache Rep 2024:10.1007/s11916-024-01269-9. [PMID: 38761296 DOI: 10.1007/s11916-024-01269-9] [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] [Accepted: 05/02/2024] [Indexed: 05/20/2024]
Abstract
PURPOSE OF REVIEW This review aimed to investigate emerging evidence regarding the effectiveness of exercise for migraines, focusing on the results of recent trials. Additionally, it explored the possibility of exercise as a treatment for migraines. RECENT FINDINGS Between 2020 and 2023, five, four, one, and two trials were conducted regarding the effect of aerobic exercise, anaerobic exercise, Tai Chi, and yoga, respectively, on migraine; all studies showed significant effects. Two trials on aerobic exercise showed that high-intensity exercise was similar to or slightly more effective than moderate-intensity exercise as a treatment for migraines. Three trials on anaerobic exercise reported its effectiveness in preventing migraines. Regarding efficacy, side effects, and health benefits, aerobic exercises and yoga are potentially beneficial strategies for the prevention of migraines. Further studies are needed to develop evidence-based exercise programs for the treatment of migraines.
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Affiliation(s)
- Woo-Seok Ha
- Department of Neurology, Severance Hospital Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea
| | - Min Kyung Chu
- Department of Neurology, Severance Hospital Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea.
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Annesi JJ, Powell SM. Temporal Aspects of Psychosocial Mediators of the Exercise-Weight Loss Maintenance Relationship Within Scalable Behavior-Change Treatments. Can J Nurs Res 2024:8445621241253876. [PMID: 38738268 DOI: 10.1177/08445621241253876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Abstract
STUDY BACKGROUND Limited knowledge of psychological correlates of weight loss is associated with continuing failures of behavioral obesity treatments beyond the short term. PURPOSE This study aimed to inform health professionals' obesity interventions via an increased knowledge of mediators of the exercise-weight loss maintenance relationship. METHODS Women participated in 6-month obesity treatments within community settings emphasizing moderate exercise and self-regulation skills development via primarily in-person (n = 54) or primarily written (n = 54) means. Changes in mood, self-regulating eating, and weight over 6, 12, and 24 months were assessed. A moderated mediation model was tested using the PROCESS macro instruction. RESULTS Improvements in mood, self-regulating eating, and weight were significantly greater in the in-person group. The relationship between a dichotomous measure of completing at least 3 sessions of exercise per week (or not) and change in weight over 6 months was no longer significant when the mediators of changes in negative mood and self-regulation of eating were sequentially entered. Paths of exercise→negative mood reduction→eating self-regulation increase→weight loss over 6, 12 and 24 months were significant. Exercise self-regulation at Month 3 significantly moderated the mood change→eating self-regulation change relationship. CONCLUSIONS Based on the identified paths, scalable obesity-treatment content and emphases were informed. This could help guide health professionals' actions concerning the management of obesity.
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Affiliation(s)
- James J Annesi
- California State University, Monterey Bay, Seaside, CA, USA
- Mind Body Wellbeing, LLC, Manahawkin, NJ, USA
| | - Sara M Powell
- California State University, Monterey Bay, Seaside, CA, USA
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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. [PMID: 38710216 DOI: 10.1055/a-2298-8510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [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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Baek JE, Hyeon SJ, Kim M, Cho HY, Hahm SC. Effects of dual-task resistance exercise on cognition, mood, depression, functional fitness, and activities of daily living in older adults with cognitive impairment: a single-blinded, randomized controlled trial. BMC Geriatr 2024; 24:369. [PMID: 38658827 PMCID: PMC11044356 DOI: 10.1186/s12877-024-04942-1] [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: 08/17/2023] [Accepted: 04/03/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Regular exercise is emphasized for the improvement of functional capacity and independence of older adults. This study aimed to compare the effects of a dual-task resistance exercise program and resistance exercise on cognition, mood, depression, physical function, and activities of daily living (ADL) in older adults with cognitive impairment. METHODS A total of 44 older adults participated in the study. Participants were randomly allocated to an experimental group (n = 22) performing a dual-task resistance exercise program for cognitive function improvement and a control group (n = 22) performing a resistance exercise program. Both groups performed the exercise for 40 min per session, three times a week, for 6 weeks (18 sessions). Cognition, mood, depression, functional fitness, and ADL were quantified before and after the intervention using the Mini-Mental State Examination (MMSE), profile of mood states (POMS), geriatric depression scale (GDS), senior fitness test (SFT), and Korean version of ADL, respectively. RESULTS There was a significant time and group interaction on the MMSE (p = 0.044). There were no significant time and group interactions in the POMS, GDS, SFT, or ADL. Cognitive function (p < 0.001), mood (p < 0.001), depression (p < 0.001), functional fitness (p < 0.001), and ADL (p < 0.001) significantly improved after dual-task resistance exercise, and cognitive function (p < 0.001), mood (p < 0.001), depression (p < 0.001), functional fitness (p < 0.001), and ADL (p < 0.001) significantly improved after resistance exercise. CONCLUSIONS Dual-task resistance exercise is more effective than resistance exercise in improving cognitive function in older adults with cognitive impairment. Both dual-task resistance exercise and resistance exercise improves mood, depression, functional fitness, and ADL after the intervention. We propose using dual-task resistance exercises for cognitive and physical health management in the older adults with cognitive impairment. TRIAL REGISTRATION This study was registered with the Clinical Research Information Service (WHO International Clinical Trials Registry Platform) (Registration ID, KCT0005389; Registration date, 09/09/2020).
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Affiliation(s)
- Ji-Eun Baek
- Department of Physical Therapy, College of Health Science, Gachon University, Incheon, Republic of Korea, 191 Hambangmoe-ro, Yeonsu-gu, Incheon
| | - Sang-Jun Hyeon
- Graduate School of Integrative Medicine, CHA University, 120 Haeryong-ro, Pocheon-si, 11160, Kyonggi-do, Republic of Korea
| | - May Kim
- Department of Physical Education, College of Education, Korea University, Seoul, Republic of Korea
| | - Hwi-Young Cho
- Department of Physical Therapy, College of Health Science, Gachon University, Incheon, Republic of Korea, 191 Hambangmoe-ro, Yeonsu-gu, Incheon.
| | - Suk-Chan Hahm
- Graduate School of Integrative Medicine, CHA University, 120 Haeryong-ro, Pocheon-si, 11160, Kyonggi-do, Republic of Korea.
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Bernstein EE, Wolfe EC, Huguenel BM, Wilhelm S. Lessons and Untapped Potential of Smartphone-Based Physical Activity Interventions for Mental Health: Narrative Review. JMIR Mhealth Uhealth 2024; 12:e45860. [PMID: 38488834 PMCID: PMC10981024 DOI: 10.2196/45860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 09/12/2023] [Accepted: 11/30/2023] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND Physical activity has well-known and broad health benefits, including antidepressive and anxiolytic effects. However, only approximately half of Americans meet even the minimum exercise recommendations. Individuals with anxiety, depression, or related conditions are even less likely to do so. With the advent of mobile sensors and phones, experts have quickly noted the utility of technology for the enhanced measurement of and intervention for physical activity. In addition to being more accessible than in-person approaches, technology-driven interventions may uniquely engage key mechanisms of behavior change such as self-awareness. OBJECTIVE This study aims to provide a narrative overview and specific recommendations for future research on smartphone-based physical activity interventions for psychological disorders or concerns. METHODS In this paper, we summarized early efforts to adapt and test smartphone-based or smartphone-supported physical activity interventions for mental health. The included articles described or reported smartphone-delivered or smartphone-supported interventions intended to increase physical activity or reduce sedentary behavior and included an emotional disorder, concern, or symptom as an outcome measure. We attempted to extract details regarding the intervention designs, trial designs, study populations, outcome measures, and inclusion of adaptations specifically for mental health. In taking a narrative lens, we drew attention to the type of work that has been done and used these exemplars to discuss key directions to build on. RESULTS To date, most studies have examined mental health outcomes as secondary or exploratory variables largely in the context of managing medical concerns (eg, cancer and diabetes). Few trials have recruited psychiatric populations or explicitly aimed to target psychiatric concerns. Consequently, although there are encouraging signals that smartphone-based physical activity interventions could be feasible, acceptable, and efficacious for individuals with mental illnesses, this remains an underexplored area. CONCLUSIONS Promising avenues for tailoring validated smartphone-based interventions include adding psychoeducation (eg, the relationship between depression, physical activity, and inactivity), offering psychosocial treatment in parallel (eg, cognitive restructuring), and adding personalized coaching. To conclude, we offer specific recommendations for future research, treatment development, and implementation in this area, which remains open and promising for flexible, highly scalable support.
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Affiliation(s)
- Emily E Bernstein
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Emma C Wolfe
- Department of Psychology, University of Virginia, Charlottesville, VA, United States
| | - Brynn M Huguenel
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Sabine Wilhelm
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
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Miyazaki T, Futohashi T, Baba H. Diet, Food Intake, and Exercise Mixed Interventions (DEMI) in the Enhancement of Wellbeing among Community-Dwelling Older Adults in Japan: Systematic Review and Meta-Analysis of Randomized Controlled Trials. Geriatrics (Basel) 2024; 9:32. [PMID: 38525749 PMCID: PMC10961817 DOI: 10.3390/geriatrics9020032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 02/23/2024] [Accepted: 02/29/2024] [Indexed: 03/26/2024] Open
Abstract
This systematic review and meta-analysis discusses the available data on the efficacy of diet, food intake, and exercise mixed interventions (DEMI) for community-dwelling older adults in Japan and assesses the evidence level. We searched the literature regarding the research questions using electronic and hand-searching methods. To ensure the reliability and quality of the evidence, we used the Cochrane risk of bias tool and GRADE system. All studies included DEMI; other interventions included group activities, health education, and community participation. All interventions were categorized into three classifications, namely "Diet and food intake", "Exercise", and "Other". Programs included lectures, practical exercises, group activities, consulting, and programs that could be implemented at home. By comparing groups and measuring outcomes at various time points, most studies reported positive results regarding the impact of the interventions. Specifically, usual gait speed, Food Frequency Questionnaire Score, and Diet Variety Score demonstrated significant improvement. Additionally, three studies demonstrated improvement in frailty. This review suggests that DEMI resulted in improvements in some outcome variables. However, the efficacy of all variables was not fully examined. The results of the meta-analysis revealed positive outcomes for some variables, although the evidence level for these outcomes was considered moderate.
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Affiliation(s)
- Takaaki Miyazaki
- Department of Rehabilitation, Tokyo University of Technology, 5-23-22 Nishikamata Ota-Ku, Tokyo 144-8535, Japan;
| | - Toshihiro Futohashi
- Department of Rehabilitation, Tokyo University of Technology, 5-23-22 Nishikamata Ota-Ku, Tokyo 144-8535, Japan;
| | - Hiroki Baba
- Department of Rehabilitation, Heisei Yokohama Hospital, 550 Totsukamach Totsuka-Ku, Yokohama 244-0003, Japan;
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Chen Z, Huang H, Liu R, Tang Z. Effects of internet-based exercise intervention on depression and anxiety: A systematic review and meta-analysis. Medicine (Baltimore) 2024; 103:e37373. [PMID: 38394484 DOI: 10.1097/md.0000000000037373] [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] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND While exercise is acknowledged for its positive effects on depression and anxiety symptoms, the benefits of internet-based exercise on mental health have not been extensively examined. This study seeks to systematically review and quantify the outcomes of high-quality randomized controlled trials (RCTs) that investigate the impact of internet-based exercise on depression and anxiety symptoms. METHODS Following the PRISMA 2020 guidelines, we conducted a comprehensive meta-analysis of RCTs. Databases, including Web of Science Core Collection, PubMed, PsycINFO, Medline, BIOSIS Previews, SPORTDiscus, and Education Source, were scoured through in September 2023. After quality assessment and data extraction, the analysis was performed using R. Using random effects models, effect sizes were determined and subsequently represented as standardized mean differences (SMD). RESULTS Our analysis incorporated data from 11 RCTs, involving a cohort of 1009 participants. We observed a modest yet significant reduction in depression and anxiety symptoms, with an SMD of -0.44 [95% confidence interval (CI) (-0.63, -0.26), I^2 = 79.3%, P < .01]. Interestingly, the effects were more pronounced in individuals diagnosed with depression, as indicated by an SMD of -0.96 [95% CI (-1.55, -0.37), I^2 = 82%, P < .01]. Furthermore, participants utilizing smartphone applications as part of their intervention reported a meaningful reduction in their symptoms, evidenced by an SMD of -0.52 [95% CI (-0.90, -0.14), I^2 = 87%, P < .01]. Additionally, short-term interventions, specifically those lasting <12 weeks, indicated a notable alleviation in depression symptoms, with an SMD of -0.76 [95% CI (-1.38, -0.14), I^2 = 86%, P < .01]. CONCLUSION Internet-based exercise interventions yield significant amelioration in depression and anxiety symptoms, with heightened efficacy observed among individuals with depression. Notably, short-term interventions, specifically those under 12 weeks, demonstrate enhanced benefits for depression relief.
