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Gajdošová L, Katrenčíková B, Borbélyová V, Muchová J. The Effect of Omega-3 Fatty Acid Supplementation and Exercise on Locomotor Activity, Exploratory Activity, and Anxiety-Like Behavior in Adult and Aged Rats. Physiol Res 2024; 73:461-480. [PMID: 39012176 DOI: 10.33549/physiolres.935245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2024] Open
Abstract
Aging is an inevitable and complex biological process that is associated with a gradual decline in physiological functions and a higher disease susceptibility. Omega-3 fatty acids, particularly docosahexaenoic acid, play a crucial role in maintaining brain health and their deficiency is linked to age-related cognitive decline. Combining omega-3-rich diets with exercise may enhance cognitive function more effectively, as both share overlapping neurobiological and physiological effects. This study aimed to evaluate the effect of exercise and omega-3 fatty acid (FA) supplementation in two different doses (160 mg/kg and 320 mg/kg) on anxiety-like behavior and cognitive abilities in both adult and aged rats. Male Wistar rats (4-5- and 23-24-month-old) were randomly divided into seven groups: 3-week control supplemented with placebo without exercise, low-dose omega-3 FAs, high-dose omega-3 FAs, 7-week control supplemented with placebo without exercise, exercise-only, low-dose omega-3 FAs with exercise, and high-dose omega-3 FAs with exercise. The administered oil contained omega-3 FAs with DHA:EPA in a ratio of 1.5:1. Our results indicate that aging negatively impacts the locomotor and exploratory activity of rats. In adult rats, a low dose of omega-3 FAs reduces locomotor activity when combined with exercise while high dose of omega-3 FAs reduces anxiety-like behavior and improves recognition memory when combined with exercise. The combination of omega-3 FAs and exercise had varying impacts on behavior, suggesting a need for further research in this area to fully understand their therapeutic efficacy in the context of cognitive changes associated with aging.
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Affiliation(s)
- L Gajdošová
- Institute of Medical Chemistry, Biochemistry and Clinical Biochemistry, Faculty of Medicine, Comenius University, Sasinkova 2, 811 08 Bratislava, Slovak Republic.
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Minatoguchi S, Minagawa T, Osawa K, Ojio S, Yasuda S, Marumo T, Takahashi S. Effects of Repeated Kurort Health Walking on Blood Pressure and Mental Health. Circ Rep 2024; 6:241-247. [PMID: 38989103 PMCID: PMC11233168 DOI: 10.1253/circrep.cr-24-0036] [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: 04/05/2024] [Revised: 05/15/2024] [Accepted: 05/26/2024] [Indexed: 07/12/2024] Open
Abstract
Background: The German word "kurort" means cure (kur) and area (ort), whereby a patient's health improves through walking in areas full of nature. A single session of kurort health walking (kurort) decreased high blood pressure and improved mental health. However, its continuing effect with repeat sessions remains unclear. Methods and Results: The subjects participated twice in kurort health walking in specially designated courses in Gifu City (n=242). Systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse rate (PR) were measured before and after kurort health walking. Mental health was assessed using a 10-item checklist after kurort health walking. Both basal SBP and DBP before walking were significantly decreased more in the second session than in the first. In both the first and second sessions SBP and DBP decreased, but the decrease in SBP (∆SBP) by kurort was significantly greater in the SBP ≥140- than in the SBP <140-mmHg group, SBP inversely correlated with ∆SBP, the decrease in DBP (∆DBP) was significantly greater in the DBP ≥90- than in the DBP <90-mmHg group, and DBP inversely correlated with ∆DBP. Mental health was similarly improved after both the first and second kurort. Conclusions: Basal SBP and DBP decreased more in the second than in the first kurort. The decrease in SBP and DBP, and improvement of mental health was noted after both sessions.
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Affiliation(s)
| | | | - Kaori Osawa
- Cardiology, Heart Failure Center, Gifu Municipal Hospital Gifu Japan
| | - Shinsuke Ojio
- Cardiology, Heart Failure Center, Gifu Municipal Hospital Gifu Japan
| | - Shinji Yasuda
- Cardiology, Heart Failure Center, Gifu Municipal Hospital Gifu Japan
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Hird EJ, Slanina-Davies A, Lewis G, Hamer M, Roiser JP. From movement to motivation: a proposed framework to understand the antidepressant effect of exercise. Transl Psychiatry 2024; 14:273. [PMID: 38961071 PMCID: PMC11222551 DOI: 10.1038/s41398-024-02922-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 03/28/2024] [Accepted: 05/10/2024] [Indexed: 07/05/2024] Open
Abstract
Depression is the leading cause of disability worldwide, exerting a profound negative impact on quality of life in those who experience it. Depression is associated with disruptions to several closely related neural and cognitive processes, including dopamine transmission, fronto-striatal brain activity and connectivity, reward processing and motivation. Physical activity, especially aerobic exercise, reduces depressive symptoms, but the mechanisms driving its antidepressant effects are poorly understood. Here we propose a novel hypothesis for understanding the antidepressant effects of exercise, centred on motivation, across different levels of explanation. There is robust evidence that aerobic exercise decreases systemic inflammation. Inflammation is known to reduce dopamine transmission, which in turn is strongly implicated in effort-based decision making for reward. Drawing on a broad range of research in humans and animals, we propose that by reducing inflammation and boosting dopamine transmission, with consequent effects on effort-based decision making for reward, exercise initially specifically improves 'interest-activity' symptoms of depression-namely anhedonia, fatigue and subjective cognitive impairment - by increasing propensity to exert effort. Extending this framework to the topic of cognitive control, we explain how cognitive impairment in depression may also be conceptualised through an effort-based decision-making framework, which may help to explain the impact of exercise on cognitive impairment. Understanding the mechanisms underlying the antidepressant effects of exercise could inform the development of novel intervention strategies, in particular personalised interventions and boost social prescribing.
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Affiliation(s)
- E J Hird
- Institute of Cognitive Neuroscience, University College London, London, UK.
| | - A Slanina-Davies
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - G Lewis
- Division of Psychiatry, University College London, London, UK
| | - M Hamer
- Institute of Sport, Exercise and Health, University College London, London, UK
| | - J P Roiser
- Institute of Cognitive Neuroscience, University College London, London, UK
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Filippou K, Knappe F, Hatzigeorgiadis A, Morres ID, Tzormpatzakis E, Havas E, Pühse U, Theodorakis Y, Gerber M. Self-Reported Physical Activity and Mental Health Among Asylum Seekers in a Refugee Camp. J Phys Act Health 2024; 21:657-667. [PMID: 38621670 DOI: 10.1123/jpah.2023-0325] [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: 07/02/2023] [Revised: 01/22/2024] [Accepted: 02/29/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND Global forced displacement has been rising steeply since 2015 as a result of wars and human rights abuses. Forcibly displaced people are often exposed to physical and mental strain, which can cause traumatic experiences and poor mental health. Physical activity has been linked with better mental health, although such evidence is scarce among those populations. The purpose of the study was to examine the relationships of self-reported physical activity and fitness with mental health indices among people residing in a refugee camp in Greece as asylum seekers. METHODS Participants were 151 individuals (76 women, 75 men; mean age 28.90 y) displaced from their homes for an average of 32.03 months. Among them, 67% were from Afghanistan and countries from southwest Asia, and 33% from sub-Saharan African countries. Participants completed self-report measures assessing physical activity, fitness, symptoms of post-traumatic stress disorder, depression, anxiety, and well-being. RESULTS High prevalence of mental health disorder symptoms and poor well-being were identified, with women and Asians showing poorer mental health. Symptoms of post-traumatic stress disorder, depression, and anxiety were related to perceived fitness, but not to self-reported physical activity. Regression analysis showed that perceived fitness (β: 0.34; 95% CI, 0.43 to 1.52) and low-intensity physical activity (β: 0.24; 95% CI, 0.001 to 0.009) significantly positively predicted well-being, showing small to medium effect. CONCLUSIONS The findings provide useful insights regarding the link between physical activity and well-being; nevertheless, further research examining objectively measured physical activity is warranted to complement these data and further explore the associations between physical activity and mental health.
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Affiliation(s)
- Konstantinia Filippou
- Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Florian Knappe
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | | | - Ioannis D Morres
- Department of Nutrition and Dietetics, University of Thessaly, Trikala, Greece
| | | | - Elsa Havas
- Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Uwe Pühse
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Yannis Theodorakis
- Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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Tian S, Liang Z, Qui F, Yu Y, Wang C, Zhang M, Wang X. Optimal exercise modality and dose to improve depressive symptoms in adults with major depressive disorder: A systematic review and Bayesian model-based network meta-analysis of RCTs. J Psychiatr Res 2024; 176:384-392. [PMID: 38944017 DOI: 10.1016/j.jpsychires.2024.06.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 05/29/2024] [Accepted: 06/24/2024] [Indexed: 07/01/2024]
Abstract
Depression is a growing public health concern, and exercise is an adjunctive treatment modality to improve depression, but the optimal form of exercise and the optimal dose are still unclear. This systematic review examined the efficacy of four major types of exercise (aerobic, resistance, mixed, and mind-body) on depression, as well as the dose-response relationship between total and specific exercise and depressive symptoms. We included randomized controlled trials that included participants aged 18 years or older with a diagnosis of major depressive disorder or a depressive symptom score above a threshold as determined by a validated screening measure, implemented one or more exercise therapy groups, and assessed depressive symptoms at baseline and follow-up. Forty-six studies (3164 patients) were included in the meta-analysis. Aerobic (standardised mean difference (SMD) = -0.93; 95% CI: -1.25 to -0.62) and mind-body exercise (SMD) = -0.81; 95% CI: -1.19 to -0.42) improved depressive symptoms better compared to controls, followed by mixed (SMD = -0.77; 95% CI: -1.20 to -0.34) and resistance exercise (SMD = -0.76; 95% CI: -1.24 to -0.28). This dose-response meta-analysis showed a U-shaped curve between exercise dose and depressive symptoms. The minimum effective dose was estimated to be 320 metabolic equivalent (METs) -min per week and the optimal response was 860 METs-min per week. These findings lead us to advocate that clinicians carefully select the appropriate dose of exercise based on the patient's individual characteristics and needs, in conjunction with psychological care interventions.