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Affiliation(s)
- Zuo Chen
- Division of Sports science and Physical Education, Tsinghua University, Beijing, China
| | - Hui Huang
- Division of Sociology, Tsinghua University, Beijing, China
| | - Ruidong Liu
- Sports Coaching College, Beijing Sport University, Beijing, China
| | - Zhengyan Tang
- Division of Sports science and Physical Education, Tsinghua University, Beijing, China
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Zhang R, Liu S, Mousavi SM. Cognitive Dysfunction and Exercise: From Epigenetic to Genetic Molecular Mechanisms. Mol Neurobiol 2024:10.1007/s12035-024-03970-7. [PMID: 38286967 DOI: 10.1007/s12035-024-03970-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/19/2024] [Indexed: 01/31/2024]
Abstract
Maintaining good health is crucial, and exercise plays a vital role in achieving this goal. It offers a range of positive benefits for cognitive function, regardless of age. However, as our population ages and life expectancy increases, cognitive impairment has become a prevalent issue, often coexisting with age-related neurodegenerative conditions. This can result in devastating consequences such as memory loss, difficulty speaking, and confusion, greatly hindering one's ability to lead an ordinary life. In addition, the decrease in mental capacity has a significant effect on an individual's physical and emotional well-being, greatly reducing their overall level of contentment and causing a significant financial burden for communities. While most current approaches aim to slow the decline of cognition, exercise offers a non-pharmacological, safe, and accessible solution. Its effects on cognition are intricate and involve changes in the brain's neural plasticity, mitochondrial stability, and energy metabolism. Moreover, exercise triggers the release of cytokines, playing a significant role in the body-brain connection and its impact on cognition. Additionally, exercise can influence gene expression through epigenetic mechanisms, leading to lasting improvements in brain function and behavior. Herein, we summarized various genetic and epigenetic mechanisms that can be modulated by exercise in cognitive dysfunction.
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Affiliation(s)
- Runhong Zhang
- Department of Physical Education, Luliang University, Lishi, 033000, Shanxi, China.
| | - Shangwu Liu
- Department of Physical Education, Luliang University, Lishi, 033000, Shanxi, China
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Berwinkel A, Driessen M, Beblo T, Weigelt M. Combined physical activity training versus aerobic activity training in unipolar depressive disorder: a quasi-randomised evaluation study. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2023; 37:206-213. [PMID: 37084073 DOI: 10.1007/s40211-023-00464-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 03/03/2023] [Indexed: 04/22/2023]
Abstract
OBJECTIVE The positive effect of sport and exercise interventions on the treatment of unipolar depressive disorder (UDD) is well documented with respect to aerobic exercise. However, few studies have determined the effectiveness of other types of interventions (e.g., weight training, body and mind oriented, qigong or progressive muscle relaxation). Additionally, the effectiveness of specific combined sport and exercise approaches has rarely been investigated. Therefore, recommendations for the use of sport and exercise therapy to treat UDD have been developed. METHODS This quasi-randomised study used a pretest/posttest design to compare the effectiveness of two different interventions (aerobic activity training vs. combined physical activity training) on psychiatric outcome parameters in a day clinic psychiatric setting. A total of 62 participants were quasi-randomised to one of the two conditions. Affective, cognitive, psychosocial and neuropsychological changes were assessed by a battery of questionnaires before (t1) and after (t2) treatment. Accelerometers were used to assess energy consumption. RESULTS The results show that both training interventions have similar effects on the treatment of UDD. CONCLUSION These findings highlight the effectiveness of different physical activities in the treatment of UDD and provide further information for good clinical practice.
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Affiliation(s)
- Andre Berwinkel
- Universitätsklinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum Bethel, Remterweg 69-71, 33617, Bielefeld, Germany.
| | - Martin Driessen
- Universitätsklinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum Bethel, Remterweg 69-71, 33617, Bielefeld, Germany
| | - Thomas Beblo
- Universitätsklinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum Bethel, Remterweg 69-71, 33617, Bielefeld, Germany
| | - Matthias Weigelt
- Department Sport & Gesundheit, Universität Paderborn, Paderborn, Germany
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Adam T, Al Sharif AI, Alamri TSM, Al-Nashri RAO, Alluwimi AIM, Samkri AY, Alharthi MA, Moafa AY, Alsaadi NA, Alraimi AMS, Alquzi RHM. The State of Cardiac Rehabilitation in Saudi Arabia: Barriers, Facilitators, and Policy Implications. Cureus 2023; 15:e48279. [PMID: 38058323 PMCID: PMC10695855 DOI: 10.7759/cureus.48279] [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: 11/04/2023] [Indexed: 12/08/2023] Open
Abstract
Cardiovascular disease (CVD) is a critical public health issue in Saudi Arabia, where it is the leading cause of death. The economic burden of CVD in the country is expected to triple by 2035, reaching $9.8 billion. This paper provides an overview of CVD in Saudi Arabia and its risk factors, impact on healthcare, and effects on patients' quality of life. The review emphasizes the potential of cardiac rehabilitation (CR) programs in addressing the CVD epidemic. CR programs have been shown to reduce morbidity, mortality, and hospital readmissions while improving patients' cardiovascular health and overall well-being. However, these programs are underutilized and inaccessible in Saudi Arabia. The paper highlights the urgent need for CR programs in the country and suggests key strategies for implementation. These include increasing patient referrals, tailoring programs to individual needs, enhancing patient education, and making CR accessible through home-based options. Fostering multidisciplinary collaboration and developing tailored guidelines for Arab countries can further enhance the impact of CR programs. In conclusion, this review underscores the vital importance of comprehensive CR programs in Saudi Arabia to combat the rising CVD burden, improve patient quality of life, and align with the goals of the Saudi 2030 Vision for a healthier society.
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Affiliation(s)
- Tasneem Adam
- Medical Affairs, College of Applied Medical Sciences, King Saud Medical City, Riyadh, SAU
| | - Abdullah I Al Sharif
- Healthcare Planning and Development, Ministry of Health, Kingdom of Saudi Arabia, Riyadh, SAU
- College of Medicine, Alfaisal University, Riyadh, SAU
| | | | - Rawan Ahmad O Al-Nashri
- General Practice, Primary Healthcare Center, General Directorate of Health Affairs, Aseer, SAU
| | | | - Amani Yosef Samkri
- General Practice, Al Aziziah Primary Health Care Center, Ministry of Health, Makkah, SAU
| | | | | | - Nawaf A Alsaadi
- Medical Affairs, College of Medicine, King Saud Medical City, Riyadh, SAU
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Kulak A, Toros T, Ogras EB, Etiler IE, Bagci E, Gokyurek B, Bilgin U. The Impact of Sustainable Exercise on Self-Efficacy and Life Satisfaction in Women before and after Menopause. Behav Sci (Basel) 2023; 13:759. [PMID: 37754037 PMCID: PMC10525491 DOI: 10.3390/bs13090759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 09/04/2023] [Accepted: 09/11/2023] [Indexed: 09/28/2023] Open
Abstract
The study aims at elucidating the association between sustainable exercise and its influence on self-efficacy and life satisfaction in women during their premenopausal and postmenopausal stages. A relational screening model was employed on a sample of 422 women, with 215 premenopausal and 207 postmenopausal participants, utilizing convenience sampling. Participants' regularity of exercise and its duration was taken into consideration. Evaluation tools included the General Self-Efficacy Scale (GSES) and the Satisfaction with Life Scale (SWLS). Data were analyzed using a statistical software package with significance set at 0.05. Sustainable exercise demonstrated no significant difference in SWLS or GSES subdimensions among premenopausal women. However, postmenopausal women engaging in regular exercise reported significantly higher scores in SWLS and all GSES subdimensions. Moreover, positive correlations between age and SWLS scores, as well as between age and certain GSES subdimensions, were found in both pre- and postmenopausal periods. While sustainable exercise does not evidently impact the life satisfaction and self-efficacy of premenopausal women, it significantly enhances these parameters in postmenopausal women. Additionally, age appears to influence life satisfaction and specific self-efficacy subdimensions across both phases.
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Affiliation(s)
- Abdulaziz Kulak
- Physical Education and Sports School, Harran University, Sanliurfa 63300, Turkey
| | - Turhan Toros
- Department of Coaching Education, Mersin University, Mersin 33000, Turkey
| | - Emre Bulent Ogras
- Faculty of Sport Sciences, Mersin University, Mersin 33000, Turkey; (E.B.O.); (I.E.E.)
| | - Ibrahim Efe Etiler
- Faculty of Sport Sciences, Mersin University, Mersin 33000, Turkey; (E.B.O.); (I.E.E.)
| | - Emre Bagci
- Faculty of Sport Sciences, Gazi University, Ankara 06560, Turkey
| | - Belgin Gokyurek
- Faculty of Sport Sciences, Gazi University, Ankara 06560, Turkey
| | - Ulviye Bilgin
- Faculty of Sport Sciences, Gazi University, Ankara 06560, Turkey
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13
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Pérez Bedoya ÉA, Puerta-López LF, López Galvis DA, Rojas Jaimes DA, Moreira OC. Physical exercise and major depressive disorder in adults: systematic review and meta-analysis. Sci Rep 2023; 13:13223. [PMID: 37580497 PMCID: PMC10425328 DOI: 10.1038/s41598-023-39783-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/31/2023] [Indexed: 08/16/2023] Open
Abstract
The objective of this study was to assess the benefits and potential risks associated with different physical exercise modalities for managing symptoms in adults with major depressive disorder who were not receiving second-generation antidepressants or cognitive behavioral therapy. A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted. The search included multiple databases: Medline, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, PsycInfo, Web of Science, Clinical Trials repository, gray literature, and manual search. No language restrictions were applied. Eligible studies involved RCTs of adults with major depressive disorder who were not on antidepressants or receiving psychological therapy, comparing various exercise modalities with second-generation antidepressants or cognitive behavioral therapy, body-mind exercise, or no exercise interventions. Nine RCTs involving 678 adults were analyzed. The pooled results indicated a small clinical effect favoring exercise in reducing depressive symptoms, although the difference was not statistically significant (SMD = 0.27, 95% CI [- 0.58, 0.04], P = 0.09). Subgroup analyses suggested that intervention duration, frequency, intensity, supervision, age, overweight/obesity status, and diagnosis of depression could influence treatment outcomes. A sensitivity analysis was conducted for studies with controls without exercise interventions and a low risk of bias in the domains related to the randomization process and deviations from the intended interventions. The results showed that there are no statistically significant differences when interventions are compared with medication and body-mind exercise (p = 0.12, I2 = 78%). Furthermore, the analysis showed a moderate effect size favoring exercise, but no statistically significant difference between groups (p = 0.05), with high heterogeneity (I2 = 85%). The evidence quality was generally low to very low, and methodological limitations compromised the certainty of the findings. Adverse events associated with exercise were manageable. The study emphasizes the need for well-designed RCTs to provide clearer insights into the potential benefits of exercise in managing major depressive disorder symptoms. Caution is warranted in interpreting these results due to the limitations of the included studies.Systematic review registration: PROSPERO CRD42022356741.
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Affiliation(s)
- Édison Andrés Pérez Bedoya
- Department of Physical Education of the Federal University of Viçosa, Av. Peter Henry Rolfs, S/N - Campus Universitário, Viçosa, MG, 36570-900, Brazil.
| | | | | | | | - Osvaldo Costa Moreira
- Department of Physical Education of the Federal University of Viçosa, Av. Peter Henry Rolfs, S/N - Campus Universitário, Viçosa, MG, 36570-900, Brazil
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14
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Izquierdo M, Fiatarone Singh M. Promoting resilience in the face of ageing and disease: The central role of exercise and physical activity. Ageing Res Rev 2023; 88:101940. [PMID: 37127094 DOI: 10.1016/j.arr.2023.101940] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/16/2023] [Accepted: 04/28/2023] [Indexed: 05/03/2023]
Abstract
Exercise and physical activity offer clinical benefits across a wide range of both physical and neuropsychological diseases and disabilities in older adults, including syndromes for which pharmacological treatment is either absent or hazardous. However, exercise is vastly under-utilised and rarely fully integrated into aged care and geriatric medicine practice. It is still absent from the core training of most geriatricians and other healthcare professionals, and myths about risks of robust exercise abound. Insufficient physical activity and sedentariness are in fact the lethal conditions. Frailty is not a barrier to exercise, but rather one of the most important reasons to prescribe it. Like any other medical treatment, to prescribe exercise as a drug will require a full understanding of its benefits, dose-response characteristics, modality-specific adaptations, potential risks, and interactions with other treatments. Additionally, exercise prescription should be a mandatory component of training for all healthcare professionals in geriatric medicine and gerontology. This personal view asserts the importance of medication management closely integrated with physical exercise prescription, as well as nutritional support as cornerstone of a coherent and holistic approach to treating both fit and frail older adults. This includes identification and management of drug-exercise interactions, in the same way that we seek out and manage drug-drug interactions and drug-nutrient interactions. Our oldest patients deserve the dignity of our urgent resolve to remember the mission of medicine: the assertion and the assurance of the human potential. Exercise medicine is core to this mission.
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Affiliation(s)
- Mikel Izquierdo
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain.
| | - Maria Fiatarone Singh
- Faculty of Medicine and Health, School of Health Sciences and Sydney Medical School, The University of Sydney, New South Wales, Australia; Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Roslindale, MA, USA
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15
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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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16
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Hulteen RM, Marlatt KL, Allerton TD, Lovre D. Detrimental Changes in Health during Menopause: The Role of Physical Activity. Int J Sports Med 2023; 44:389-396. [PMID: 36807278 PMCID: PMC10467628 DOI: 10.1055/a-2003-9406] [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] [Indexed: 02/19/2023]
Abstract
Midlife women experience changes in cardiometabolic, physical, and psychosocial health during menopause that negatively impacts their overall quality of life. Factors that contribute to these increases in cardiometabolic risk include weight gain as well as increases in fat mass (particularly abdominal adiposity), insulin resistance, and vascular dysfunction. Other deleterious changes in physical health (e. g. reduced sleep health, bone density, and balance) as well as changes in psychosocial health (e. g. mood, anxiety, and depression) often coincide and are linked to these increases in cardiometabolic risk. Physical activity and exercise are important lifestyle components that have been demonstrated to improve cardiometabolic, physical, and psychosocial health, yet physical activity and exercise is known to decline during perimenopause and into the postmenopausal years. In this narrative review, we summarize these changes in overall health during menopause as well as how declining physical activity contributes to these changes. Additionally, we discuss how incorporating physical activity and exercise during menopause can potentially ameliorate health declines. We conclude that there exists a significant, positive impact of physical activity on cardiometabolic, physical, and psychological health among midlife women, particularly if undertaken during the perimenopausal and postmenopausal years.