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Affiliation(s)
- Shudong Tian
- School of Physical Education, Shandong University, Jinan, 250061, China.
| | - Zhide Liang
- Department of Physical Education, Qingdao University, Qingdao, 266071, China.
| | - Fanghui Qui
- Department of Physical Education, Qingdao University, Qingdao, 266071, China.
| | - Yingdanni Yu
- School of Physical Education, Shandong University, Jinan, 250061, China.
| | - Chuanzhi Wang
- School of Physical Education and Sports Science, South China Normal University, Guangzhou, 510006, China.
| | - Meng Zhang
- Xi'an Physical Education University, Xi'an, 710068, China.
| | - Xianliang Wang
- School of Physical Education, Shandong University, Jinan, 250061, China.
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Zeng Y, Huang R, Zhao L, He X, Mao S. The effectiveness of mind-body therapy and physical training in alleviating depressive symptoms in adult cancer patients: a meta-analysis. J Cancer Res Clin Oncol 2024; 150:289. [PMID: 38836958 PMCID: PMC11153279 DOI: 10.1007/s00432-024-05813-3] [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: 05/05/2024] [Accepted: 05/20/2024] [Indexed: 06/06/2024]
Abstract
PURPOSE The aim of this study was to assess the effectiveness of mind-body therapy (MBT) and/or physical training in alleviating depressive symptoms among adult cancer patients through a meta-analysis. METHODS PubMed, Embase, EBSCO, Web of Science, and Cochrane Library databases were searched from up to October 21, 2023. Effect sizes, 95% confidence intervals, and other pertinent values were computed utilizing a random-effects model with Review Manager 5.3 and StataMP 14. The reporting of findings adhered to the guidelines for systematic reviews and meta-analyses. The PROSPERO registration code for this review is 4,203,477,316. RESULTS 10 randomized controlled trials (11 datasets) involving a total of 620 participants were selected for analysis. The results demonstrated that complementary therapies, encompassing MBT and physical training, were effective in alleviating depressive symptoms in adult cancer patients (SMD= -0.47; 95%CI: -0.87, -0.08; P = 0.02). Subgroup analysis indicate that physical training may effectively alleviate depressive symptoms (SMD= -0.72; 95%CI: -1.31, -0.13; P = 0.02), demonstrating moderate effect sizes. Conversely, MBT does not seem to significantly influence depressive symptoms (P = 0.69). CONCLUSIONS Complementary therapy lasting four weeks or more, incorporating physical training and MBT, has been shown to alleviate depressive symptoms in adult cancer patients. And physical training has a significant effect on depressive symptoms, while MBT has no effect. Nevertheless, given the constraints of the included studies, further research is required in the future to provide more robust evidence.
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Affiliation(s)
- Yixian Zeng
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, 100084, China
| | - Ruixin Huang
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, 100084, China
| | - Li Zhao
- School of Sports Science, Beijing Sport University, Beijing, 100084, China
| | - Xingfei He
- Wuxi Huishan District Rehabilitation Hospital, Wuxi, 214001, China.
| | - Shanshan Mao
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, 100084, China.
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Wolf S, Seiffer B, Zeibig JM, Frei AK, Studnitz T, Welkerling J, Meinzinger E, Bauer LL, Baur J, Rosenstiel S, Fiedler DV, Helmhold F, Ray A, Herzog E, Takano K, Nakagawa T, Günak MM, Kropp S, Peters S, Flagmeier AL, Zwanzleitner L, Sundmacher L, Ramos-Murguialday A, Hautzinger M, Sudeck G, Ehring T. A transdiagnostic group exercise intervention for mental health outpatients in Germany (ImPuls): results of a pragmatic, multisite, block-randomised, phase 3 controlled trial. Lancet Psychiatry 2024; 11:417-430. [PMID: 38670127 DOI: 10.1016/s2215-0366(24)00069-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 02/23/2024] [Accepted: 02/29/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Globally, mental health conditions pose a substantial burden of disease. Despite the availability of evidence-based pharmacological and psychological treatments, the symptoms of a substantial subgroup of patients do not respond to these interventions, and only a minority of patients have access to them. This study aimed to assess the efficacy of ImPuls, a 6-month transdiagnostic group exercise intervention, plus treatment-as-usual, compared with treatment-as-usual alone in outpatients with various mental disorders. METHODS In this pragmatic, two-arm, multisite, randomised controlled trial in Germany, ten outpatient rehabilitative and medical care facilities were involved as study sites. Participants were outpatients diagnosed according to ICD-10 with one or more of the following disorders based on structured clinical interviews: moderate or severe depression, primary insomnia, post-traumatic stress disorder (PTSD), panic disorder, or agoraphobia. Participants were required to be aged between 18 years and 65 years, insured by the health insurers Allgemeine Ortskrankenkasse Baden-Württemberg or Techniker Krankenkasse, fluent in German, and without medical contraindications for exercise. Blocks of six participants were randomly allocated to ImPuls plus treatment-as-usual or treatment-as-usual alone (allocation ratio: 1:1), stratified by study site. The randomisation sequence was generated by an external data manager. The team responsible for data collection and management was masked to the randomisation sequence. The ImPuls intervention comprised evidence-based outdoor exercises lasting 30 min, and aimed at achieving at least moderate intensity. It also incorporated behavioural change techniques targeting motivational and volitional determinants of exercise behaviour. Treatment-as-usual was representative of typical outpatient health care in Germany, allowing patients access to any standard treatments. The primary outcome was global symptom severity at 6 months after randomisation, measured using self-report on the Brief Symptom Inventory (BSI-18) and analysed in the intention-to-treat sample. No individuals with lived experience of mental illness were involved in conducting the study or writing the final publication. Safety was assessed in all participants. The trial was registered with the German Clinical Trials Register (DRKS00024152) with a completion date of June 30, 2024. FINDINGS 600 patients provided informed consent, were recruited to the study, and underwent a diagnostic interview between Jan 1, 2021, and May 31, 2022. Following this, 199 were excluded on the basis of inclusion and exclusion criteria and one withdrew consent during the baseline assessment. Of the 400 eligible participants, 284 (71%) self-identified as female, 106 (27%) self-identified as male, and nine (2%) self-identified as other. The mean age was 42·20 years (SD 13·23; range 19-65). Ethnicity data were not assessed. 287 (72%) participants met the criteria for moderate or severe depression, 81 (20%) for primary insomnia, 37 (9%) for agoraphobia, 46 (12%) for panic disorder, and 72 (18%) for PTSD. 199 participants were allocated to the intervention group of ImPuls plus treatment-as-usual and 201 to the control group of treatment-as-usual alone. 38 (19%) participants did not receive the minimum ImPuls intervention dose. ImPuls plus treatment-as-usual demonstrated superior efficacy to treatment-as-usual alone in reducing global symptom severity, with an adjusted difference on BSI-18 of 4·11 (95% CI 1·74-6·48; d=0·35 [95% CI 0·14-0·56]; p=0·0007) at 6 months. There were no significant differences in the total number of adverse events or serious adverse events between the two groups. There was one serious adverse event (male, torn ligament) related to the intervention. INTERPRETATION ImPuls is an efficacious transdiagnostic adjunctive treatment in outpatient mental health care. Our findings suggest that exercise therapy should be implemented in outpatient mental health care as an adjunctive transdiagnostic treatment for mental disorders such as depression, insomnia, panic disorder, agoraphobia, and PTSD. Transdiagnostic group exercise interventions might ameliorate the existing disparity in care provision between the many individuals in need of evidence-based treatment and the few who are receiving it. FUNDING The German Innovation Fund of the Federal Joint Committee of Germany.
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Affiliation(s)
- Sebastian Wolf
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany.
| | - Britta Seiffer
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
| | - Johanna-Marie Zeibig
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
| | - Anna Katharina Frei
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
| | - Thomas Studnitz
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
| | - Jana Welkerling
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
| | - Edith Meinzinger
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
| | - Leonie Louisa Bauer
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
| | - Julia Baur
- Faculty of Science, Psychological Institute, Department of Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Stephanie Rosenstiel
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
| | - David Victor Fiedler
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
| | - Florian Helmhold
- Medical Faculty, Institute of Medical Psychology and Behavioural Neurobiology, University of Tübingen, Tübingen, Germany; International Max Planck Research School for Cognitive and Systems Neuroscience, Tübingen, Germany
| | - Andreas Ray
- Medical Faculty, Institute of Medical Psychology and Behavioural Neurobiology, University of Tübingen, Tübingen, Germany
| | - Eva Herzog
- Department of Psychology, Division of Clinical Psychology and Psychological Treatment, LMU Munich, Munich, Germany
| | - Keisuke Takano
- Department of Psychology, Division of Clinical Psychology and Psychological Treatment, LMU Munich, Munich, Germany; Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, Japan
| | - Tristan Nakagawa
- Department of Psychology, Division of Clinical Psychology and Psychological Treatment, LMU Munich, Munich, Germany
| | - Mia Maria Günak
- Department of Psychology, Division of Clinical Psychology and Psychological Treatment, LMU Munich, Munich, Germany
| | - Saskia Kropp
- Chair of Health Economics, Technical University Munich, Munich, Germany
| | - Stefan Peters
- German Association for Health-Enhancing Physical Activity and Exercise Therapy, Hürth-Efferen, Germany; Department of Human Sciences, Institute of Sport Science, Bundeswehr University Munich, Munich, Germany
| | | | | | - Leonie Sundmacher
- Chair of Health Economics, Technical University Munich, Munich, Germany
| | - Ander Ramos-Murguialday
- Medical Faculty, Institute of Medical Psychology and Behavioural Neurobiology, University of Tübingen, Tübingen, Germany; Department of Neurology & Stroke, University of Tübingen, Tübingen, Germany; Tecnalia, Basque Research and Technology Alliance, San Sebastián, Spain; Athenea Neuroclinics, San Sebastián, Spain
| | - Martin Hautzinger
- Faculty of Science, Psychological Institute, Department of Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Gorden Sudeck
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
| | - Thomas Ehring
- Department of Psychology, Division of Clinical Psychology and Psychological Treatment, LMU Munich, Munich, Germany; German Center for Mental Health, Munich, Germany
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Motl RW, Bombardier CH, Duffecy J, Hibner B, Wathen A, Carrithers M, Cutter G. Study protocol: exercise training for treating major depressive disorder in multiple sclerosis. BMC Neurol 2024; 24:131. [PMID: 38632556 PMCID: PMC11022372 DOI: 10.1186/s12883-024-03634-y] [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: 03/05/2024] [Accepted: 04/10/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is prevalent, yet sub-optimally treated among persons with multiple sclerosis (MS). We propose that exercise training may be a promising approach for treating depression in persons with MS who have MDD. Our primary hypothesis predicts a reduction in depression severity immediately after an exercise training intervention compared with minimal change in an attention control condition, and the reduction will be maintained during a follow-up period. METHODS This study involves a parallel-group, assessor-blinded RCT that examines the effect of a 4-month home-based exercise training intervention on depression severity in a sample of persons with MS who have MDD based on the MINI International Neuropsychiatric Interview. The primary outcomes of depression severity are the Patient Health Questionnaire-9 and Hamilton Depression Rating Scale. Participants (N = 146) will be recruited from within 200 miles of the University of Illinois at Chicago and randomized (1:1) into either a home-based exercise training condition or control condition with concealed allocation. The exercise training and social-contact, attention control (i.e., stretching) conditions will be delivered remotely over a 4-month period and supported through eight, 1:1 Zoom-based behavioral coaching sessions guided by social-cognitive theory and conducted by persons who are uninvolved in screening, recruitment, random assignment, and outcome assessment. We will collect outcome data at 0, 4 and 8 months using treatment-blinded assessors, and data analyses will involve intent-to-treat principles. DISCUSSION If successful, the proposed study will provide the first Class I evidence supporting a home-based exercise training program for treating MDD in persons with MS. This is critical as exercise training would likely have positive secondary effects on symptoms, cognition, and quality of life, and provide a powerful, behavioral approach for managing the many negative outcomes of MDD in MS. The program in the proposed research is accessible and scalable for broad treatment of depression in MS, and provides the potential for integration in the clinical management of MS. TRIAL REGISTRATION The trial was registered on September 10, 2021 at clinicaltrials.gov with the identifier NCT05051618. The registration occurred before we initiated recruitment on June 2, 2023.
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Affiliation(s)
- Robert W Motl
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, 60612, USA.
| | - Charles H Bombardier
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Jennifer Duffecy
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Brooks Hibner
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, 60612, USA
| | - Alison Wathen
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, 60612, USA
| | - Michael Carrithers
- Department of Neurology and Rehabilitation, University of Illinois at Chicago, Chicago, IL, USA
| | - Gary Cutter
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
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Rossi R, Cutter CJ, Beitel M, Covelli M, Fiellin DA, Kerns RD, Vassilieva S, Olabisi D, Barry DT. Stepped Care for Patients to Optimize Whole Recovery (SC-POWR): An Effectiveness Trial Evaluating a Stepped Care Model for Individuals With Opioid Use Disorder and Chronic Pain. SUBSTANCE USE & ADDICTION JOURNAL 2024:29767342241245095. [PMID: 38606900 DOI: 10.1177/29767342241245095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Many patients who receive treatment for opioid use disorder (OUD) report experiencing chronic pain (CP), which is associated with high levels of ongoing nonmedical opioid use and low retention in OUD treatment. In pilot studies of patients with OUD receiving buprenorphine or methadone who had CP, cognitive behavioral therapy (CBT) attenuated nonmedical opioid use compared with treatment-as-usual (TAU), but patients in both treatment arms exhibited similar pain improvements. Adding exercise and stress reduction to this model may augment pain-related outcomes. With funding from National Institutes of Health, we plan to conduct a randomized clinical trial of 316 patients with OUD and CP to test the effectiveness of TAU compared with Stepped Care for Patients to Optimize Whole Recovery (SC-POWR) to reduce nonmedical opioid use and pain (primary outcomes) (Aim 1) and decrease pain intensity and interference, alcohol use, anxiety, depression and stress, and improve sleep (secondary outcomes) (Aim 2). Eligible participants will be randomized to receive TAU (buprenorphine or methadone and at least once a month individual or group counseling) or SC-POWR (ie, TAU and up to 12 CBT sessions) for 24 weeks. Based on prespecified nonresponse criteria, SC-POWR may be stepped up at week 6 to receive onsite weekly group sessions of exercise (Wii Fit, Tai Chi) and "stepped up" again at week 15 to receive weekly group sessions of stress reduction (relaxation training, auricular acupuncture). They will be followed for another 24 weeks to evaluate durability of treatment response for illicit opioid use, alcohol use, pain, anxiety, depression, stress, sleep, and retention in medications for OUD (Aim 3).
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Affiliation(s)
- Raiza Rossi
- Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Christopher J Cutter
- Yale Child Study Center, New Haven, CT, USA
- Yale Program in Addiction Medicine, Yale School of Medicine, New Haven, CT, USA
| | | | | | - David A Fiellin
- Internal Medicine, Yale School of Medicine, New Haven, CT, USA
- Yale Program in Addiction Medicine, Yale School of Medicine, New Haven, CT, USA
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA
| | - Robert D Kerns
- Yale Program in Addiction Medicine, Yale School of Medicine, New Haven, CT, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Svetlana Vassilieva
- Internal Medicine, Yale School of Medicine, New Haven, CT, USA
- Yale Program in Addiction Medicine, Yale School of Medicine, New Haven, CT, USA
| | | | - Declan T Barry
- Yale Child Study Center, New Haven, CT, USA
- Yale Program in Addiction Medicine, Yale School of Medicine, New Haven, CT, USA
- APT Foundation, New Haven, CT, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
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10
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Holland-Winkler AM, Greene DR, Oberther TJ. The Cyclical Battle of Insomnia and Mental Health Impairment in Firefighters: A Narrative Review. J Clin Med 2024; 13:2169. [PMID: 38673442 PMCID: PMC11050272 DOI: 10.3390/jcm13082169] [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: 03/04/2024] [Revised: 03/27/2024] [Accepted: 04/05/2024] [Indexed: 04/28/2024] Open
Abstract
The occupational requirements of full-time non-administrative firefighters include shift-work schedules and chronic exposure to alerting emergency alarms, hazardous working conditions, and psychologically traumatic events that they must attend and respond to. These compiling and enduring aspects of the career increase the firefighter's risk for insomnia and mental health conditions compared to the general population. Poor sleep quality and mental health impairments are known to coincide with and contribute to the symptom severity of one another. Thus, it is important to determine approaches that may improve sleep and/or mental health specifically for firefighters, as their occupation varies in many aspects from any other occupation. This review will discuss symptoms of insomnia and mental health conditions such as PTSD, anxiety, depression, substance abuse, and suicide in firefighters. The influencing factors of sleep and mental health will be examined including anxiety sensitivity, emotional regulation, and distress tolerance. Current sleep and mental health interventions specific to full-time firefighters are limited in number; however, the existing experimental studies will be outlined. Lastly, this review will provide support for exploring exercise as a possible intervention that may benefit the sleep and mental health of this population.
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Affiliation(s)
- Angelia M. Holland-Winkler
- Department of Kinesiology, Augusta University, 3109 Wrightsboro Road, Augusta, GA 30909, USA; (D.R.G.); (T.J.O.)
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11
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Liu X, Read SJ. Development of a multivariate prediction model for antidepressant resistant depression using reward-related predictors. Front Psychiatry 2024; 15:1349576. [PMID: 38590792 PMCID: PMC10999634 DOI: 10.3389/fpsyt.2024.1349576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 03/11/2024] [Indexed: 04/10/2024] Open
Abstract
Introduction Individuals with depression who do not respond to two or more courses of serotonergic antidepressants tend to have greater deficits in reward processing and greater internalizing symptoms, yet there is no validated self-report method to determine the likelihood of treatment resistance based on these symptom dimensions. Methods This online case-control study leverages machine learning techniques to identify differences in self-reported anhedonia and internalizing symptom profiles of antidepressant non-responders compared to responders and healthy controls, as an initial proof-of-concept for relating these indicators to medication responsiveness. Random forest classifiers were used to identify a subset from a set of 24 reward predictors that distinguished among serotonergic medication resistant, non-resistant, and non-depressed individuals recruited online (N = 393). Feature selection was implemented to refine model prediction and improve interpretability. Results Accuracies for full predictor models ranged from .54 to .71, while feature selected models retained 3-5 predictors and generated accuracies of .42 to .70. Several models performed significantly above chance. Sensitivity for non-responders was greatest after feature selection when compared to only responders, reaching .82 with 3 predictors. The predictors retained from feature selection were then explored using factor analysis at the item level and cluster analysis of the full data to determine empirically driven data structures. Discussion Non-responders displayed 3 distinct symptom profiles along internalizing dimensions of anxiety, anhedonia, motivation, and cognitive function. Results should be replicated in a prospective cohort sample for predictive validity; however, this study demonstrates validity for using a limited anhedonia and internalizing self-report instrument for distinguishing between antidepressant resistant and responsive depression profiles.