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Affiliation(s)
- Ryan M. Hulteen
- Kinesiology, Louisiana State University, Baton Rouge, United States
| | - Kara L. Marlatt
- Clinical Science, Pennington Biomedical Research Center, Baton Rouge, United States
| | - Timothy D. Allerton
- Basic Science, Pennington Biomedical Research Center, Baton Rouge, United States
| | - Dragana Lovre
- School of Medicine, Tulane University Health Sciences Center, New Orleans, United States
- Medicine, Southeast Louisiana Veterans Health Care System, New Orleans, United States
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17
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Marx W, Manger SH, Blencowe M, Murray G, Ho FYY, Lawn S, Blumenthal JA, Schuch F, Stubbs B, Ruusunen A, Desyibelew HD, Dinan TG, Jacka F, Ravindran A, Berk M, O'Neil A. Clinical guidelines for the use of lifestyle-based mental health care in major depressive disorder: World Federation of Societies for Biological Psychiatry (WFSBP) and Australasian Society of Lifestyle Medicine (ASLM) taskforce. World J Biol Psychiatry 2023; 24:333-386. [PMID: 36202135 PMCID: PMC10972571 DOI: 10.1080/15622975.2022.2112074] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/24/2022] [Accepted: 08/07/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVES The primary objectives of these international guidelines were to provide a global audience of clinicians with (a) a series of evidence-based recommendations for the provision of lifestyle-based mental health care in clinical practice for adults with Major Depressive Disorder (MDD) and (b) a series of implementation considerations that may be applicable across a range of settings. METHODS Recommendations and associated evidence-based gradings were based on a series of systematic literature searches of published research as well as the clinical expertise of taskforce members. The focus of the guidelines was eight lifestyle domains: physical activity and exercise, smoking cessation, work-directed interventions, mindfulness-based and stress management therapies, diet, sleep, loneliness and social support, and green space interaction. The following electronic bibliographic databases were searched for articles published prior to June 2020: PubMed, EMBASE, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Methodology Register), CINAHL, PsycINFO. Evidence grading was based on the level of evidence specific to MDD and risk of bias, in accordance with the World Federation of Societies for Biological Psychiatry criteria. RESULTS Nine recommendations were formed. The recommendations with the highest ratings to improve MDD were the use of physical activity and exercise, relaxation techniques, work-directed interventions, sleep, and mindfulness-based therapies (Grade 2). Interventions related to diet and green space were recommended, but with a lower strength of evidence (Grade 3). Recommendations regarding smoking cessation and loneliness and social support were based on expert opinion. Key implementation considerations included the need for input from allied health professionals and support networks to implement this type of approach, the importance of partnering such recommendations with behaviour change support, and the need to deliver interventions using a biopsychosocial-cultural framework. CONCLUSIONS Lifestyle-based interventions are recommended as a foundational component of mental health care in clinical practice for adults with Major Depressive Disorder, where other evidence-based therapies can be added or used in combination. The findings and recommendations of these guidelines support the need for further research to address existing gaps in efficacy and implementation research, especially for emerging lifestyle-based approaches (e.g. green space, loneliness and social support interventions) where data are limited. Further work is also needed to develop innovative approaches for delivery and models of care, and to support the training of health professionals regarding lifestyle-based mental health care.
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Affiliation(s)
- Wolfgang Marx
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Sam H Manger
- College of Medicine and Dentistry, James Cook University, Queensland, Australia
- Australasian Society of Lifestyle Medicine, Melbourne, Australia
| | - Mark Blencowe
- Australasian Society of Lifestyle Medicine, Melbourne, Australia
| | - Greg Murray
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
| | - Fiona Yan-Yee Ho
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong SAR
| | - Sharon Lawn
- Lived Experience Australia Ltd, Adelaide, Australia
- Flinders University, College of Medicine and Public Health, Adelaide, Australia
| | - James A. Blumenthal
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham NC 27710
| | - Felipe Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Anu Ruusunen
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland
| | - Hanna Demelash Desyibelew
- Department of Nutrition and Dietetics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | | | - Felice Jacka
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Arun Ravindran
- Department of Psychiatry & Institute of Medical Sciences, University of Toronto. Centre for Addiction and Mental Health, Toronto, Canada
| | - Michael Berk
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Adrienne O'Neil
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
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18
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Verhoeven JE, Han LKM, Lever-van Milligen BA, Hu MX, Révész D, Hoogendoorn AW, Batelaan NM, van Schaik DJF, van Balkom AJLM, van Oppen P, Penninx BWJH. Antidepressants or running therapy: Comparing effects on mental and physical health in patients with depression and anxiety disorders. J Affect Disord 2023; 329:19-29. [PMID: 36828150 DOI: 10.1016/j.jad.2023.02.064] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 02/11/2023] [Accepted: 02/14/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND Antidepressant medication and running therapy are both effective treatments for patients with depressive and anxiety disorders. However, they may work through different pathophysiological mechanisms and could differ in their impact on physical health. This study examined effects of antidepressants versus running therapy on both mental and physical health. METHODS According to a partially randomized patient preference design, 141 patients with depression and/or anxiety disorder were randomized or offered preferred 16-week treatment: antidepressant medication (escitalopram or sertraline) or group-based running therapy ≥2 per week. Baseline (T0) and post-treatment assessment at week 16 (T16) included mental (diagnosis status and symptom severity) and physical health indicators (metabolic and immune indicators, heart rate (variability), weight, lung function, hand grip strength, fitness). RESULTS Of the 141 participants (mean age 38.2 years; 58.2 % female), 45 participants received antidepressant medication and 96 underwent running therapy. Intention-to-treat analyses showed that remission rates at T16 were comparable (antidepressants: 44.8 %; running: 43.3 %; p = .881). However, the groups differed significantly on various changes in physical health: weight (d = 0.57; p = .001), waist circumference (d = 0.44; p = .011), systolic (d = 0.45; p = .011) and diastolic (d = 0.53; p = .002) blood pressure, heart rate (d = 0.36; p = .033) and heart rate variability (d = 0.48; p = .006). LIMITATIONS A minority of the participants was willing to be randomized; the running therapy was larger due to greater preference for this intervention. CONCLUSIONS While the interventions had comparable effects on mental health, running therapy outperformed antidepressants on physical health, due to both larger improvements in the running therapy group as well as larger deterioration in the antidepressant group. TRIAL REGISTRATION Trialregister.nl Number of identification: NTR3460.
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Affiliation(s)
- Josine E Verhoeven
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute & Amsterdam Neuroscience, Oldenaller 1, Amsterdam, the Netherlands.
| | - Laura K M Han
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute & Amsterdam Neuroscience, Oldenaller 1, Amsterdam, the Netherlands
| | - Bianca A Lever-van Milligen
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute & Amsterdam Neuroscience, Oldenaller 1, Amsterdam, the Netherlands
| | - Mandy X Hu
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute & Amsterdam Neuroscience, Oldenaller 1, Amsterdam, the Netherlands
| | - Dóra Révész
- Center of Research on Psychological and Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - Adriaan W Hoogendoorn
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute & Amsterdam Neuroscience, Oldenaller 1, Amsterdam, the Netherlands
| | - Neeltje M Batelaan
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute & Amsterdam Neuroscience, Oldenaller 1, Amsterdam, the Netherlands
| | - Digna J F van Schaik
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute & Amsterdam Neuroscience, Oldenaller 1, Amsterdam, the Netherlands
| | - Anton J L M van Balkom
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute & Amsterdam Neuroscience, Oldenaller 1, Amsterdam, the Netherlands
| | - Patricia van Oppen
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute & Amsterdam Neuroscience, Oldenaller 1, Amsterdam, the Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute & Amsterdam Neuroscience, Oldenaller 1, Amsterdam, the Netherlands
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19
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Rozanski A. New principles, the benefits, and practices for fostering a physically active lifestyle. Prog Cardiovasc Dis 2023; 77:37-49. [PMID: 37030619 DOI: 10.1016/j.pcad.2023.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 04/04/2023] [Indexed: 04/10/2023]
Abstract
The modern environment has led to an increased risk and incidence of sedentary lifestyles. When physical activity (PA) becomes insufficient, pathophysiological pathways are invoked and the future risk for chronic diseases and premature mortality increases. As a consequence, since the 1970s governmental agencies and medical societies have published guidelines to promote PA. The 2018 Guidelines for Physical Activity for Americans contain important updated guidelines, but many of these guidelines are not yet sufficiently known by the public or health providers. In addition, to make use of these guidelines, they need to be integrated with optimal behavioral interventions. Accordingly, this narrative review critically assesses five tenets that stem from the 2018 Guidelines and illustrates how these tenets can be integrated with tools and techniques for motivating individuals to initiate and maintain a more physically active lifestyle. The first tenet indicates that there is no lower threshold of PA that must be obtained before health benefits begin to accrue. Second, it is no longer required that PA be obtained in bouts of 10 min or more to "count". Bouts of lesser duration also count. Pending further study, new accelerometry data suggest that vigorous intermittent PA of just 1-2 min may also benefit health, such as that acquired by stair climbing or carrying heavy groceries. This has led to a new concept of promoting "lifestyle physical activity". Third, excessive sitting is health damaging if it is not accompanied by sufficient daily life PA or accrues over long uninterrupted bouts. Fourth, it is essential to incorporate resistance exercises for optimal health and to promote successful aging. Fifth, a wealth of new evidence indicates that PA strongly protects and promotes all aspects of brain health and may improve cognition even after a single bout of exercise.
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Affiliation(s)
- Alan Rozanski
- Division of Cardiology, Mount Sinai Morningside Hospital, Mount Sinai Heart and the Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
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20
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Gilbert C, Earleywine M, Altman BR. Undergraduate student perceptions of cognitive behavioral therapy, aerobic exercise, and their combination for depression. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-9. [PMID: 36862695 DOI: 10.1080/07448481.2023.2185461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 01/21/2023] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE Both aerobic exercise and Cognitive Behavioral Therapy (CBT) improve depression, but perceptions of their credibility and efficacy are underexplored. These perceptions can contribute to treatment seeking and outcome. A previous online sample ranging in age and education rated a combined treatment higher than individual components and underestimated their efficacy. The current study is a replication exclusively focused on college students. PARTICIPANTS Undergraduates (N = 260) participated during the 2021-2022 school year. METHODS Students reported impressions of each treatment's credibility, efficacy, difficulty, and recovery rate. RESULTS Students viewed combined therapy as potentially better, but also more difficult, and underestimated recovery rates, replicating previous work. Their efficacy ratings significantly underestimated both meta-analytic estimates and the previous sample's perceptions. CONCLUSIONS Consistent underestimation of treatment effectiveness suggests that realistic education could prove especially beneficial. Students might be more willing than the broader population to accept exercise as a treatment or adjunct for depression.
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Affiliation(s)
- Cody Gilbert
- Department of Psychology, University at Albany, State University of New York, Albany, New York, USA
| | - Mitch Earleywine
- Department of Psychology, University at Albany, State University of New York, Albany, New York, USA
| | - Brianna R Altman
- Department of Psychology, University at Albany, State University of New York, Albany, New York, USA
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21
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Blumenthal JA, Rozanski A. Exercise as a therapeutic modality for the prevention and treatment of depression. Prog Cardiovasc Dis 2023; 77:50-58. [PMID: 36848966 DOI: 10.1016/j.pcad.2023.02.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 02/21/2023] [Indexed: 02/27/2023]
Abstract
While maintaining an active lifestyle and engaging in regular exercise are known to promote cardiovascular (CV) health, increasing evidence has emerged to indicate that these lifestyle behaviors also can promote psychological health and well-being. This has led to research to determine if exercise can serve as a potential therapeutic modality for major depressive disorder (MDD), which is a leading cause of mental-health impairment and overall disability worldwide. The strongest evidence to support this use comes from an increasing number of randomized clinical trials (RCTs) that have compared exercise to usual care, placebo controls, or established therapies in healthy adults and in various clinical populations. The relatively large number of RCTs has led to numerous reviews and meta-analyses, which generally have been concordant in indicating that exercise ameliorates depressive symptoms, improves self-esteem, and enhances various aspects of quality of life. Together, these data indicate that exercise should be considered as a therapeutic modality for improving CV health and psychological well-being. The emerging evidence also has led to a new proposed subspecialty of "lifestyle psychiatry", which promotes the use of exercise as an adjunctive treatment for patients with MDD. Indeed, some medical organizations have now endorsed lifestyle-based approaches as foundational aspects of depression management, with adoption of exercise as a treatment option for MDD. This review summarizes research in the area and provides practical suggestions for the use of exercise in clinical practice.
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Affiliation(s)
- James A Blumenthal
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
| | - Alan Rozanski
- Division of Cardiology, Mount Sinai Morningside Hospital, Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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22
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Gartlehner G, Dobrescu A, Chapman A, Toromanova A, Emprechtinger R, Persad E, Affengruber L, Pieh C, Klerings I, Wagner G. Nonpharmacologic and Pharmacologic Treatments of Adult Patients With Major Depressive Disorder: A Systematic Review and Network Meta-analysis for a Clinical Guideline by the American College of Physicians. Ann Intern Med 2023; 176:196-211. [PMID: 36689750 DOI: 10.7326/m22-1845] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Primary care patients and clinicians may prefer alternative options to second-generation antidepressants for major depressive disorder (MDD). PURPOSE To compare the benefits and harms of nonpharmacologic treatments with second-generation antidepressants as first-step interventions for acute MDD, and to compare second-step treatment strategies for patients who did not achieve remission after an initial attempt with antidepressants. DATA SOURCES English-language studies from several electronic databases from 1 January 1990 to 8 August 2022, trial registries, gray literature databases, and reference lists to identify unpublished research. STUDY SELECTION 2 investigators independently selected randomized trials of at least 6 weeks' duration. DATA EXTRACTION Reviewers abstracted data about study design and conduct, participants, interventions, and outcomes. They dually rated the risk of bias of studies and the certainty of evidence for outcomes of interest. DATA SYNTHESIS 65 randomized trials met the inclusion criteria; eligible data from nonrandomized studies were not found. Meta-analyses and network meta-analyses indicated similar benefits of most nonpharmacologic treatments and antidepressants as first-step treatments. Antidepressants had higher risks for discontinuation because of adverse events than most other treatments. For second-step therapies, different switching and augmentation strategies provided similar symptomatic relief. The certainty of evidence for most comparisons is low; findings should be interpreted cautiously. LIMITATIONS Many studies had methodological limitations or dosing inequalities; publication bias might have affected some comparisons. In some cases, conclusions could not be drawn because of insufficient evidence. CONCLUSION Although benefits seem to be similar among first- and second-step MDD treatments, the certainty of evidence is low for most comparisons. Clinicians and patients should focus on options with the most reliable evidence and take adverse event profiles and patient preferences into consideration. PRIMARY FUNDING SOURCE American College of Physicians. (PROSPERO: CRD42020204703).
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Affiliation(s)
- Gerald Gartlehner
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, University of Krems, Krems, Austria, and RTI International, Research Triangle Park, North Carolina (G.G.)
| | - Andreea Dobrescu
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, University of Krems, Krems, Austria (A.D., A.C., A.T., E.P., I.K., G.W.)
| | - Andrea Chapman
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, University of Krems, Krems, Austria (A.D., A.C., A.T., E.P., I.K., G.W.)
| | - Ana Toromanova
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, University of Krems, Krems, Austria (A.D., A.C., A.T., E.P., I.K., G.W.)
| | | | - Emma Persad
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, University of Krems, Krems, Austria (A.D., A.C., A.T., E.P., I.K., G.W.)
| | - Lisa Affengruber
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, University of Krems, Krems, Austria, and Department of Family Medicine, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands (L.A.)
| | - Christoph Pieh
- Department for Psychotherapy and Biopsychosocial Health, University of Krems, Krems, Austria (C.P.)
| | - Irma Klerings
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, University of Krems, Krems, Austria (A.D., A.C., A.T., E.P., I.K., G.W.)
| | - Gernot Wagner
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, University of Krems, Krems, Austria (A.D., A.C., A.T., E.P., I.K., G.W.)
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Jemni M, Zaman R, Carrick FR, Clarke ND, Marina M, Bottoms L, Matharoo JS, Ramsbottom R, Hoffman N, Groves SJ, Gu Y, Konukman F. Exercise improves depression through positive modulation of brain-derived neurotrophic factor (BDNF). A review based on 100 manuscripts over 20 years. Front Physiol 2023; 14:1102526. [PMID: 36969600 PMCID: PMC10030936 DOI: 10.3389/fphys.2023.1102526] [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: 11/19/2022] [Accepted: 01/30/2023] [Indexed: 03/29/2023] Open
Abstract
The aim of this review was to explore the relevant neurobiology and the association between peripheral levels of brain-derived neurotrophic factor (BDNF) and acute and short to long-term exercise regimes, as well as its relation to depression and antidepressant treatment. A 20-year literature search was conducted. The screening process resulted in 100 manuscripts. Antidepressants as well as acute exercise, particularly high-intensity, elevates BDNF in healthy humans and clinical populations, as evidenced from aerobic and resistance-based studies. Although exercise is increasingly recognised in the management of depression, acute and short-term exercise studies have failed to establish a relationship between the severity of depression and changes in peripheral BDNF. The latter rapidly returns to baseline, possibly indicating a quick re-uptake by the brain, aiding its neuroplasticity functions. The timescale of administration needed for the antidepressants to stimulate biochemical changes is longer than similar increases with acute exercise.
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Affiliation(s)
- Monèm Jemni
- Faculty of Physical Education, Ningbo University, Ningbo, Zhejiang, China
- The Carrick Institute of Neuroscience, Cape Canaveral, FL, United States
- Centre for Mental Health Research in association with The University of Cambridge, Cambridge, United Kingdom
- *Correspondence: Monèm Jemni, ; Yaodong Gu,
| | - Rashid Zaman
- Centre for Mental Health Research in association with The University of Cambridge, Cambridge, United Kingdom
- Department of Psychiatry, The University of Cambridge, Cambridge, United Kingdom
| | - Frederick Robert Carrick
- The Carrick Institute of Neuroscience, Cape Canaveral, FL, United States
- Centre for Mental Health Research in association with The University of Cambridge, Cambridge, United Kingdom
- University of Central Florida College of Medicine, Orlando, FL, United states
- MGH Institute of Health Professions, Boston, MA, United States
| | - Neil David Clarke
- Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, United Kingdom
| | - Michel Marina
- Institut Nacional d'Educació Física de Catalunya (INEFC), Sport Performance, Barcelona, Spain
| | - Lindsay Bottoms
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Hertfordshire, United Kingdom
| | | | - Roger Ramsbottom
- Sport and Health Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, United Kingdom
| | - Norman Hoffman
- The Carrick Institute of Neuroscience, Cape Canaveral, FL, United States
| | - Shad James Groves
- The Carrick Institute of Neuroscience, Cape Canaveral, FL, United States
| | - Yaodong Gu
- Faculty of Physical Education, Ningbo University, Ningbo, Zhejiang, China
- *Correspondence: Monèm Jemni, ; Yaodong Gu,
| | - Ferman Konukman
- Department of Physical Education, College of Education, Qatar University, Doha, Qatar
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Depression and PTSD as Predictors of Attrition in Older Adult Exercise Programs. TOPICS IN GERIATRIC REHABILITATION 2023. [DOI: 10.1097/tgr.0000000000000383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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COVID-19-related stress, exercise, and oral health-related quality of life among community-dwelling older adults who participated in the CHEER Iwamizawa project, Japan. Sci Rep 2022; 12:20347. [PMID: 36437300 PMCID: PMC9701693 DOI: 10.1038/s41598-022-24806-1] [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: 02/16/2022] [Accepted: 11/18/2022] [Indexed: 11/28/2022] Open
Abstract
This study examined the association between coronavirus disease 2019 (COVID-19)-related stress, exercise habits, and oral health-related quality of life (OHRQoL) in a sample of 215 community-dwelling older adults in Japan (57 men, 158 women; Mage = 74.2 years, SD = 6.0). Data were collected during wellness checkups in October 2020 and included participants' demographic characteristics, measures of instrumental activities of daily living and depressive tendencies, number of teeth, oral hypofunction, OHRQoL, COVID-19-related stress, and exercise habits. Four mutually exclusive groups were created, using the presence or absence of COVID-19-related stress and lack of exercise habits as risk factors for poor OHRQoL (no COVID-19-related stress and no lack of exercise, COVID-19-related stress only, lack of exercise habits only, and both COVID-19-related stress and lack of exercise habits). Poisson regression with robust standard errors provided the prevalence ratio for poor OHRQoL. The presence of both COVID-19-related stress and lack of exercise habits (adjusted prevalence ratio: 2.20, 95% CI: 1.31- 3.69) was associated with poor OHRQoL. The results indicate that COVID-19-related stress and exercise habits should be considered when designing oral health and public health initiatives.
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Yu Q, Wong KK, Lei OK, Nie J, Shi Q, Zou L, Kong Z. Comparative Effectiveness of Multiple Exercise Interventions in the Treatment of Mental Health Disorders: A Systematic Review and Network Meta-Analysis. SPORTS MEDICINE - OPEN 2022; 8:135. [PMID: 36308622 PMCID: PMC9617247 DOI: 10.1186/s40798-022-00529-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 10/16/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND The efficacy of exercise interventions in the treatment of mental health disorders is well known, but research is lacking on the most efficient exercise type for specific mental health disorders. OBJECTIVE The present study aimed to compare and rank the effectiveness of various exercise types in the treatment of mental health disorders. METHODS The PubMed, Web of Science, PsycINFO, SPORTDiscus, CINAHL databases, and the Cochrane Central Register of Controlled Trials as well as Google Scholar were searched up to December 2021. We performed pairwise and network meta-analyses as well as meta-regression analyses for mental health disorders in general and each type of mental health disorder, with alterations in symptom severity as the primary outcome. RESULTS A total of 6456 participants from 117 randomized controlled trials were surveyed. The multimodal exercise (71%) had the highest probability of being the most efficient exercise for relieving depressive symptoms. While resistance exercise (60%) was more likely to be the most effective treatment for anxiety disorder, patients with post-traumatic stress disorder (PTSD) benefited more from mind-body exercise (52%). Furthermore, resistance exercise (31%) and multimodal exercise (37%) had more beneficial effects in the treatment of the positive and negative symptoms of schizophrenia, respectively. The length of intervention and exercise frequency independently moderated the effects of mind-body exercise on depressive (coefficient = 0.14, p = .03) and negative schizophrenia (coefficient = 0.96, p = .04) symptoms. CONCLUSION Multimodal exercise ranked best for treating depressive and negative schizophrenic symptoms, while resistance exercise seemed to be more beneficial for those with anxiety-related and positive schizophrenic symptoms. Mind-body exercise was recommended as the most promising exercise type in the treatment of PTSD. However, the findings should be treated with caution due to potential risk of bias in at least one dimension of assessment and low-to-moderate certainty of evidence. Trial Registration This systematic review was registered in the PROSPERO international prospective register of systematic reviews (CRD42022310237).
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Affiliation(s)
- Qian Yu
- grid.437123.00000 0004 1794 8068Faculty of Education, University of Macau, Macao, China
| | - Ka-Kit Wong
- grid.437123.00000 0004 1794 8068Faculty of Education, University of Macau, Macao, China
| | - On-Kei Lei
- grid.437123.00000 0004 1794 8068Faculty of Education, University of Macau, Macao, China
| | - Jinlei Nie
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao, China
| | - Qingde Shi
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao, China
| | - Liye Zou
- grid.263488.30000 0001 0472 9649Body-Brain-Mind Laboratory, The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, School of Psychology, Shenzhen University, Shenzhen, 518060 China
| | - Zhaowei Kong
- grid.437123.00000 0004 1794 8068Faculty of Education, University of Macau, Macao, China
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The association between the restriction of daily life and depression during the COVID-19 pandemic in Korea: a nationwide based survey. Sci Rep 2022; 12:17722. [PMID: 36271227 PMCID: PMC9586933 DOI: 10.1038/s41598-022-21301-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 09/26/2022] [Indexed: 01/18/2023] Open
Abstract
The coronavirus (COVID-19) pandemic has led to substantial daily life changes for people worldwide. We investigated the association between daily life restrictions and depression during the COVID-19 pandemic based on the Korea Community Health Survey. Daily life restrictions were evaluated using a questionnaire to population into three restriction categories: no/slightly, moderately, and severely. Depression was assessed by the Korean version of the Patient Health Questionnaire-9 (PHQ-9). Chi-square tests and Fisher's exact tests were used to compare the demographic characteristics of individuals with and without depression. Logistic regression was used to assess the association between the severity of daily life restrictions and the prevalence of depression. The prevalence of depression was 2.4% in the total population: 5.7% in the severely restricted group and 2.7% in the moderately restricted group. After adjusting for age, sex, educational level, income, marital status, and employment status, the severely restricted group was more likely to have depression than was the no change/slightly restricted group (OR = 2.40, 95% CI 2.16-2.67, p < 0.001). Employers with severely restricted daily life exhibited a higher OR for depression compared to the no/slightly restricted group (OR = 3.24, 95% CI 2.37-4.45, p < 0.001). It is necessary to consider the mental health of vulnerable affected by the COVID-19 pandemic.
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Recchia F, Leung CK, Chin EC, Fong DY, Montero D, Cheng CP, Yau SY, Siu PM. Comparative effectiveness of exercise, antidepressants and their combination in treating non-severe depression: a systematic review and network meta-analysis of randomised controlled trials. Br J Sports Med 2022; 56:1375-1380. [PMID: 36113975 PMCID: PMC9685718 DOI: 10.1136/bjsports-2022-105964] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2022] [Indexed: 11/30/2022]
Abstract
Objective To assess the comparative effectiveness of exercise, antidepressants and their combination for alleviating depressive symptoms in adults with non-severe depression. Design Systematic review and network meta-analysis. Data sources Embase, MEDLINE, PsycINFO, Cochrane Library, Web of Science, Scopus and SportDiscus. Eligibility criteria Randomised controlled trials (1990–present) that examined the effectiveness of an exercise, antidepressant or combination intervention against either treatment alone or a control/placebo condition in adults with non-severe depression. Study selection and analysis Risk of bias, indirectness and the overall confidence in the network were assessed by two independent investigators. A frequentist network meta-analysis was performed to examine postintervention differences in depressive symptom severity between groups. Intervention drop-out was assessed as a measure of treatment acceptability. Results Twenty-one randomised controlled trials (n=2551) with 25 comparisons were included in the network. There were no differences in treatment effectiveness among the three main interventions (exercise vs antidepressants: standardised mean differences, SMD, −0.12; 95% CI −0.33 to 0.10, combination versus exercise: SMD, 0.00; 95% CI −0.33 to 0.33, combination vs antidepressants: SMD, −0.12; 95% CI −0.40 to 0.16), although all treatments were more beneficial than controls. Exercise interventions had higher drop-out rates than antidepressant interventions (risk ratio 1.31; 95% CI 1.09 to 1.57). Heterogeneity in the network was moderate (τ2=0.03; I2=46%). Conclusions The results suggest no difference between exercise and pharmacological interventions in reducing depressive symptoms in adults with non-severe depression. These findings support the adoption of exercise as an alternative or adjuvant treatment for non-severe depression in adults. Systematic review registration PROSPERO CRD4202122656.