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Affiliation(s)
- Xiao Liu
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
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12
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Kreppke JN, Cody R, Beck J, Brand S, Donath L, Eckert A, Faude O, Hatzinger M, Imboden C, Lang UE, Ludyga S, Mans S, Mikoteit T, Oswald A, Schweinfurth-Keck N, Holsboer-Trachsler E, Zahner L, Gerber M. Long-term outcomes of physical activity counseling in in-patients with major depressive disorder: results from the PACINPAT randomized controlled trial. Transl Psychiatry 2024; 14:160. [PMID: 38521772 PMCID: PMC10960795 DOI: 10.1038/s41398-024-02885-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 03/14/2024] [Accepted: 03/18/2024] [Indexed: 03/25/2024] Open
Abstract
Major depressive disorder (MDD) is an increasingly common psychiatric illness associated with a high risk of insufficient physical activity, which in turn is associated with negative mental and physical health outcomes. Theory-based, individually tailored, in-person and remote physical activity counseling has the potential to increase physical activity levels in various populations. Given this, the present study investigated the effect of such a physical activity intervention on the physical activity behavior of in-patients with MDD. This was a multi-center, two-arm randomized controlled trial including initially insufficiently physically active adult in-patients with MDD from four study sites in Switzerland. The sample consisted of 220 participants (Mage = 41 ± 12.6 years, 52% women), 113 of whom were randomized to the intervention group and 107 to the control group. The main outcome, moderate-to-vigorous physical activity (MVPA), was assessed at three time points via hip-worn accelerometer. According to accelerometer measures, there was no significant difference in minutes spent in MVPA over a 12-month intervention period when comparing the intervention with the control group (β = -1.02, 95% CI = -10.68 to 8.64). Higher baseline physical activity significantly predicted physical activity at post and follow-up. This study showed that it is feasible to deliver an individually tailored, theory-based physical activity counseling intervention to in-patients with MDD, however yielding no significant effects on accelerometer-based MVPA levels. Further efforts are warranted to identify efficacious approaches.Trial registration: ISRCTN, ISRCTN10469580, registered on 3rd September 2018, https://www.isrctn.com/ISRCTN10469580 .
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Affiliation(s)
- Jan-Niklas Kreppke
- Department for Sport, Exercise and Health, University of Basel, Basel, Switzerland.
| | - Robyn Cody
- Department for Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | | | - Serge Brand
- Department for Sport, Exercise and Health, University of Basel, Basel, Switzerland
- Adult Psychiatric Clinics (UPKE), University of Basel, Basel, Switzerland
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, 6719851115, Iran
- Substance Use Prevention Research Center and Sleep Disorder Research Center, Kermanshah, University of Medical Sciences (KUMS), Kermanshah, 6715847141, Iran
- School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Lars Donath
- German Sport University Cologne, Department of Intervention Research in Exercise Training, Cologne, Germany
| | - Anne Eckert
- Adult Psychiatric Clinics (UPKE), University of Basel, Basel, Switzerland
| | - Oliver Faude
- Department for Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Martin Hatzinger
- Psychiatric Services, Solothurn, and Medical Faculty, University of Basel, Basel, Switzerland
| | - Christian Imboden
- Private Clinic Wyss, Muenchenbuchsee, Switzerland
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Undine E Lang
- Adult Psychiatric Clinics (UPKE), University of Basel, Basel, Switzerland
| | - Sebastian Ludyga
- Department for Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Sarah Mans
- Private Clinic Wyss, Muenchenbuchsee, Switzerland
| | - Thorsten Mikoteit
- Psychiatric Services, Solothurn, and Medical Faculty, University of Basel, Basel, Switzerland
| | - Anja Oswald
- Psychiatric Clinic Sonnenhalde, Riehen, Switzerland
| | | | | | - Lukas Zahner
- Department for Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Markus Gerber
- Department for Sport, Exercise and Health, University of Basel, Basel, Switzerland
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13
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Stassen HH, Bachmann S, Bridler R, Cattapan K, Seifritz E. Polypharmacy in psychiatry and weight gain: longitudinal study of 832 patients hospitalized for depression or schizophrenia, along with data of 3180 students from Europe, the U.S., South America, and China. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01767-2. [PMID: 38462586 DOI: 10.1007/s00406-024-01767-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 01/19/2024] [Indexed: 03/12/2024]
Abstract
Epidemiologic data indicate that overweight and obesity are on the rise worldwide. Psychiatric patients are particularly vulnerable in this respect as they have an increased prevalence of overweight and obesity, and often experience rapid, highly undesirable weight gain under psychotropic drug treatment. Current treatment strategies in psychiatry are oriented towards polypharmacy, so that the information on drug-induced weight gain from earlier monotherapy studies is of very limited validity. We have analyzed the longitudinal data of 832 inpatients with ICD-10 diagnoses of either F2 (schizophrenia; n = 282) or F3 (major depression; n = 550) with the goal of ranking treatment regimens in terms of weight gain, side effects, and response to treatment. The patient data were complemented by the data of 3180 students aged 18-22 years, with which we aimed to identify factors that enable the early detection and prevention of obesity and mental health problems. After 3 weeks of treatment, 47.7% of F2 patients and 54.9% of F3 patients showed a weight gain of 2 kg and more. Major predictive factors were "starting weight" (r = 0.115), "concurrent medications" (r = 0.176), and "increased appetite"(r = 0.275). Between 11 and 30% of the observed variance in weight gain could be explained by these factors, complemented by sex and age. The comparison between monotherapy (n = 409) and polypharmacy (n = 399) revealed significant drawbacks for polypharmacy: higher weight gain (p = 0.0005), more severe side effects (p = 0.0011), and lower response rates (F2: p = 0.0008); F3: p = 0.0101). The data of 3180 students made it clear that overweight and obesity often begin early in life among those affected, and are interconnected with personality traits, while increasing the risk of developing psychosomatic disturbances, mental health problems, or somatic illnesses. Although the available data did not readily lead to a comprehensive, clinically applicable model of unwanted weight gain, our results have nevertheless demonstrated that there are ways to successfully counteract such weight gain at early stages of treatment.
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Affiliation(s)
- H H Stassen
- Department of Psychiatry, Psychotherapy and Psychosomatics, Institute for Response-Genetics, Psychiatric University Hospital, 8032, Zurich, Switzerland.
| | - S Bachmann
- Department of Psychiatry, Psychotherapy, and Psychosomatics, University of Halle, 06112, Halle, Germany
- Germany and Clienia AG, Psychiatric Hospital, 9573, Littenheid, Switzerland
- Department of Psychiatry, Geneva University Hospitals, 1226, Thônex, Switzerland
| | - R Bridler
- Sanatorium Kilchberg, 8802, Kilchberg, Switzerland
| | - K Cattapan
- Sanatorium Kilchberg, 8802, Kilchberg, Switzerland
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - E Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, 8032, Zurich, Switzerland
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14
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Yu L, Zhang X, Li W. Causal effects of various types of physical activities on psychiatric disorders: a Mendelian randomization study. Front Sports Act Living 2024; 6:1331586. [PMID: 38500549 PMCID: PMC10944951 DOI: 10.3389/fspor.2024.1331586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 02/21/2024] [Indexed: 03/20/2024] Open
Abstract
Background Psychiatric disorders (PD) pose a significant burden, with vast prevalence and mortality, inflicting substantial costs on individuals and society. Despite its widespread prevalence, the complex pathogenesis of PD remains elusive, leading to limited and challenging therapeutic development. An emerging risk factor for chronic diseases, prolonged sedentary behavior, contrasts with the therapeutic potential of exercise, regardless of its intensity, for various ailments, including PD. Yet, the diversity in exercise modalities and intensities may offer varied impacts on health. This study, leveraging Mendelian Randomization (MR), seeks to investigate the causal relationship between exercise and PD, aiming to elucidate the optimal exercise modality and intensity for PD mitigation while addressing potential confounders. Methods This study employed a Mendelian randomization analysis using the genome-wide association study (GWAS) database to investigate the causal relationship between types of physical activity and psychiatric disorders. Sensitivity analysis was conducted to demonstrate the reliability and robustness of the results. Results In the past 4 weeks, engaging in a substantial amount of DIY physical activity was found to have a causal relationship with psychiatric disorders (IVW: OR = 0.228, 95% CI: 0.113-0.461, P = 0.000038). As for the types of exercises, there may be a potential causal association between aerobic training (including swimming, cycling, fitness, and bowling) and psychiatric disorders (IVW: OR = 0.322, 95% CI = 0.148-0.704, P = 0.004). However, there was no causal relationship found between mild DIY physical activity and psychiatric disorders (IVW: OR = 0.918, 95% CI = 0.417-2.021, P = 0.831). Furthermore, it seems that there is no causal relationship between vigorous exercise and psychiatric disorders (IVW: OR = 2.705, 95% CI = 0.081-3.419, P = 0.578). Conclusion Our study confirms that only a certain level of training activity can have a protective effect on psychiatric disorders, while mild physical activity or vigorous training does not have an impact on psychiatric disorders.