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Affiliation(s)
- Francesco Recchia
- Division of Kinesiology, School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
| | - Chit K Leung
- Division of Kinesiology, School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
| | - Edwin C Chin
- Division of Kinesiology, School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
| | - Daniel Y Fong
- School of Nursing, The University of Hong Kong, Hong Kong, Hong Kong
| | - David Montero
- Division of Kinesiology, School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
| | - Calvin P Cheng
- Department of Psychiatry, The University of Hong Kong, Hong Kong, Hong Kong
| | - Suk Yu Yau
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Parco M Siu
- Division of Kinesiology, School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
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Kong L, Cui Y, Gong Q. Duration of Keeping an Exercise Habit and Mental Illness and Life Attitude among University Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811669. [PMID: 36141940 PMCID: PMC9517129 DOI: 10.3390/ijerph191811669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 09/07/2022] [Accepted: 09/13/2022] [Indexed: 05/12/2023]
Abstract
Physical exercise has beneficial effects on human health, and several studies have examined the association between exercise and mental health. However, most of these studies focused on exercise intensity, duration, or frequency. Evidence for the association between the duration of maintaining an exercise habit and mental illness is lacking, especially in young adulthood-a crucial period that bridges adolescence and adulthood. This study investigated the association between the duration of keeping an exercise habit and mental illness and life attitude among Chinese university students. A total of 11,392 university students participated in this study (6866 men and 4526 women). The duration of keeping an exercise habit was evaluated using a questionnaire with relevant questions. Exercise habit was defined as exercising for longer than 30 min per session and more than twice a week. Mental illness consisted of two elements: depressive symptoms-assessed using the Zung Self-rating Depression Scale, and anxiety symptoms-assessed using the seven-item Generalized Anxiety Disorder scale. Life attitude was assessed using a questionnaire with relevant questions. Multivariate logistic regression analysis examined the adjusted association between the duration of keeping an exercise habit and mental illness and life attitude. In the final adjusted model, compared to the no exercise category, the odds ratios and 95% confidence intervals (CIs) of depressive symptoms were 0.80 (0.70, 0.91) for those with an exercise habit of 1-4 months, and 0.72 (0.63, 0.83) for those with one of >4 months (p for trend <0.001). Additionally, when compared to participants with no exercise habit, the adjusted odds ratios (95% CIs) for anxiety symptoms were 1.01 (0.90, 1.14) for those with a habit of 1-4 months and 0.78 (0.69, 0.88) for those with one of >4 months (p for trend =0.001). A longer duration of keeping an exercise habit was also significantly associated with positive life attitudes. Our results showed that a long duration of keeping an exercise habit was significantly associated with a lower prevalence of mental illness among university students. Further, maintaining a more prolonged exercise habit may benefit individuals' mental health in young adulthood.
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Affiliation(s)
- Lingfeng Kong
- Department of Physical Education, Hohai University, 1 Xikang Road, Nanjing 210098, China
| | - Yufei Cui
- Department of Physical Education, Huaiyin Institute of Technology, Huaian 223003, China
- Department of Medicine and Science in Sports and Exercise, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan
| | - Qiang Gong
- Department of Physical Education, Huaiyin Institute of Technology, Huaian 223003, China
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Shahtahmassebi B, Hatton J, Hebert JJ, Hecimovich M, Correia H, Fairchild TJ. The effect of the inclusion of trunk-strengthening exercises to a multimodal exercise program on physical activity levels and psychological functioning in older adults: secondary data analysis of a randomized controlled trial. BMC Geriatr 2022; 22:738. [PMID: 36088283 PMCID: PMC9463852 DOI: 10.1186/s12877-022-03435-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 09/07/2022] [Indexed: 11/26/2022] Open
Abstract
Background Engaging in multimodal exercise program helps mitigate age-related decrements by improving muscle size, muscle strength, balance, and physical function. The addition of trunk-strengthening within the exercise program has been shown to significantly improve physical functioning outcomes. Whether these improvements result in improved psychological outcomes associated with increased physical activity levels requires further investigation. We sought to explore whether the inclusion of trunk-strengthening exercises to a multimodal exercise program improves objectively measured physical activity levels and self-reported psychological functioning in older adults. Method We conducted a secondary analysis within a single-blinded parallel-group randomized controlled trial. Sixty-four healthy older (≥ 60 years) adults were randomly allocated to a 12-week walking and balance exercise program with (n = 32) or without (n = 32) inclusion of trunk strengthening exercises. Each program involved 12 weeks of exercise training, followed by a 6-week walking-only program (identified as detraining). Primary outcome measures for this secondary analysis were physical activity (accelerometry), perceived fear-of-falling, and symptoms of anxiety and depression. Results Following the 12-week exercise program, no significant between-group differences were observed for physical activity, sedentary behaviour, fear-of-falling, or symptoms of anxiety or depression. Significant within-group improvements (adjusted mean difference [95%CI]; percentage) were observed in moderate-intensity physical activity (6.29 [1.58, 11.00] min/day; + 26.3%) and total number of steps per min/day (0.81 [0.29 to 1.33] numbers or + 16.3%) in trunk-strengthening exercise group by week 12. With respect to within-group changes, participants in the walking-balance exercise group increased their moderate-to-vigorous physical activity (MVPA) (4.81 [0.06 to 9.56] min/day; + 23.5%) and reported reduction in symptoms of depression (-0.26 [-0.49 to -0.04] points or -49%) after 12 weeks of the exercise program. The exercise-induced increases in physical activity levels in the trunk-strengthening exercise group were abolished 6-weeks post-program completion. While improvements in physical activity levels were sustained in the walking-balance exercise group after detraining phase (walking only). Conclusions The inclusion of trunk strengthening to a walking-balance exercise program did not lead to statistically significant between-group improvements in physical activity levels or psychological outcomes in this cohort following completion of the 12-week exercise program. Trial registration Australian and New Zealand Clinical Trials Registry (ACTRN12613001176752), registered on 28/10/2013. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03435-3.
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Aung TNN, Moolphate S, Koyanagi Y, Angkurawaranon C, Supakankunti S, Yuasa M, Aung MN. Depression and Associated Factors among Community-Dwelling Thai Older Adults in Northern Thailand: The Relationship between History of Fall and Geriatric Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191710574. [PMID: 36078289 PMCID: PMC9518436 DOI: 10.3390/ijerph191710574] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 05/13/2023]
Abstract
BACKGROUND Globally, population aging is happening more quickly than in the past, and Thailand ranks the world's number three among the rapidly aging countries. Age-related decline in physical and mental health would impact depression among older adults. We aimed to determine the depression among the community-dwelling Thai older adults in Chiang Mai, Thailand. METHODS The baseline data, collected by door-to-door household visits of an intervention arm from a cluster randomized controlled trial (Community-Integrated Intermediary Care (CIIC): TCTR20190412004), were included in this cross-sectional study. Descriptive analysis and binary logistic regression were applied. RESULTS The mean age was 69.31 ± 7.10 years and 23.8% of study participants were older than 75 years. The Thai geriatric depression scale showed 6.5% had depression. Adjusted risk factors for depression were older age, being single, drinking alcohol daily, having diabetes, having experience of a fall last year, self-rated health as neutral, poor/very poor, and moderate/severe dependency by ADL scoring. CONCLUSION Our findings highlighted the potentially modifiable risk factors in addition to the common predictors affecting depression among community-dwelling older adults. Fall prevention programs and public health interventions to prevent diabetes are recommended. Furthermore, self-rated health and Barthel's ADL scoring would be simple tools to predict risk factors for geriatric depression.
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Affiliation(s)
- Thin Nyein Nyein Aung
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Saiyud Moolphate
- Department of Public Health, Faculty of Science and Technology, Chiang Mai Rajabhat University, Chiang Mai 50300, Thailand
| | - Yuka Koyanagi
- Department of Medical and Health Science, Tokyo Ariake University, Tokyo 135-0063, Japan
| | - Chaisiri Angkurawaranon
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Siripen Supakankunti
- Centre of Excellence for Health Economics, Faculty of Economics, Chulalongkorn University, Bangkok 10330, Thailand
| | - Motoyuki Yuasa
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan
- Faculty of International Liberal Arts, Juntendo University, Tokyo 113-8421, Japan
| | - Myo Nyein Aung
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan
- Faculty of International Liberal Arts, Juntendo University, Tokyo 113-8421, Japan
- Advanced Research Institute for Health Sciences, Juntendo University, Tokyo 113-8421, Japan
- Correspondence:
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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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D’Aurea CVR, Frange C, Poyares D, Souza AALD, Lenza M. Physical exercise as a therapeutic approach for adults with insomnia: systematic review and meta-analysis. EINSTEIN-SAO PAULO 2022; 20:eAO8058. [PMID: 35894372 PMCID: PMC9299578 DOI: 10.31744/einstein_journal/2022ao8058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 12/22/2021] [Indexed: 11/13/2022] Open
Abstract
Objective To systematically review the effects (benefits and harms) of different types of physical exercise on insomnia outcomes in adult populations with no mood disorders. Objective and subjective sleep outcomes and related mismatches were analyzed. Methods Systematic review and meta-analysis. Quality of evidence was also examined. Results Six studies including 295 participants with insomnia diagnosis were selected. Yoga, Tai Chi, resistance exercise and aerobic exercise were used in protocols with different duration, intensity and frequency. Studies involved different populations, including inactive or sedentary individuals, older adults and postmenopausal women. Physical exercise improved subjective sleep quality (very low quality of evidence) and reduced insomnia severity (high quality of evidence). Conclusion Findings suggest individualized physical exercise must be addressed to design optimal protocols, with standardized type, duration, intensity, and frequency. For the time being, physical exercise may be considered an alternative and/or ancillary therapeutic modality for patients diagnosed with insomnia. Physical exercise can be used to improve subjective complaints, but not objective sleep outcomes.
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Gohari J, Grosman-Rimon L, Arazi M, Caspi-Avissar N, Granot D, Gleitman S, Badarny J, Lubovich A, Sudarsky D, Rimon J, Carasso S, Birati EY, Kachel E. Clinical factors and pre-surgical depression scores predict pain intensity in cardiac surgery patients. BMC Anesthesiol 2022; 22:204. [PMID: 35787245 PMCID: PMC9252086 DOI: 10.1186/s12871-022-01740-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 05/27/2022] [Indexed: 11/23/2022] Open
Abstract
Background Severe pain is prevalent in cardiac surgery patients and can increase cardiac complications, morbidity and mortality. The objectives of the study were to assess perioperative pain intensity and to assess predictors of pain post-cardiac surgery, including clinical characteristics and depression. Methods A total of 98 cardiac surgery patients were included in the study. Pain intensity was assessed using a Numerical Rating System. Pain was measured one day pre-operatively and recorded daily from Post-operative Day 2 to Day 7. Clinical data were recorded and depression scores were assessed using the Center for Epidemiological Study of Depression (CES-D). Results Pain intensity increased significantly during hospitalization from pre-operative levels, surging at 2 days post-operatively. Predictors of high pain intensity were high pre-operative CES-D scores, female gender, cardiac function, smoking and high body mass index (BMI). Significantly higher pre-operative CES-D scores were found in patients with severe pain compared to patients with no pain to moderate pain (18.23 ± 1.80 vs 12.84 ± 1.22, p = 0.01 pre-operatively). Patients with severe pain (NRS 7–10) had significantly higher levels of white blood cells (WBC) compared to patients with no pain-moderate pain (NRS 0–6), (p = 0.01). However, CES-D scores were only weakly correlated maximum WBC levels perioperatively. Conclusion Pain intensity significantly increased following surgery, and was associated with depressive symptoms, female sex, cardiac function, BMI, and smoking. These factors may serve as a basis for identification and intervention to help prevent the transition from acute pain to chronic pain.
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Affiliation(s)
- Jacob Gohari
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.,Creedmoor Psychiatric Center, Queens Village, New York City, NY, USA
| | - Liza Grosman-Rimon
- The Lydia and Carol Kittner, Lea and Benjamin Davidai Division of Cardiovascular Medicine and Surgery, Padeh Poriya Medical Center, Tiberias, Israel.,The Academic College at Wingate, Wingate Institute, Netanya, Israel
| | - Mattan Arazi
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.,Department of Cardiac Surgery, Leviev HeartCenter, Sheba Medical Center, Tel Hashomer, Israel
| | - Noa Caspi-Avissar
- The Lydia and Carol Kittner, Lea and Benjamin Davidai Division of Cardiovascular Medicine and Surgery, Padeh Poriya Medical Center, Tiberias, Israel
| | - Dina Granot
- The Lydia and Carol Kittner, Lea and Benjamin Davidai Division of Cardiovascular Medicine and Surgery, Padeh Poriya Medical Center, Tiberias, Israel
| | - Sagi Gleitman
- The Lydia and Carol Kittner, Lea and Benjamin Davidai Division of Cardiovascular Medicine and Surgery, Padeh Poriya Medical Center, Tiberias, Israel
| | - Jawdat Badarny
- The Lydia and Carol Kittner, Lea and Benjamin Davidai Division of Cardiovascular Medicine and Surgery, Padeh Poriya Medical Center, Tiberias, Israel
| | - Alla Lubovich
- The Lydia and Carol Kittner, Lea and Benjamin Davidai Division of Cardiovascular Medicine and Surgery, Padeh Poriya Medical Center, Tiberias, Israel.,The Azrieli Faculty of Medicine, Bar-Ilan University, Zefat, Israel
| | - Doron Sudarsky
- The Lydia and Carol Kittner, Lea and Benjamin Davidai Division of Cardiovascular Medicine and Surgery, Padeh Poriya Medical Center, Tiberias, Israel.,The Azrieli Faculty of Medicine, Bar-Ilan University, Zefat, Israel
| | - Jordan Rimon
- The Lydia and Carol Kittner, Lea and Benjamin Davidai Division of Cardiovascular Medicine and Surgery, Padeh Poriya Medical Center, Tiberias, Israel.,Faculty of Health, York University, Toronto, Canada
| | - Shemy Carasso
- The Lydia and Carol Kittner, Lea and Benjamin Davidai Division of Cardiovascular Medicine and Surgery, Padeh Poriya Medical Center, Tiberias, Israel.,The Azrieli Faculty of Medicine, Bar-Ilan University, Zefat, Israel
| | - Edo Y Birati
- The Lydia and Carol Kittner, Lea and Benjamin Davidai Division of Cardiovascular Medicine and Surgery, Padeh Poriya Medical Center, Tiberias, Israel.,The Azrieli Faculty of Medicine, Bar-Ilan University, Zefat, Israel
| | - Erez Kachel
- The Lydia and Carol Kittner, Lea and Benjamin Davidai Division of Cardiovascular Medicine and Surgery, Padeh Poriya Medical Center, Tiberias, Israel. .,Department of Cardiac Surgery, Leviev HeartCenter, Sheba Medical Center, Tel Hashomer, Israel. .,The Azrieli Faculty of Medicine, Bar-Ilan University, Zefat, Israel.