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Affiliation(s)
- Lan Yu
- Department of Gynaecology, Dalian Women and Children’s Medical Center (Group), Dalian, Liaoning, China
| | - Xu Zhang
- Department of Clinical Medicine, Harbin Medical University, Harbin, Heilongjiang, China
- Department of Clinical Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Wangshu Li
- Department of Gynaecology, Dalian Women and Children’s Medical Center (Group), Dalian, Liaoning, China
- Department of Key Laboratory for Early Diagnosis and Biotherapy of Malignant Tumors in Children and Women in Liaoning Province, Dalian, Liaoning, China
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15
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Correia ÉM, Monteiro D, Bento T, Rodrigues F, Cid L, Vitorino A, Figueiredo N, Teixeira DS, Couto N. Analysis of the Effect of Different Physical Exercise Protocols on Depression in Adults: Systematic Review and Meta-analysis of Randomized Controlled Trials. Sports Health 2024; 16:285-294. [PMID: 37994044 PMCID: PMC10916777 DOI: 10.1177/19417381231210286] [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: 11/24/2023] Open
Abstract
CONTEXT Physical exercise (PE) is an effective treatment for depression, alone or as an adjunct. OBJECTIVE There is a lack of indicators regarding the frequency, intensity, duration, and type of physical exercise (PE). This study aims to synthesize and analyze the dose-effect of different PE protocols in adult subjects in the treatment of depression, based on the analysis of randomized controlled trials (RCTs). DATA SOURCES The search was conducted using Web of Science, PubMed, and Cochrane Library electronic databases. STUDY SELECTION Studies with an exercise-based intervention published by December 31, 2021 were identified. RCTs and meta-analyses involving adults with depression were also included; 10 studies were selected, including a total of 956 subjects. STUDY DESIGN Systematic review and meta-analysis. LEVEL OF EVIDENCE Level 1. RESULTS Effect sizes were summarized using standardized mean differences (95% confidence interval) by effected randomized models. The results reinforce that exercise appears to be beneficial in improving depression among adults aged 18 to 65 years. Interventions lasting above 150 minutes per week of moderate intensity and group interventions seem to have a more significant effect on reducing depression. Studies have revealed that aerobic exercise, compared with resistance or flexibility, has a more positive effect on depression. CONCLUSION PE can be a way to reduce depression and can be used as a possible adjunctive tool for pharmacological and/or alternative treatments. Considering the findings of this study, it is important that health professionals (eg, exercise physiologists, physicians, nurses, psychologists) promote the practice of PE as a complementary alternative and act early to prevent the worsening of depression. PROSPERO REGISTRATION NUMBER CRD42020188909.
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Affiliation(s)
- Érica M Correia
- Sport Sciences School of Rio Maior, Polytechnic of Santarém [ESDRM-IPSantarém], Rio Maior, Portugal
| | - Diogo Monteiro
- ESECS - Polytechnic of Leiria, Leiria, Portugal and Research Center in Sports Sciences, Health Sciences and Human Development [CIDESD], Vila Real, Portugal
| | - Teresa Bento
- Sport Sciences School of Rio Maior, Polytechnic of Santarém [ESDRM-IPSantarém], Rio Maior, Portugal; and Research Center in Sports Sciences, Health Sciences and Human Development [CIDESD], Vila Real, Portugal
| | - Filipe Rodrigues
- ESECS - Polytechnic of Leiria, Leiria, Portugal and Life Quality Research Center [CIEQV], Rio Maior, Portugal
| | - Luís Cid
- Sport Sciences School of Rio Maior, Polytechnic of Santarém [ESDRM-IPSantarém], Rio Maior, Portugal; and Research Center in Sports Sciences, Health Sciences and Human Development [CIDESD], Vila Real, Portugal
| | - Anabela Vitorino
- Sport Sciences School of Rio Maior, Polytechnic of Santarém [ESDRM-IPSantarém], Rio Maior, Portugal; Research Center in Sports Sciences, Health Sciences and Human Development [CIDESD], Vila Real, Portugal, and Life Quality Research Center [CIEQV], Rio Maior, Portugal
| | | | - Diogo S Teixeira
- Faculty of Physical Education and Sport, Lusófona University [ULHT/FEFD], Lisbon, Portugal, and Research Center in Physical Education, Sport, Exercise and Health [CIDEFES], Lisbon, Portugal
| | - Nuno Couto
- Sport Sciences School of Rio Maior, Polytechnic of Santarém [ESDRM-IPSantarém], Rio Maior, Portugal and Research Center in Sports Sciences, Health Sciences and Human Development [CIDESD], Vila Real, Portugal
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16
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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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17
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Damme KSF, Vargas TG, Walther S, Shankman SA, Mittal VA. Physical and mental health in adolescence: novel insights from a transdiagnostic examination of FitBit data in the ABCD study. Transl Psychiatry 2024; 14:75. [PMID: 38307840 PMCID: PMC10837202 DOI: 10.1038/s41398-024-02794-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 02/04/2024] Open
Abstract
Adolescence is among the most vulnerable period for the emergence of serious mental illnesses. Addressing this vulnerability has generated interest in identifying markers of risk for symptoms and opportunities for early intervention. Physical fitness has been linked to psychopathology and may be a useful risk marker and target for early intervention. New wearable technology has made assessing fitness behavior more practical while avoiding recall and self-report bias. Still, questions remain regarding the clinical utility of physical fitness metrics for mental health, both transdiagnostically and along specific symptom dimensions. The current study includes 5007 adolescents (ages 10-13) who participated in the Adolescent Brain Cognitive Development (ABCD) study and additional sub-study that collected fitness data from wearable technology and clinical symptom measures. Physical fitness metrics included resting heart rate (RHR- an index of cardiovascular health), time spent sedentary (associated with increased inflammation and cardiovascular disease), and time spent in moderate physical activity (associated with increased neurogenesis, neuroplasticity, and healthy neurodevelopment). Self-report clinical symptoms included measures of psychosis-like experiences (PLE), internalizing symptoms, and externalizing symptoms. Increased RHR- lower cardiovascular fitness- related only to greater internalizing symptoms (t = 3.63). More sedentary behavior related to elevated PLE severity (t = 5.49). More moderate activity related to lower PLE (t = -2.69) and internalizing (t = -6.29) symptom severity. Wearable technology fitness metrics linked physical health to specific mental health dimensions, which emphasizes the utility of detailed digital health data as a marker for risk and the need for precision in targeting physical health behaviors to benefit symptoms of psychopathology.
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Affiliation(s)
- Katherine S F Damme
- Department of Psychology, Northwestern University, Evanston, IL, USA.
- Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston and Chicago, IL, USA.
| | - Teresa G Vargas
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Sebastian Walther
- University of Bern, University Hospital of Psychiatry, Translational Research Center, Bern, Switzerland
| | | | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, IL, USA
- Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston and Chicago, IL, USA
- Department of Psychiatry, Northwestern University, Chicago, IL, USA
- Medical Social Sciences, Northwestern University, Chicago, IL, USA
- Institute for Policy Research (IPR), Northwestern University, Chicago, IL, USA
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18
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Lakeman R. A file audit of gym usage in an Australian private inpatient psychiatric hospital. Australas Psychiatry 2024; 32:74-78. [PMID: 38105642 PMCID: PMC10809721 DOI: 10.1177/10398562231222835] [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] [Indexed: 12/19/2023]
Abstract
OBJECTIVE This study aimed to determine the extent to which people admitted to a private psychiatric inpatient unit access and utilise the gymnasium and individualised coaching with an exercise physiologist (EP). METHODS An audit of the medical record of 100 consecutive discharges and 60 individuals referred to an EP during the audit period was undertaken. Selected demographic information, physical health status, psychiatric diagnosis and routinely collected outcome data were extracted from files. RESULTS Twenty-four percent of people discharged from the hospital had documentary evidence of having attended the gym. These people were noted to have used the gym regularly and had an exercise prescription documented on discharge. Those with substance use disorder were more likely to use the gym than those diagnosed with an affective disorder. There were no significant differences in outcomes between those who were noted to exercise and those who did not. CONCLUSION Those who may most benefit from coaching around exercise in the context of hospital admission are not presently the individuals most likely to be referred to an EP. Standardised procedures for assessment, referral, exercise prescription and ongoing monitoring of activity and outcomes are recommended across the care continuum.
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Affiliation(s)
- Richard Lakeman
- Faculty of Health, Southern Cross University, Bilinga, QLD, Australia
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19
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Liutsko L, Leonov S, Pashenko A, Polikanova I. Is Frequency of Practice of Different Types of Physical Activity Associated with Health and a Healthy Lifestyle at Different Ages? Eur J Investig Health Psychol Educ 2024; 14:256-271. [PMID: 38275342 PMCID: PMC10814358 DOI: 10.3390/ejihpe14010017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 01/12/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open
Abstract
Physical activity (PA) has been shown to be related to physical and mental health. Yet there are few studies on how the frequency of PA relates to health and a healthy lifestyle. We aimed to investigate how the frequency of different PAs is associated with the following health indicators: body mass index (BMI), substance consumption, physical health, and mental health. We focused on three types of PA: (1) medium- to high-intensity aerobic exercise; (2) low- to medium-intensity relaxing exercise; and (3) outdoor leisure PA. A total of 9617 volunteers, aged 19 to 81, participated in the study. The relationships between the frequencies of the three types of PA and health-related and sociodemographic factors were analyzed using multinomial logistic regression. We found that women more frequently engaged in PA type 2, and men in types 1 and 3. A higher frequency of PA was associated with lower BMI and less or no smoking behavior; higher education (PAs 1 and 3); higher age (PAs 2 and 3); better physical health (PAs 1 and 3); and better mental health (PA 3). In conclusion, higher frequency of different PAs was significantly associated with better physical and mental health, less smoking, higher age, and a higher level of education.
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Affiliation(s)
- Liudmila Liutsko
- ISAN, International Society of Applied Neuropsychology, 08787 La Pobla de Claramunt, Spain
- IDIAP JGol, 08007 Barcelona, Spain
| | - Sergey Leonov
- Federal Scientific Centre for Psychological and Interdisciplinary Research, Moscow 125009, Russia; (S.L.); (A.P.)
| | - Alexander Pashenko
- Federal Scientific Centre for Psychological and Interdisciplinary Research, Moscow 125009, Russia; (S.L.); (A.P.)
| | - Irina Polikanova
- Federal Scientific Centre for Psychological and Interdisciplinary Research, Moscow 125009, Russia; (S.L.); (A.P.)