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35
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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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Yu DJ, Yu AP, Leung CK, Chin EC, Fong DY, Cheng CP, Yau SY, Siu PM. Comparison of moderate and vigorous walking exercise on reducing depression in middle-aged and older adults: A pilot randomized controlled trial. Eur J Sport Sci 2022; 23:1018-1027. [PMID: 35579606 DOI: 10.1080/17461391.2022.2079424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The optimal intensity of physical activity for alleviating depression in middle-aged and older adults remains unclear. The comparative effects of moderate and vigorous physical activity on reducing depression have not been directly examined. The World Health Organization (WHO) physical activity guidelines recommend adults and older adults to accumulate at least 150-300 minutes of moderate or 75-150 minutes of vigorous aerobic-type physical activity weekly or an equivalent combination of both for health benefits including reduced risk of depression. This parallel, assessor-blinded, pilot randomized controlled trial preliminarily compared the effectiveness of the minimal volume of aerobic-type physical activity at different intensities as recommended by WHO (150 minutes of moderate walking exercise and 75 minutes of vigorous walking exercise weekly) on alleviating depression in middle-aged and older adults. Middle-aged and older adults diagnosed with depression were randomized to the control group (CON), moderate walking exercise group (MOD), or vigorous walking exercise group (VIG). The exercise frequency of the moderate and vigorous walking exercise were three times a week and the intervention duration were 12 weeks. The primary outcome was the severity of depression assessed by Beck Depression Inventory. Secondary outcomes included severity of anxiety, sleep quality, quality of life, and cardiorespiratory fitness. Thirty participants completed the study (CON: n = 10, MOD: n = 10, VIG: n = 10). Participants in both MOD and VIG had significantly decreased depression severity after the intervention compared to CON (both p < 0.001). There was no significant difference between MOD and VIG (p = 0.92). Both MOD and VIG interventions also mitigated anxiety severity, improved quality of life and cardiorespiratory fitness. The minimum volume of walking exercise at either moderate or vigorous intensity was found to alleviate depression in middle-aged and older adults.Trial registration: ClinicalTrials.gov identifier: NCT04403373..
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Affiliation(s)
- Danny J Yu
- Division of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Angus P Yu
- Division of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Chit K Leung
- Division of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Edwin C Chin
- Division of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Daniel Y Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Calvin P Cheng
- Department of Psychiatry, Queen Mary Hospital, Hong Kong, China.,Department of Psychiatry, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Suk Y Yau
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Parco M Siu
- Division of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
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37
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The Effect of Physical Exercise on the Elderly’s Anxiety: Based on Systematic Reviews and Meta-Analysis. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:4848290. [PMID: 35586669 PMCID: PMC9110195 DOI: 10.1155/2022/4848290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 04/18/2022] [Indexed: 11/26/2022]
Abstract
Purpose Based on meta-analysis to explore the effect of physical exercise on relieving the anxiety of the elderly. Methods The retrieval time was published in the domestic and foreign literatures on the effect of physical exercise on the anxiety of the elderly published from 2005 to 2021. The random effects model was used to evaluate the mean standard deviation of the scores of the intervention group on reducing the anxiety level of the elderly before and after the test. According to the inclusion and exclusion criteria, the articles were screened, quality evaluated, and data extracted, and the literature was meta-analyzed by RevMan5.3. Results In meta-analysis and systematic review, 17 papers finally met the inclusion criteria. After sensitivity analysis, the random effects model (MD = 8.00, 95% CI (6.90, 9.10), Z = 14.23 (P < 0.00001)) and the fixed effects model (MD = 7.71, 95% CI (6.98, 8.43), Z = 20.72 (P < 0.00001)) show that physical exercise has a positive and significant effect on the anxiety of the elderly. Conclusion Physical exercise plays an important role in reducing the anxiety of the elderly. Therefore, regular physical exercise can be regarded as part of the elderly pension plan, but more high-quality research is needed to further explore the impact of physical exercise on elderly anxiety.
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Brush CJ, Hajcak G, Bocchine AJ, Ude AA, Muniz KM, Foti D, Alderman BL. A randomized trial of aerobic exercise for major depression: examining neural indicators of reward and cognitive control as predictors and treatment targets. Psychol Med 2022; 52:893-903. [PMID: 32838817 DOI: 10.1017/s0033291720002573] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Aerobic exercise has demonstrated antidepressant efficacy among adults with major depression. There is a poor understanding of the neural mechanisms associated with these effects. Deficits in reward processing and cognitive control may be two candidate targets and predictors of treatment outcome to exercise in depression. METHODS Sixty-six young adults aged 20.23 years (s.d. = 2.39) with major depression were randomized to 8 weeks of moderate-intensity aerobic exercise (n = 35) or light stretching (n = 31). Depressive symptoms were assessed across the intervention to track symptom reduction. Reward processing [reward positivity (RewP)] and cognitive control [error-related negativity (ERN)] were assessed before and after the intervention using event-related brain potentials. RESULTS Compared to stretching, aerobic exercise resulted in greater symptom reduction (gs = 0.66). Aerobic exercise had no impact on the RewP (gav = 0.08) or ERN (gav = 0.21). In the aerobic exercise group, individuals with a larger pre-treatment RewP [odds ratio (OR) = 1.45] and increased baseline depressive symptom severity (OR = 1.18) were more likely to respond to an aerobic exercise program. Pre-treatment ERN did not predict response (OR = 0.74). CONCLUSIONS Aerobic exercise is effective in alleviating depressive symptoms in adults with major depression, particularly for those with increased depressive symptom severity and a larger RewP at baseline. Although aerobic exercise did not modify the RewP or ERN, there is preliminary support for the utility of the RewP in predicting who is most likely to respond to exercise as a treatment for depression.
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Affiliation(s)
- C J Brush
- Department of Psychology, Florida State University, Tallahassee, FL, USA
- Department of Kinesiology and Health and Center of Alcohol & Substance Use Studies, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Greg Hajcak
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Anthony J Bocchine
- Department of Kinesiology and Health and Center of Alcohol & Substance Use Studies, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Andrew A Ude
- Department of Kinesiology and Health and Center of Alcohol & Substance Use Studies, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Kristina M Muniz
- Department of Kinesiology and Health and Center of Alcohol & Substance Use Studies, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
- Department of Psychiatry and Neurobehavioral Sciences, Division of Child and Family Psychiatry, University of Virginia Health System, Charlottesville, VA, USA
| | - Dan Foti
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA
| | - Brandon L Alderman
- Department of Kinesiology and Health and Center of Alcohol & Substance Use Studies, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
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Elsayed MM, El Refaye GE, Rabiee A, Abouzeid S, Elsisi HF. Aerobic exercise with diet induces hormonal, metabolic, and psychological changes in postmenopausal obese women. Heliyon 2022; 8:e09165. [PMID: 35368551 PMCID: PMC8971591 DOI: 10.1016/j.heliyon.2022.e09165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/05/2022] [Accepted: 03/18/2022] [Indexed: 11/25/2022] Open
Abstract
Physical activity and diet are recommended lifestyle strategies to improve human health. Consequently, this study aimed to investigate the impact of aerobic exercise combined with dietary restriction on hormonal, metabolic, and psychological variables in postmenopausal women. Eligible 60 women were enrolled and assigned into two equal groups; the experimental group performed aerobic exercise three times per week for 12 weeks with diet restriction, and the control group only received the same diet program. Serum levels of sex hormones, insulin resistance, and depression scores were measured before and after the intervention. Results All measured variables were significantly changed in the experimental group compared to the control group (P = 0.001). Conclusion Changes in sex hormones are a biological marker of metabolic complications such as insulin resistance, which can be reduced with exercise and diet. In addition, they are effective therapeutic interventions in the treatment of mild depression. Trial registration Registration identifier number of this study is: NCT05136742 on https://register.ClinicalTrials.gov.
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Affiliation(s)
- Marwa M Elsayed
- Department of Physical Therapy for Cardiovascular/Respiratory Disorders and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Ghada E El Refaye
- Department of Physical Therapy for Women's Health, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Ahmed Rabiee
- Department of Internal Medicine, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Sameh Abouzeid
- Department of Nephrology, Theodor Bilharz Research Institute, Giza, Egypt
| | - Hany F Elsisi
- Department of Physical Therapy for Cardiovascular/Respiratory Disorders and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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40
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Poon K. Effects of Aerobic Exercise and High-Intensity Interval Training on the Mental Health of Adolescents Living in Poverty: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e34915. [PMID: 35037892 PMCID: PMC8804952 DOI: 10.2196/34915] [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: 11/12/2021] [Revised: 11/19/2021] [Accepted: 11/30/2021] [Indexed: 11/13/2022] Open
Abstract
Background The increasing rate of mental health issues among adolescents has recently been a considerable concern in Hong Kong. In particular, adolescents with low socioeconomic status (SES) are likely to experience poor mental health, including low self-esteem and high levels of anxiety, anger, and depression. Previous research has found that physical activities have a positive impact on improving mental health outcomes among adolescents. However, approximately 96% of adolescents in Hong Kong do not engage in regular exercise, which potentially increases the risk of poor mental health. Objective In this study, we aim to examine whether changes in the 3 indicators (reduced ill-being, enhanced well-being, and cognitive functions) of mental health among adolescents with low SES are evident before and after exercise. In addition, this study compares the effectiveness of aerobic exercise and high-intensity interval training on these indicators among adolescents with low SES. Methods A total of 78 participants from low-income families aged between 12 and 15 years from 3 to 4 secondary schools will be recruited for this study. They will be randomly assigned to either an aerobic exercise group (26/78, 33%), a high-intensity interval training group (26/78, 33%), or a control group (26/78, 33%). Participants in the first 2 groups will take part in a 10-week training program period. Participants in the control group will participate in other physical activities during the same intervention period. The training sessions will be conducted 3 times per week on nonconsecutive days. A range of neuropsychological tests and psychometric scales will be used to measure the executive functions and indicators of psychological well-being and ill-being, including enjoyment, self-efficacy, mood, depression, anxiety, and stress at pretest, posttest, and follow-up assessments. Results The project was funded in 2021 by the Research Matching Grant Scheme, through the University Grants Committee of the Hong Kong Special Administrative Region Government. Ethical approval has been obtained from the author’s institution. Participant recruitment will begin in January 2022 and continue through to April 2022. Data collection and follow-up are expected to be completed by the end of 2022. The results are expected to be submitted for publication in 2023. Conclusions The findings will help inform policy makers and practitioners in promoting the importance of physical exercise to enhance mental health. Trial Registration ClinicalTrials.gov NCT050293888; https://clinicaltrials.gov/ct2/show/record/NCT05029388 International Registered Report Identifier (IRRID) PRR1-10.2196/34915
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Affiliation(s)
- Kean Poon
- Department of Special Education and Counselling, The Education University of Hong Kong, Tai Po, New Territories, Hong Kong
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41
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Falkai P, Schmitt A, Rosenbeiger CP, Maurus I, Hattenkofer L, Hasan A, Malchow B, Heim-Ohmayer P, Halle M, Heitkamp M. Aerobic exercise in severe mental illness: requirements from the perspective of sports medicine. Eur Arch Psychiatry Clin Neurosci 2022; 272:643-677. [PMID: 34873635 PMCID: PMC9095557 DOI: 10.1007/s00406-021-01360-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 11/24/2021] [Indexed: 12/21/2022]
Abstract
Major depression, bipolar disorder, and schizophrenia are severe mental illnesses. Despite receiving psychopharmacological and psychosocial treatments, about half of patients develop a chronic course with residual cognitive and negative symptoms and have a high risk for cardiovascular disease and reduced life expectancy. Therefore, add-on innovative treatment approaches are needed to improve outcome. Aerobic exercise interventions have been shown to improve global functioning, cognition, and negative and depressive symptoms in these patients. The basic mechanism of these exercise-related changes has been reported to be improved brain plasticity, e.g., increased volume of disease-related brain regions such as the hippocampus. The optimal type, duration, and frequency of exercise have not yet been determined and need to be addressed in supervised physical exercise studies. Because of the low physical activity levels, lack of drive related to negative and depressive symptoms, and high prevalence of cardiovascular comorbidities in patients with severe mental illness, besides aiming to improve symptoms of mental illness, exercise interventions should also aim to increase cardiorespiratory fitness, which they should comprehensively assess by direct measurements of maximal oxygen uptake. Based on the recommendations for developing cardiorespiratory fitness by the American College of Sports Medicine, 150 min moderate-intensity training per week or vigorous-intensity exercise training for 75 min per week are appropriate. Most studies have had relatively short intervention periods, so future studies should focus on long-term adherence to exercise by implementing motivational strategies supported by telemedicine and by identifying and targeting typical barriers to exercise in this patient population.
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Affiliation(s)
- Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany
| | - Andrea Schmitt
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany ,Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Christian P. Rosenbeiger
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany
| | - Isabel Maurus
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336, Munich, Germany.
| | - Lisa Hattenkofer
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany
| | - Alkomiet Hasan
- Department of Psychiatry and Psychosomatics of the University Augsburg, Medical Faculty, Bezirkskrankenhaus Augsburg, University of Augsburg, Augsburg, Germany
| | - Berend Malchow
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Von-Siebold-Str. 5, 37075 Göttingen, Germany
| | - Pascale Heim-Ohmayer
- Department of Prevention and Sports Medicine, Medical Faculty, Technical University of Munich, University Hospital ‘Klinikum Rechts der Isar’, Munich, Germany
| | - Martin Halle
- Department of Prevention and Sports Medicine, Medical Faculty, Technical University of Munich, University Hospital ‘Klinikum Rechts der Isar’, Munich, Germany ,DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Melanie Heitkamp
- Department of Prevention and Sports Medicine, Medical Faculty, Technical University of Munich, University Hospital ‘Klinikum Rechts der Isar’, Munich, Germany
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Effectiveness and Benefits of Exercise on Older People Living With Mental Illness’ Physical and Psychological Outcomes in Regional Australia: A Mixed-Methods Study. J Aging Phys Act 2022; 31:417-429. [DOI: 10.1123/japa.2021-0514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 08/22/2022] [Accepted: 08/25/2022] [Indexed: 11/06/2022]
Abstract
Regular exercise is reported to improve depressive symptoms and quality of life for people experiencing mental illness. For older adults, including strength and balance can also decrease falls. Mental health services seldom include funding for Accredited Exercise Physiologist programs. A 9-week Accredited Exercise Physiologist-led program for older adults receiving mental health treatment with a community Older People’s Mental Health Service was trialed in regional Australia. This clinician-conceived small-scale feasibility study utilized a two-phase concurrent triangulation mixed-method design to evaluate physical and psychological program outcomes and identify factors related to engaging in physical activity. This tailored exercise program led to improvements in measures of psychological distress and physical and psychological function. These changes corresponded with participants identifying benefits of exercising as a group of adults living with mental illness. Such findings suggest a supervised, individualized program for older mental health consumers confers physical and psychological benefits; however, further research evaluating exercise interventions with this population is required.
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Iwon K, Skibinska J, Jasielska D, Kalwarczyk S. Elevating Subjective Well-Being Through Physical Exercises: An Intervention Study. Front Psychol 2021; 12:702678. [PMID: 34975608 PMCID: PMC8719442 DOI: 10.3389/fpsyg.2021.702678] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 11/15/2021] [Indexed: 01/07/2023] Open
Abstract
Background: Physical activity is associated with higher levels of subjective well-being. However, little research has been conducted in naturalistic conditions with a longitudinal design. In the current study, we aimed to examine whether regular activity initiation can impact happiness, life satisfaction, and self-esteem 4 weeks later. Methods: The sample (N = 217, 124 women) was divided into three groups based on level of physical activity (active people, beginners, and inactive people). The participants completed measures of happiness, satisfaction with life, self-esteem, and a survey on physical activity. Ninety-five of participants who completed the same set of measures sent by email after 4 weeks were included in the analyses. Results: The study showed a strong relationship between subjective well-being and physical activity. Active people showed higher levels of happiness and self-esteem compared to beginners and inactive people and a higher level of life satisfaction than inactive people. Furthermore, after 4 weeks of exercising, beginners revealed greater life satisfaction and happiness compared to the baseline. Conclusion: These findings confirm that regular physical activity leads to higher levels of well-being. It seems that even a short engagement in physical activity (4 weeks) may contribute to an increase in subjective well-being.
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Affiliation(s)
- Katarzyna Iwon
- Institute of Psychology, The Maria Grzegorzewska University, Warsaw, Poland
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Sakai Y, Chen C, Toyomaki A, Hashimoto N, Kitagawa K, Inoue T, Sato A, Makihara K, Kameyama R, Wakatsuki Y, Udo N, Shirakawa R, Yokota T, Nakagawa S, Kusumi I. A Brief, Individualized Exercise Program at Intensities Below the Ventilatory Threshold Exerts Therapeutic Effects for Depression: A Pilot Study. Front Behav Neurosci 2021; 15:787688. [PMID: 34880736 PMCID: PMC8648260 DOI: 10.3389/fnbeh.2021.787688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 10/20/2021] [Indexed: 12/03/2022] Open
Abstract
Due to the fact that existing pharmacological treatments for depression are not ideal, effort has been devoted to the development of complementary, alternative therapies such as physical exercise. The antidepressant effect of exercise is well documented. However, current recommendations and prescriptions of exercise may be too demanding for depressed patients, as some complain about the design of exercise programs and depression is associated with reduced motivation and capacity to exercise. Therefore, appropriately designed, patient-friendly exercise programs may prove critical for the long-term maintenance and therapeutic effects of exercise. In this pilot study, we developed an exercise program based on patients’ individual level of ventilatory threshold (VT), a submaximal index of aerobic capacity measured by Cardiopulmonary Exercise Testing (CPX). Compared to traditional measures, CPX provides more trustable indices of aerobic capacity and more homogenous exercise prescriptions. The main episode of the program consisted of 15–25 min of cycling twice a week at an intensity that approached but never went higher than subjects’ VT (considered low to moderate in intensity). We found that in patients diagnosed with major depressive disorder or persistent depressive disorder (n = 8), the program resulted in a significant reduction in depressive symptoms at week 8, which was maintained at week 16. Meanwhile, patients’ social functioning, quality of life, and cognitive functions improved. Although we used a single arm, non-randomized design, our results suggest that even a brief, low to moderate intensity exercise program may exert therapeutic effects for depression and CPX may be a useful tool for exercise prescriptions.
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Affiliation(s)
- Yuri Sakai
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Chong Chen
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Atsuhito Toyomaki
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Naoki Hashimoto
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Kan Kitagawa
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Takao Inoue
- Department of Health Sciences, Hokkaido University Graduate School of Health Sciences, Sapporo, Japan
| | - Asumi Sato
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Keisuke Makihara
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Rie Kameyama
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Yumi Wakatsuki
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Niki Udo
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Ryosuke Shirakawa
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Takashi Yokota
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Shin Nakagawa
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan.,Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Ichiro Kusumi
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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Efficacy of exercise combined with standard treatment for depression compared to standard treatment alone: A systematic review and meta-analysis of randomized controlled trials. J Affect Disord 2021; 295:1494-1511. [PMID: 34565591 DOI: 10.1016/j.jad.2021.09.043] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 09/08/2021] [Accepted: 09/11/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Exercise is indicated as a monotherapy for depression, as well as an augmentation strategy alongside standard treatments. However, it is not yet clear how exercise and standard treatments interact with regards to patient outcomes. The primary aim of the current systematic review and meta-analysis was to compare the antidepressant effects of exercise combined with standard treatment to standard treatment alone. METHOD A systematic search was conducted for trials comparing the efficacy of standard treatments alone or in combination with exercise for reducing symptoms of depression. Random effects meta-analysis was used to estimate pooled standardized mean difference for standard treatment alone versus standard treatment with exercise. RESULTS Twenty-two studies were included in the meta-analysis. There was a moderate pooled effect in favour of exercise combined with standard treatment compared to standard treatment alone (SMD = -0.62, p < 0.00001, I2 = 70%), with greatest benefits accruing for more severe patients (SMD = -0.99, p < 0.00001; I2 = 0%). Sensitivity analyses remained significant for trials with lower risk of bias (SMD = -0.41, p = 0.0009; I2 = 52%) and patients with a major depressive disorder diagnosis (SMD = -0.70, p < 0.0001; I2 = 72%). LIMITATIONS There was considerable heterogeneity between trials. Uneven covariate distributions within subgroups limited our ability to explore the sources of heterogeneity. CONCLUSIONS Exercise combined with standard treatments leads to significantly greater antidepressant effects over standard treatment alone. Patients and clinicians should consider using exercise alongside standard treatments to enhance therapeutic efficacy for depression.
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Murri MB, Amore M, Menchetti M, Toni G, Neviani F, Cerri M, Rocchi MBL, Zocchi D, Bagnoli L, Tam E, Buffa A, Ferrara S, Neri M, Alexopoulos GS, Zanetidou S. Physical Exercise for Late-Life Major Depression. FOCUS: JOURNAL OF LIFE LONG LEARNING IN PSYCHIATRY 2021; 19:365-373. [PMID: 34690606 DOI: 10.1176/appi.focus.19306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
(Reprinted with permission from Br J Psychiatry 2005; 207: 235-242).
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Affiliation(s)
- M Belvederi Murri
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy, and Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK; Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Italy; Department of Medical and Surgical Sciences, University of Bologna; Cardiology Unit, Ramazzini Hospital, Carpi; Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena; Department of Biomedical and Neuromotor Sciences, University of Bologna; Department of Biomolecular Sciences, Service of Biostatistics, University of Urbino; primary care physicians, Bologna; Department of Movement and Neurological Sciences, University of Verona; Unit of Internal Medicine, Geriatrics and Nephrology, S. Orsola Malpighi Hospital, Bologna; Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna; Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena, Italy; Department of Psychiatry, Weill Cornell Medical College, New York, USA; Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna, Italy; the Safety and Efficacy of Exercise for Depression in Seniors (SEEDS) Study Group
| | - M Amore
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy, and Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK; Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Italy; Department of Medical and Surgical Sciences, University of Bologna; Cardiology Unit, Ramazzini Hospital, Carpi; Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena; Department of Biomedical and Neuromotor Sciences, University of Bologna; Department of Biomolecular Sciences, Service of Biostatistics, University of Urbino; primary care physicians, Bologna; Department of Movement and Neurological Sciences, University of Verona; Unit of Internal Medicine, Geriatrics and Nephrology, S. Orsola Malpighi Hospital, Bologna; Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna; Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena, Italy; Department of Psychiatry, Weill Cornell Medical College, New York, USA; Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna, Italy; the Safety and Efficacy of Exercise for Depression in Seniors (SEEDS) Study Group
| | - M Menchetti
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy, and Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK; Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Italy; Department of Medical and Surgical Sciences, University of Bologna; Cardiology Unit, Ramazzini Hospital, Carpi; Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena; Department of Biomedical and Neuromotor Sciences, University of Bologna; Department of Biomolecular Sciences, Service of Biostatistics, University of Urbino; primary care physicians, Bologna; Department of Movement and Neurological Sciences, University of Verona; Unit of Internal Medicine, Geriatrics and Nephrology, S. Orsola Malpighi Hospital, Bologna; Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna; Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena, Italy; Department of Psychiatry, Weill Cornell Medical College, New York, USA; Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna, Italy; the Safety and Efficacy of Exercise for Depression in Seniors (SEEDS) Study Group
| | - G Toni
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy, and Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK; Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Italy; Department of Medical and Surgical Sciences, University of Bologna; Cardiology Unit, Ramazzini Hospital, Carpi; Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena; Department of Biomedical and Neuromotor Sciences, University of Bologna; Department of Biomolecular Sciences, Service of Biostatistics, University of Urbino; primary care physicians, Bologna; Department of Movement and Neurological Sciences, University of Verona; Unit of Internal Medicine, Geriatrics and Nephrology, S. Orsola Malpighi Hospital, Bologna; Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna; Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena, Italy; Department of Psychiatry, Weill Cornell Medical College, New York, USA; Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna, Italy; the Safety and Efficacy of Exercise for Depression in Seniors (SEEDS) Study Group
| | - F Neviani
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy, and Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK; Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Italy; Department of Medical and Surgical Sciences, University of Bologna; Cardiology Unit, Ramazzini Hospital, Carpi; Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena; Department of Biomedical and Neuromotor Sciences, University of Bologna; Department of Biomolecular Sciences, Service of Biostatistics, University of Urbino; primary care physicians, Bologna; Department of Movement and Neurological Sciences, University of Verona; Unit of Internal Medicine, Geriatrics and Nephrology, S. Orsola Malpighi Hospital, Bologna; Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna; Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena, Italy; Department of Psychiatry, Weill Cornell Medical College, New York, USA; Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna, Italy; the Safety and Efficacy of Exercise for Depression in Seniors (SEEDS) Study Group
| | - M Cerri
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy, and Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK; Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Italy; Department of Medical and Surgical Sciences, University of Bologna; Cardiology Unit, Ramazzini Hospital, Carpi; Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena; Department of Biomedical and Neuromotor Sciences, University of Bologna; Department of Biomolecular Sciences, Service of Biostatistics, University of Urbino; primary care physicians, Bologna; Department of Movement and Neurological Sciences, University of Verona; Unit of Internal Medicine, Geriatrics and Nephrology, S. Orsola Malpighi Hospital, Bologna; Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna; Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena, Italy; Department of Psychiatry, Weill Cornell Medical College, New York, USA; Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna, Italy; the Safety and Efficacy of Exercise for Depression in Seniors (SEEDS) Study Group
| | - M B L Rocchi
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy, and Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK; Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Italy; Department of Medical and Surgical Sciences, University of Bologna; Cardiology Unit, Ramazzini Hospital, Carpi; Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena; Department of Biomedical and Neuromotor Sciences, University of Bologna; Department of Biomolecular Sciences, Service of Biostatistics, University of Urbino; primary care physicians, Bologna; Department of Movement and Neurological Sciences, University of Verona; Unit of Internal Medicine, Geriatrics and Nephrology, S. Orsola Malpighi Hospital, Bologna; Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna; Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena, Italy; Department of Psychiatry, Weill Cornell Medical College, New York, USA; Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna, Italy; the Safety and Efficacy of Exercise for Depression in Seniors (SEEDS) Study Group
| | - D Zocchi