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20
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Xi L, Fang F, Zhou J, Xu P, Zhang Y, Zhu P, Tu J, Sun Q. Association of hemoglobin-to-red blood cell distribution width ratio and depression in older adults: A cross sectional study. J Affect Disord 2024; 344:191-197. [PMID: 37832737 DOI: 10.1016/j.jad.2023.10.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 09/05/2023] [Accepted: 10/08/2023] [Indexed: 10/15/2023]
Abstract
BACKGROUND The association between hemoglobin-to-red blood cell distribution width ratio (HRR) and the depression in old adults was not clear. METHODS We extracted data on depression, general characteristics, lifestyle, medical history, drug use, and blood indicators from the National Health and Nutrition Examination Survey 2005-2018 to investigate the relationship between HRR and depression. RESULTS A total of 4141 individuals were evaluated, among whom 266 (6.4 %) were identified as having depression. HRR was significantly lower in the low depression group, and Spearman correlation analysis revealed an inverse association between HRR and depression scores (r = -0.148, P < 0.001). Multiple linear regression showed that HRR was associated with depression after adjusted for general characteristics, life style, medical history, drug use and blood indicators (P = 0.010). ROC analysis demonstrated that in participants with depression, the area under the curve (AUC) for HRR was 0.612, surpassing both Hb(0.586) and RDW(0.401). These findings were statistically significant (P < 0.05). LIMITATIONS Only participants aged 65-79 years are selected for this study and this was a cross-sectional study that can only represent an association between HRR and depression, but not a cause-and-effect relationship. CONCLUSIONS HRR, being more potent than Hb or RDW, emerges as an independent risk factor for depression. It has the potential to facilitate early depression detection, aiding in the prevention of clinical deterioration or relapses, and could also serve as a viable treatment target.
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Affiliation(s)
- Lijuan Xi
- Yangzhou University School of Nursing School of Public Health, Yangzhou, Jiangsu, China.
| | - Fang Fang
- Subei People's Hospital, Yangzhou, Jiangsu, China
| | - Jiajie Zhou
- Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Peirong Xu
- Yangzhou University School of Nursing School of Public Health, Yangzhou, Jiangsu, China
| | - Yan Zhang
- Yangzhou University School of Nursing School of Public Health, Yangzhou, Jiangsu, China
| | - Pingting Zhu
- Yangzhou University School of Nursing School of Public Health, Yangzhou, Jiangsu, China
| | - Jiayuan Tu
- Yangzhou University School of Nursing School of Public Health, Yangzhou, Jiangsu, China
| | - Qiannan Sun
- Subei People's Hospital, Yangzhou, Jiangsu, China
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21
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Bendau A, Petzold MB, Kaminski J, Plag J, Ströhle A. Exercise as Treatment for "Stress-Related" Mental Disorders. Curr Neuropharmacol 2024; 22:420-436. [PMID: 37779399 PMCID: PMC10845075 DOI: 10.2174/1570159x22666230927103308] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 03/29/2023] [Accepted: 04/02/2023] [Indexed: 10/03/2023] Open
Abstract
The beneficial impact of physical activity on preventing and treating mental disorders has captured growing (research) interest. This article aims to provide a concise overview of essential evidence regarding the effectiveness and underlying mechanisms of physical activity for individuals with mental disorders clustered as "stress-related" conditions. Empirical findings (e.g., longitudinalprospective studies, interventional randomized-controlled-trials, reviews, meta-analyses) regarding the effects of physical activity in the prevention and treatment of stress-related mental disorders are summarized. Furthermore, potential mechanisms underlying these effects are discussed, and recommendations regarding the use of physical activity are outlined. The majority of studies indicate good efficacy of physical activity in prospectively lowering the risk for the incidence of subsequent stress-related mental disorders as well as in the treatment of manifest disorders. Most evidence targets unipolar depressive disorder and, secondly, anxiety disorders. Research regarding posttraumatic stress disorder, obsessive-compulsive disorders, and somatoform disorders is promising but scarce. Physical activity seems to be useful as a stand-alone-treatment as well as in combination with other psychotherapeutic or pharmacological treatments. Multiple intertwined physiological, psychological, and social mechanisms are assumed to mediate the beneficial effects. Recommendations regarding physical activity can orientate on official guidelines but should consider the individual needs and circumstances of each subject. In summary, physical activity seems to be effective in the prevention and treatment of stressrelated mental disorders and, therefore, should be fostered in healthcare-settings. Future studies are needed to clarify partly inconsistent patterns of results and to close research gaps, e.g., concerning somatoform disorders.
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Affiliation(s)
- Antonia Bendau
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, CCM, Charitéplatz 1, 10117, Berlin, Germany
- HMU Health and Medical University Potsdam, Potsdam, Germany
| | - Moritz Bruno Petzold
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, CCM, Charitéplatz 1, 10117, Berlin, Germany
- Department of Psychology, MSB Medical School Berlin, Berlin, Germany
| | - Jan Kaminski
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, CCM, Charitéplatz 1, 10117, Berlin, Germany
| | - Jens Plag
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, CCM, Charitéplatz 1, 10117, Berlin, Germany
- HMU Health and Medical University Potsdam, Potsdam, Germany
- Oberberg Fachklinik Potsdam, Potsdam, Germany
| | - Andreas Ströhle
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, CCM, Charitéplatz 1, 10117, Berlin, Germany
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22
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Seiffer B, Rösel I, Welkerling J, Schuch FB, Sudeck G, Wolf S. The association of changes in leisure-time physical activity on depressive symptoms during Covid-19 in German adults: A longitudinal study. PSYCHOLOGY OF SPORT AND EXERCISE 2024; 70:102562. [PMID: 37956817 DOI: 10.1016/j.psychsport.2023.102562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/12/2023] [Accepted: 11/06/2023] [Indexed: 11/15/2023]
Abstract
This longitudinal survey assessed preventive and curative antidepressant effects of at least 75 min/week of leisure-time physical activity (LTPA) at different timepoints of the Covid-19 pandemic. We further investigated if high self-regulation skills were associated with higher odds of initiating or maintaining LTPA during the pandemic. Data was collected online from 4253 participants (age: m = 33.65 years, SD = 0.79; 79 % female) during the first quarantine measures in Germany (T1), as well as 4 weeks (T2), and 8 months (T3) later. We performed linear mixed models with changes (T2-T1, T3-T1) in LTPA and baseline major depressive disorder (MDD) as predictors (main effects and interaction effect) and depressive symptoms (at T2, T3) as the primary outcome. We found significant interaction effects of baseline depression and change in LTPA on depressive symptoms at T2 and T3 (p < 0.001). For probable cases of MDD an increasing LTPA to ≥75 min/week (vs. no change, <75 min/week) was associated with less depressive symptoms at T2 and T3 (p = 0.003, d = 0.28). For absence of depression at baseline, remaining at ≥75 min/week of LTPA was associated with less depressive symptoms at T2 and T3 compared to remaining at <75 min/week (p = 0.006, d = 0.11) or decreasing LTPA to <75 min/week (p = 0.018, d = 0.11). Reporting high self-regulation at T1 was associated with higher odds of performing ≥75 min/week of LTPA at T2/T3 (OR = 1.74, p < 0.001). In general, studies report reduced LTPA during Covid-19. To benefit from the reported preventive and interventional effects, further interventions should focus on improving physical activity related self-regulation to identify and overcome barriers for LTPA.
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Affiliation(s)
- Britta Seiffer
- Institute of Sports Science, University of Tuebingen, 72074, Tuebingen, Germany.
| | - Inka Rösel
- Institute for Clinical Epidemiology and Applied Biometry, University Hospital Tuebingen, 72076, Tuebingen, Germany; Institute for General Practice and Interprofessional Care, University Hospital Tuebingen, 72076, Tuebingen, Germany
| | - Jana Welkerling
- Institute of Sports Science, University of Tuebingen, 72074, Tuebingen, Germany
| | - Felipe Barreto Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, 97105-900, Santa Maria, Brazil; Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Institue of Health Sciences, Universidad Autônoma de Chile, Providência, Chile
| | - Gorden Sudeck
- Institute of Sports Science, University of Tuebingen, 72074, Tuebingen, Germany
| | - Sebastian Wolf
- Institute of Sports Science, University of Tuebingen, 72074, Tuebingen, Germany
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23
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Heinen D, Heissel A, Heinzel S, Fydrich T, Ströhle A, Rapp MA, Vogel H. Effect of acute and long-term exercise on leptin levels in depressed outpatients. BMC Public Health 2023; 23:2509. [PMID: 38098007 PMCID: PMC10722655 DOI: 10.1186/s12889-023-17362-4] [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: 05/25/2023] [Accepted: 11/28/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Depression is a leading cause of disability worldwide and a significant contributor to the global burden of disease. Altered leptin levels are known to be associated with depressive symptoms, however discrepancies in the results of increased or decreased levels exist. Due to various limitations associated with commonly used antidepressant drugs, alternatives such as exercise therapy are gaining more importance. Therefore, the current study investigates whether depressed patients have higher leptin levels compared to healthy controls and if exercise is efficient to reduce these levels. METHODS Leptin levels of 105 participants with major depressive disorder (MDD; 45.7% female, age mean ± SEM: 39.1 ± 1.0) and 34 healthy controls (HC; 61.8% female, age mean ± SEM: 36.0 ± 2.0) were measured before and after a bicycle ergometer test. Additionally, the MDD group was separated into three groups: two endurance exercise intervention groups (EX) differing in their intensities, and a waiting list control group (WL). Leptin levels were measured pre and post a 12-week exercise intervention or the waiting period. RESULTS Baseline data showed no significant differences in leptin levels between the MDD and HC groups. As expected, correlation analyses displayed significant relations between leptin levels and body weight (HC: r = 0.474, p = 0.005; MDD: r = 0.198, p = 0.043) and even more with body fat content (HC: r = 0.755, p < 0.001; MDD: r = 0.675, p < 0.001). The acute effect of the bicycle ergometer test and the 12-week training intervention showed no significant changes in circulating leptin levels. CONCLUSION Leptin levels were not altered in patients with major depression compared to healthy controls and exercise, both the acute response and after 12 weeks of endurance training, had no effect on the change in leptin levels. TRIAL REGISTRATION The study was registered at the German register for clinical studies (DRKS) and the International Clinical Trials Registry Platform of the World Health Organization https://trialsearch.who.int/Trial2.aspx?TrialID=DRKS00008869 on 28/07/2015.
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Affiliation(s)
- Darlene Heinen
- Social- and Preventive Medicine, Department of Exercise and Health Sciences, University of Potsdam, Potsdam, Germany
- Research Group Molecular and Clinical Life Science of Metabolic Diseases, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
| | - Andreas Heissel
- Social- and Preventive Medicine, Department of Sports and Health Sciences, Intra-Faculty Unit Cognitive Sciences, Faculty of Human Science, and Faculty of Health Sciences Brandenburg, Research Area Services Research and E-Health, University of Potsdam, Potsdam, Germany
- Sport-Gesundheitspark Berlin E.V./Zentrum Für Sportmedizin, Berlin, Germany
| | - Stephan Heinzel
- Clinical Psychology and Psychotherapy, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
- Institute of Psychology, Department of Educational Sciences and Psychology, TU Dortmund University, Dortmund, Deutschland
| | - Thomas Fydrich
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Andreas Ströhle
- Department of Psychology, Humboldt University Berlin, Berlin, Germany
| | - Michael A Rapp
- Social- and Preventive Medicine, Department of Sports and Health Sciences, Intra-Faculty Unit Cognitive Sciences, Faculty of Human Science, and Faculty of Health Sciences Brandenburg, Research Area Services Research and E-Health, University of Potsdam, Potsdam, Germany
| | - Heike Vogel
- Research Group Molecular and Clinical Life Science of Metabolic Diseases, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany.
- Research Group Genetics of Obesity, German Institute of Human Nutrition Potsdam-Rehbruecke, Potsdam, Germany.
- German Center for Diabetes Research (DZD), Munich-Neuherberg, 85764, München, Germany.
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24
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Meghani NAA, Hudson J, Stratton G, Mullins J. Older adults' perspectives on physical activity and sedentary behaviour within their home using socio-ecological model. PLoS One 2023; 18:e0294715. [PMID: 37983222 PMCID: PMC10659182 DOI: 10.1371/journal.pone.0294715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 11/07/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND There are few studies that focus explicitly on the impact of the home environment on older adults' sedentary behaviour (SB) and physical activity (PA) using the socio-ecological model (SEM). This study aims to investigate older adults' PA and SB within the home environment integrating the SEM as a theoretical framework. METHODS A qualitative exploratory research design was employed to conduct 33 in-depth interviews (IDIs) and five focus group (FGs; n = 16) with multi-diverse ethnic older adults (mean age 72±5 years). Using reflexive thematic analysis themes were generated from the data set and were interpreted using the SEM. RESULTS The findings indicate that different levels of the SEM had an impact on older adults' PA and SB. These include the 1) Individual level: Attitude, perception and motivation 2) Interpersonal level: Family and Friends: a motive to remain active 3) Organisational level: healthcare institutes, 4) Community level factors: Significance of social groups, 5) Physical Environment: Microenvironment and 6) Policy level factors (lockdown restrictions and healthcare system). This model can be utilised to foster activity within the home by focusing on the facilitators and barriers identified at each of these levels of influence. CONCLUSION The study findings suggest that modifying PA and SB in the home environment is complex and is influenced across different levels of the SEM. Therefore, a holistic approach is required that integrates these multiple influences. This understanding can inform the design of interventions that seek to optimize PA and minimize SB within the home environment.
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Affiliation(s)
- Naureen Akber Ali Meghani
- Applied Sports Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Bay Campus, Swansea, United Kingdom
| | - Joanne Hudson
- Professor of Exercise and Sport Psychology, Applied Sports Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Bay Campus, Swansea, United Kingdom
| | - Gareth Stratton
- Chair in Paediatric Exercise Science, Applied Sports Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Bay Campus, Swansea, United Kingdom
| | - Jane Mullins
- College of Human and Health Sciences, Swansea University, Singleton Campus, Swansea, United Kingdom
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25
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Augustin N, Bendau A, Heuer S, Kaminski J, Ströhle A. Resistance Training in Depression. DEUTSCHES ARZTEBLATT INTERNATIONAL 2023; 120:757-762. [PMID: 37656468 PMCID: PMC10745562 DOI: 10.3238/arztebl.m2023.0196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 08/11/2023] [Accepted: 08/11/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND More than 320 million people around the world suffer from depression. Physical activity and sports are effective treatment strategies. Endurance training has already been intensively studied, but any potential antidepressant effect of resistance training is unknown at present, nor is it clear whether this could yield any relevant benefit in clinical use. METHODS The PubMed database was selectively searched for recent studies and review articles concerning the use, efficacy, and safety of resistance training in persons with depressive symptoms and diagnosed depression. RESULTS Two meta-analyses revealed that resistance training alleviated depressive symptoms with a low to moderate effect size (0.39-0.66). Resistance training in patients with diagnosed depression was studied in seven randomized controlled trials, in which the duration of the intervention ranged from eight weeks to eight months. In six of these trials, the depressive symptoms were reduced. In one trial, a persistent benefit was seen in the resistance-training group at 26 months of follow-up (adherence, 33%). Moreover, resistance training improved strength, quality of life, and quality of sleep. No serious adverse events occurred; this indicates that resistance training in depression is safe. CONCLUSION Resistance training seems to have an antidepressant effect. Open questions remain concerning its effects in different age groups, as well as the optimal training parameters. Further high-quality trials will be needed to document the effect of resistance training more conclusively and to enable the formulation of treatment recommendations.
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Affiliation(s)
- Noah Augustin
- Department of Psychiatry and Psychotherapy at the Charité Campus Mitte
| | - Antonia Bendau
- Department of Psychiatry and Psychotherapy at the Charité Campus Mitte
- HMU Health and -Medical University Potsdam
| | - Selina Heuer
- Department of Psychiatry and Psychotherapy at the Charité Campus Mitte
| | - Jan Kaminski
- Department of Psychiatry and Psychotherapy at the Charité Campus Mitte
| | - Andreas Ströhle
- Department of Psychiatry and Psychotherapy at the Charité Campus Mitte
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26
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Martínez-Calderon J, Casuso-Holgado MJ, Muñoz-Fernandez MJ, Garcia-Muñoz C, Heredia-Rizo AM. Yoga-based interventions may reduce anxiety symptoms in anxiety disorders and depression symptoms in depressive disorders: a systematic review with meta-analysis and meta-regression. Br J Sports Med 2023; 57:1442-1449. [PMID: 37369553 DOI: 10.1136/bjsports-2022-106497] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 06/29/2023]
Abstract
OBJECTIVE To summarise the effect of mind-body exercises on anxiety and depression symptoms in adults with anxiety or depressive disorders. DESIGN Systematic review with meta-analysis and meta-regression. DATA SOURCES Five electronic databases were searched from inception to July 2022. Manual searches were conducted to explore clinical trial protocols, secondary analyses of clinical trials and related systematic reviews. ELIGIBILITY CRITERIA Randomised clinical trials evaluating qigong, tai chi or yoga styles with anxiety or depression symptoms as the outcomes were included. No intervention, waitlist or active controls were considered as control groups. The risk of bias and the certainty of the evidence were assessed. Meta-analyses, meta-regressions and sensitivity analyses were performed. RESULTS 23 studies, comprising 22 different samples (n=1420), were included. Overall, meta-analyses showed yoga interventions were superior to controls in reducing anxiety symptoms in anxiety disorders. Furthermore, yoga-based interventions decreased depression symptoms in depressive disorders after conducting sensitivity analyses. No differences between groups were found in the rest of the comparisons. However, the certainty of the evidence was judged as very low for all outcomes due to concerns of high risk of bias, indirectness of the evidence, inconsistency and imprecision of the results. In addition, there was marked heterogeneity among yoga-based interventions and self-reported tools used to evaluate the outcomes of interest. CONCLUSION Although yoga-based interventions may help to improve mental health in adults diagnosed with anxiety or depressive disorders, methodological improvements are needed to advance the quality of clinical trials in this field. PROSPERO REGISTRATION NUMBER CRD42022347673.