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy, and Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK; Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Italy; Department of Medical and Surgical Sciences, University of Bologna; Cardiology Unit, Ramazzini Hospital, Carpi; Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena; Department of Biomedical and Neuromotor Sciences, University of Bologna; Department of Biomolecular Sciences, Service of Biostatistics, University of Urbino; primary care physicians, Bologna; Department of Movement and Neurological Sciences, University of Verona; Unit of Internal Medicine, Geriatrics and Nephrology, S. Orsola Malpighi Hospital, Bologna; Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna; Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena, Italy; Department of Psychiatry, Weill Cornell Medical College, New York, USA; Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna, Italy; the Safety and Efficacy of Exercise for Depression in Seniors (SEEDS) Study Group
| | - L Bagnoli
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy, and Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK; Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Italy; Department of Medical and Surgical Sciences, University of Bologna; Cardiology Unit, Ramazzini Hospital, Carpi; Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena; Department of Biomedical and Neuromotor Sciences, University of Bologna; Department of Biomolecular Sciences, Service of Biostatistics, University of Urbino; primary care physicians, Bologna; Department of Movement and Neurological Sciences, University of Verona; Unit of Internal Medicine, Geriatrics and Nephrology, S. Orsola Malpighi Hospital, Bologna; Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna; Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena, Italy; Department of Psychiatry, Weill Cornell Medical College, New York, USA; Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna, Italy; the Safety and Efficacy of Exercise for Depression in Seniors (SEEDS) Study Group
| | - E Tam
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy, and Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK; Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Italy; Department of Medical and Surgical Sciences, University of Bologna; Cardiology Unit, Ramazzini Hospital, Carpi; Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena; Department of Biomedical and Neuromotor Sciences, University of Bologna; Department of Biomolecular Sciences, Service of Biostatistics, University of Urbino; primary care physicians, Bologna; Department of Movement and Neurological Sciences, University of Verona; Unit of Internal Medicine, Geriatrics and Nephrology, S. Orsola Malpighi Hospital, Bologna; Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna; Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena, Italy; Department of Psychiatry, Weill Cornell Medical College, New York, USA; Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna, Italy; the Safety and Efficacy of Exercise for Depression in Seniors (SEEDS) Study Group
| | - A Buffa
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy, and Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK; Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Italy; Department of Medical and Surgical Sciences, University of Bologna; Cardiology Unit, Ramazzini Hospital, Carpi; Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena; Department of Biomedical and Neuromotor Sciences, University of Bologna; Department of Biomolecular Sciences, Service of Biostatistics, University of Urbino; primary care physicians, Bologna; Department of Movement and Neurological Sciences, University of Verona; Unit of Internal Medicine, Geriatrics and Nephrology, S. Orsola Malpighi Hospital, Bologna; Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna; Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena, Italy; Department of Psychiatry, Weill Cornell Medical College, New York, USA; Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna, Italy; the Safety and Efficacy of Exercise for Depression in Seniors (SEEDS) Study Group
| | - S Ferrara
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy, and Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK; Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Italy; Department of Medical and Surgical Sciences, University of Bologna; Cardiology Unit, Ramazzini Hospital, Carpi; Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena; Department of Biomedical and Neuromotor Sciences, University of Bologna; Department of Biomolecular Sciences, Service of Biostatistics, University of Urbino; primary care physicians, Bologna; Department of Movement and Neurological Sciences, University of Verona; Unit of Internal Medicine, Geriatrics and Nephrology, S. Orsola Malpighi Hospital, Bologna; Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna; Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena, Italy; Department of Psychiatry, Weill Cornell Medical College, New York, USA; Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna, Italy; the Safety and Efficacy of Exercise for Depression in Seniors (SEEDS) Study Group
| | - M Neri
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy, and Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK; Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Italy; Department of Medical and Surgical Sciences, University of Bologna; Cardiology Unit, Ramazzini Hospital, Carpi; Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena; Department of Biomedical and Neuromotor Sciences, University of Bologna; Department of Biomolecular Sciences, Service of Biostatistics, University of Urbino; primary care physicians, Bologna; Department of Movement and Neurological Sciences, University of Verona; Unit of Internal Medicine, Geriatrics and Nephrology, S. Orsola Malpighi Hospital, Bologna; Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna; Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena, Italy; Department of Psychiatry, Weill Cornell Medical College, New York, USA; Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna, Italy; the Safety and Efficacy of Exercise for Depression in Seniors (SEEDS) Study Group
| | - G S Alexopoulos
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy, and Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK; Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Italy; Department of Medical and Surgical Sciences, University of Bologna; Cardiology Unit, Ramazzini Hospital, Carpi; Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena; Department of Biomedical and Neuromotor Sciences, University of Bologna; Department of Biomolecular Sciences, Service of Biostatistics, University of Urbino; primary care physicians, Bologna; Department of Movement and Neurological Sciences, University of Verona; Unit of Internal Medicine, Geriatrics and Nephrology, S. Orsola Malpighi Hospital, Bologna; Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna; Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena, Italy; Department of Psychiatry, Weill Cornell Medical College, New York, USA; Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna, Italy; the Safety and Efficacy of Exercise for Depression in Seniors (SEEDS) Study Group
| | - S Zanetidou
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy, and Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK; Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Italy; Department of Medical and Surgical Sciences, University of Bologna; Cardiology Unit, Ramazzini Hospital, Carpi; Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena; Department of Biomedical and Neuromotor Sciences, University of Bologna; Department of Biomolecular Sciences, Service of Biostatistics, University of Urbino; primary care physicians, Bologna; Department of Movement and Neurological Sciences, University of Verona; Unit of Internal Medicine, Geriatrics and Nephrology, S. Orsola Malpighi Hospital, Bologna; Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna; Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena, Italy; Department of Psychiatry, Weill Cornell Medical College, New York, USA; Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna, Italy; the Safety and Efficacy of Exercise for Depression in Seniors (SEEDS) Study Group
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Husain-Krautter S, Ellison JM. Late Life Depression: The Essentials and the Essential Distinctions. FOCUS: JOURNAL OF LIFE LONG LEARNING IN PSYCHIATRY 2021; 19:282-293. [PMID: 34690594 DOI: 10.1176/appi.focus.20210006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Late life depression (LLD), a familiar syndrome, is not differentiated in the DSM-5. LLD can resemble depressive syndromes in younger adults but it differs in demographic characteristics, phenomenology, prognosis, treatment, suicide risk, relationship to other disorders, and etiology. Older depressed adults often present with fewer major depressive symptoms, less emphasis on mood disturbance, greater preoccupation with somatic or psychotic symptoms, and misleading cognitive deficits. LLD's relationships with medical and neurocognitive symptoms and with inflammatory and immune factors are complex. Formal screening tools and biopsychosocial assessment informs diagnosis and treatment. Evidence supports the effectiveness of lifestyle interventions, several psychotherapies, and a variety of somatic treatment approaches. Comorbid medical disorders must be taken into account when planning treatment. In this article, the authors describe the characteristics of LLD, present an approach to assessment and management, and recommend that future DSM editions include a new specifier to differentiate LLD from other depressive syndromes.
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Affiliation(s)
- Sehba Husain-Krautter
- Zucker Hillside Hospital, North Shore, Long Island Jewish Health System, Glen Oaks, New York (Husain-Krautter); Litwin-Zucker Research Center for the Study of Alzheimer's Disease, Feinstein Institute for Medical Research, Manhasset, New York (Husain-Krautter); Swank Center for Memory Care and Geriatric Consultation, ChristianaCare, Wilmington, Delaware (Ellison); Sidney Kimmel College of Medicine, Thomas Jefferson University, Philadelphia (Ellison)
| | - James M Ellison
- Zucker Hillside Hospital, North Shore, Long Island Jewish Health System, Glen Oaks, New York (Husain-Krautter); Litwin-Zucker Research Center for the Study of Alzheimer's Disease, Feinstein Institute for Medical Research, Manhasset, New York (Husain-Krautter); Swank Center for Memory Care and Geriatric Consultation, ChristianaCare, Wilmington, Delaware (Ellison); Sidney Kimmel College of Medicine, Thomas Jefferson University, Philadelphia (Ellison)
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Al-Rawaf HA, Alghadir AH, Gabr SA. Circulating microRNAs and Molecular Oxidative Stress in Older Adults with Neuroprogression Disorders. DISEASE MARKERS 2021; 2021:4409212. [PMID: 34721735 PMCID: PMC8556086 DOI: 10.1155/2021/4409212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 09/28/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND circulating microRNAs are potential blood biomarkers differentially expressed in many diseases including neuro depression disorders. It controls the expression of human genes and associated cellular and physiological processes in normal and diseased cells. We aimed to evaluate the potential role of circulating miRNAs and their association with both stress hormones and cellular oxidative stress in neuro depression disorders occurred among older adults. METHODS a total of 70 healthy subjects were included in this study. Based upon the profile of mood states (POMS-32 score), the participants classified into two groups; healthy subjects (n =30) and depression (n =40). The expression of microRNAs; miR-124, miR-34a-5p, miR-135, and miR-451-a and their correlation with cellular oxidative stress parameters; cellular NO, genes of SOD2, CAT and iNOS, and hormones; cortisol and serotonin were estimated by a quantitative real-time RT-PCR, high-performance liquid chromatography, and ELISA Immunoassay techniques, respectively. RESULTS depression was reported in 57.14% of the participants. The results showed a significant increase (p =0.01) in the total mood scores, and relative depression domains in older adults with depression compared to healthy controls. The relative expression levels of miR-124, miR-34a-5p significantly increased and the expression levels of miR-135, and miR-451-a significantly decreased in older adults with depression compared to healthy controls. In addition, the levels of cortisol significantly increased and serotonin (5HT) significantly reduced in all participants with depression. Cellular oxidative stress analysis for depressed subjects showed that serum NO levels and the expression of iNO gene significantly increased conversely with a decline in the molecular expression antioxidative genes; SOD2, CAT, respectively. The results showed that cellular oxidative stress parameters correlated positively with depression scores, cortisol, and negatively with cellular serotonin levels. In depressed subjects, the relative expression of microRNAs correlated positively with depression score, NO, iNOS, cortisol, and negatively associated with SOD2, CAT, and serotonin. CONCLUSION The combination of cellular oxidative stress and hormonal levels strongly supports a role for circulating miRNAs; miR-124, miR-34a-5p, miR-135, and miR-451-a in the regulation of depression and mood disorders among older adults. The expressed microRNAs with their related association to cellular oxidative stress and adrenal hormones are a step towards understanding the role of these small RNA molecules in the progression of depression among older adults. Thus, cellular miRNAs might have a prognostic role in the diagnosis and as a target for treatment strategies in depressed subjects.
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Affiliation(s)
- Hadeel A. Al-Rawaf
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ahmad H. Alghadir
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Sami A. Gabr
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Brush CJ, Burani K, Schmidt KM, Santopetro NJ, Hajcak G. The impact of a single session of aerobic exercise on positive emotional reactivity in depression: Insight into individual differences from the late positive potential. Behav Res Ther 2021; 144:103914. [PMID: 34218001 PMCID: PMC8610214 DOI: 10.1016/j.brat.2021.103914] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 04/29/2021] [Accepted: 06/09/2021] [Indexed: 01/14/2023]
Abstract
Depression has been characterized by a broad disengagement from the environment, as reflected by dampened positive and negative emotional reactivity. Research has shown that acute exercise may enhance positive emotional reactivity in healthy adults. It is unknown whether it can alter positive emotional reactivity in depression. In the present study, positive emotional reactivity was assessed using the late positive potential (LPP) event-related potential before and after 30 min of moderate-intensity aerobic exercise in 43 adults with current or a lifetime history of depression (Mage = 32.74 years; Min/Max = 18/59) and 18 never-depressed healthy adults (Mage = 37.94 years; Min/Max = 21/61). Acute exercise increased the LPP for healthy adults; the LPP did not change among those with current or a lifetime history of depression. A secondary aim was to identify moderators of change in positive emotional reactivity among subgroups of adults with current depression. Compared to adults with impaired mood reactivity, those with intact mood reactivity had a pre-to-post increase in the LPP. The current study provides preliminary support for the LPP as a neural indicator of exercise efficacy and highlights individual differences in response to acute exercise in depression.
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Affiliation(s)
- C J Brush
- Department of Psychology, Florida State University, Tallahassee, FL, USA.
| | - Kreshnik Burani
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Kendall M Schmidt
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | | | - Greg Hajcak
- Department of Psychology, Florida State University, Tallahassee, FL, USA; Department of Biomedical Sciences, Florida State University, Tallahassee, FL, USA
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Abstract
OBJECTIVE There is growing evidence that higher levels of physical activity are associated with better mental health. Furthermore, interventional studies have shown that exercise may improve symptoms in a number of psychiatric conditions. Despite this evidence, relatively little information is available about how these findings have been translated into clinical practice. The goal of this study was to characterize the exercise prescribing practices of health care providers from different subspecialties and evaluate factors that may influence their prescribing practices. METHODS We conducted a cross-sectional survey among faculty and staff from a large academic tertiary care medical center in the southeastern United States. Participants were invited to complete the survey via email or departmental newsletters. Descriptive statistics were used to characterize the sample and ordered logistic regression was used to analyze practices about exercise as a therapy for psychiatric illness. RESULTS A total of 185 respondents completed the survey. More than half of the providers (58%) reported that they regularly recommend exercise as part of the treatment for patients with psychiatric conditions; however, few providers offered specific exercise instructions (24%) or followed national guidelines (30%). Depression (84.9%) and anxiety (69.2%) were the most common indications for exercise prescription, while insufficient knowledge or training was the most common barrier to prescribing exercise. We also found significant differences in prescription practices depending on the providers' formal clinical degree and their reported personal exercise habits. CONCLUSIONS Exercise is recognized by most clinicians as a therapeutic option for psychiatric conditions. Despite this recognition, only a small proportion provide recommendations consistent with national guidelines or empirical research.
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