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Affiliation(s)
- Javier Martínez-Calderon
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Sevilla, Spain
| | - María Jesús Casuso-Holgado
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Sevilla, Spain
| | - Maria Jesus Muñoz-Fernandez
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Sevilla, Spain
- Department of Physiotherapy, University School Francisco Maldonado, Sevilla, Spain
| | - Cristina Garcia-Muñoz
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Sevilla, Spain
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, Cadiz, Spain
| | - Alberto Marcos Heredia-Rizo
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Sevilla, Spain
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27
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Ro E, Vittengl JR, Jarrett RB, Clark LA. Disinhibition domain and facets uniquely predict changes in depressive symptoms and psychosocial functioning. Personal Ment Health 2023; 17:363-376. [PMID: 37165469 DOI: 10.1002/pmh.1585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/28/2023] [Accepted: 04/11/2023] [Indexed: 05/12/2023]
Abstract
This study aimed to understand the role of disinhibition (low conscientiousness)-in conjunction with the other major personality traits of negative affectivity, detachment, antagonism, and psychoticism-in predicting changes in depressive symptoms and psychosocial functioning. Both the disinhibition trait domain and its primary facets (i.e., irresponsibility, impulsivity, and distractibility) were examined. In a large sample (Time 1 N = 605, Time 2 N = 497) of psychiatric outpatients and high-risk community residents, personality traits, depressive symptoms (both self-reported and interviewer-rated), and psychosocial functioning levels (i.e., daily functioning, interpersonal functioning, health-related quality of life, and global quality of life) were collected across two time points. Results showed that the disinhibition domain was the strongest predictor of changes in depressive symptoms and general quality of life levels. Disinhibition facets also predicted changes in depressive symptoms but showed a less consistent pattern compared to the broader trait domain. Finally, the irresponsibility and distractibility facets significantly and uniquely explained changes in interpersonal functioning. The study highlights the importance of assessing the disinhibition trait rather than only negative and positive affectivity (which are well-known correlates of depression), for understanding changes in depressive symptoms and psychosocial functioning. The findings identify potential targets in psychotherapy for individuals with disinhibition traits and depressive disorders.
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Affiliation(s)
- Eunyoe Ro
- Department of Psychology, Southern Illinois University Edwardsville, Edwardsville, Illinois, USA
| | - Jeffrey R Vittengl
- Department of Psychology, Truman State University, Kirksville, Missouri, USA
| | - Robin B Jarrett
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Lee Anna Clark
- Department of Psychology, University of Notre Dame, Notre Dame, Indiana, USA
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28
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Damme K, Vargas T, Walther S, Shankman S, Mittal V. Physical and Mental Health in Adolescence: Novel Insights from a transdiagnostic examination of FitBit data in the ABCD Study. RESEARCH SQUARE 2023:rs.3.rs-3270112. [PMID: 37886441 PMCID: PMC10602093 DOI: 10.21203/rs.3.rs-3270112/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Adolescence is among the most vulnerable period for the emergence of serious mental illnesses. Addressing this vulnerability has generated interest in identifying markers of risk for symptoms and opportunities for early intervention. Physical fitness has been linked to psychopathology and may be a useful risk marker and target for early intervention. New wearable technology has made assessing fitness behavior more practical while avoiding recall and self-report bias. Still, questions remain regarding the clinical utility of physical fitness metrics for mental health, both transdiagnostically and along specific symptom dimensions. The current study includes 5007 adolescents (ages 10 to 13) who participated in the Adolescent Brain Cognitive Development (ABCD) study and additional sub-study that collected fitness data from wearable technology and clinical symptom measures. Physical fitness metrics included resting heart rate (RHR- an index of cardiovascular health), time spent sedentary (associated with increased inflammation and cardiovascular disease), and time spent in moderate physical activity (associated with increased neurogenesis, neuroplasticity, and healthy neurodevelopment). Self-report clinical symptoms included measures of internalizing symptoms, externalizing symptoms, and psychosis-like experiences - PLE). Increased RHR- lower cardiovascular fitness- related only to greater internalizing symptoms (t = 3.63). More sedentary behavior related to elevated PLE severity (t = 5.49). More moderate activity related to lower PLE (t=-2.69) and internalizing (t=-6.29) symptom severity. Wearable technology fitness metrics linked physical health to specific mental health dimensions, which emphasizes the utility of detailed digital health data as a marker for risk and the need for precision in targeting physical health behaviors to benefit symptoms of psychopathology.
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Hebron C, Juniper J. The lived experience of exercise in persons with depression: A journey to finding a sense of contentment. Physiother Theory Pract 2023; 39:2120-2130. [PMID: 35469545 DOI: 10.1080/09593985.2022.2069063] [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: 06/10/2021] [Revised: 04/02/2022] [Accepted: 04/14/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Depression is often part of the embodied experience of persons living with pain and other health conditions. In addition to other benefits, exercise has been recognized to reduce depressive symptoms. Physiotherapists help persons to develop multidimensional understanding including an understanding of how exercise can help manage symptoms, and how they can individualize exercise to them. Thus, physiotherapists need insights into how exercise is experienced and meaningfully related to depression. PURPOSE This study aimed to explore the lived experience of exercise in persons with depression. METHODS In this interpretive (hermeneutic) phenomenological study, participants with depression were purposively recruited and data collected via semi-structured interviews. Hermeneutic analysis was used alongside the crafting of hermeneutic stories to reveal the meaning of exercise for these participants. FINDINGS Participants conveyed their experience of exercise as a journey to finding a sense of contentment. Two master themes: 1) Finding the exercise for me; and 2) the experienced importance of the environment, illuminated participants' journey to finding a sense of contentment through exercise. Two subthemes 1) changing sense of self; and 2) building resilience further described participants' experience. CONCLUSION Physiotherapists may reflect on these individual exercise stories and share these insights with persons receiving their care to explore if exercise may help them to find a sense of contentment.
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Affiliation(s)
- Clair Hebron
- School of Sport and Health Science, Univerity of Brighton, Eastbourne, UK
| | - Jack Juniper
- Physiotherapy department Medway Maritime Hospital, Gillingham, UK
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30
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Price M, Hidalgo JE, Bird YM, Bloomfield LSP, Buck C, Cerutti J, Dodds PS, Fudolig MI, Gehman R, Hickok M, Kim J, Llorin J, Lovato J, McGinnis EW, McGinnis RS, Norton R, Ramirez V, Stanton K, Ricketts TH, Danforth CM. A large clinical trial to improve well-being during the transition to college using wearables: The lived experiences measured using rings study. Contemp Clin Trials 2023; 133:107338. [PMID: 37722484 PMCID: PMC10591842 DOI: 10.1016/j.cct.2023.107338] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 09/06/2023] [Accepted: 09/15/2023] [Indexed: 09/20/2023]
Abstract
INTRODUCTION The transition to college is a period of elevated risk for a range of mental health conditions. Although colleges and universities strive to provide mental health support to their students, the high demand for these services makes it difficult to provide scalable, cost-effective solutions. OBJECTIVE To address these issues, the present study aims to compare the efficacy of three different treatments using a large cohort of 600 students transitioning to college. Interventions were selected based on their potential for generalizability and cost-effectiveness on college campuses. METHODS The study is a Phase II parallel-group, four-arm, randomized controlled trial with 1:1 allocation that will assign 600 participants to one (n = 150 per condition) of four arms: 1) group-based therapy, 2) physical activity program, 3) nature experiences, or 4) weekly assessment condition as a control group. Physiological data will be collected from all participants using a wearable device to develop algorithmic mental and physical health functioning predictions. Once recruitment is complete, modeling strategies will be used to evaluate the outcomes and effectiveness of each intervention. DISCUSSION The findings of this study will provide evidence as to the benefits of implementing scalable and proactive interventions using technology with the goal of improving the well-being and success of new college students.
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Affiliation(s)
- Matthew Price
- Department of Psychological Science, University of Vermont, 2 Colchester Ave, Burlington VT 05405, USA; Vermont Complex Systems Center, University of Vermont, 2 Colchester Ave, Burlington VT 05405, USA.
| | - Johanna E Hidalgo
- Department of Psychological Science, University of Vermont, 2 Colchester Ave, Burlington VT 05405, USA
| | - Yoshi M Bird
- Vermont Complex Systems Center, University of Vermont, 2 Colchester Ave, Burlington VT 05405, USA; MassMutual Center of Excellence in Complex Systems and Data Science, 2 Colchester Ave, Burlington VT 05405, USA
| | - Laura S P Bloomfield
- Vermont Complex Systems Center, University of Vermont, 2 Colchester Ave, Burlington VT 05405, USA; MassMutual Center of Excellence in Complex Systems and Data Science, 2 Colchester Ave, Burlington VT 05405, USA; Gund Institute for Environment, University of Vermont, 2 Colchester Ave, Burlington VT 05405, USA; Rubenstein School of Environment and Natural Resources, University of Vermont, 2 Colchester Ave, Burlington VT 05405, USA
| | - Casey Buck
- Department of Psychological Science, University of Vermont, 2 Colchester Ave, Burlington VT 05405, USA
| | - Janine Cerutti
- Department of Psychological Science, University of Vermont, 2 Colchester Ave, Burlington VT 05405, USA
| | - Peter Sheridan Dodds
- MassMutual Center of Excellence in Complex Systems and Data Science, 2 Colchester Ave, Burlington VT 05405, USA; Department of Computer Science, University of Vermont, 2 Colchester Ave, Burlington VT 05405, USA
| | - Mikaela Irene Fudolig
- Vermont Complex Systems Center, University of Vermont, 2 Colchester Ave, Burlington VT 05405, USA; MassMutual Center of Excellence in Complex Systems and Data Science, 2 Colchester Ave, Burlington VT 05405, USA
| | - Rachel Gehman
- Department of Psychological Science, University of Vermont, 2 Colchester Ave, Burlington VT 05405, USA
| | - Marc Hickok
- UVM Athletics, 2 Colchester Ave, Burlington VT 05405, USA
| | - Julia Kim
- Vermont Complex Systems Center, University of Vermont, 2 Colchester Ave, Burlington VT 05405, USA; MassMutual Center of Excellence in Complex Systems and Data Science, 2 Colchester Ave, Burlington VT 05405, USA
| | - Jordan Llorin
- Vermont Complex Systems Center, University of Vermont, 2 Colchester Ave, Burlington VT 05405, USA; MassMutual Center of Excellence in Complex Systems and Data Science, 2 Colchester Ave, Burlington VT 05405, USA
| | - Juniper Lovato
- Vermont Complex Systems Center, University of Vermont, 2 Colchester Ave, Burlington VT 05405, USA; MassMutual Center of Excellence in Complex Systems and Data Science, 2 Colchester Ave, Burlington VT 05405, USA
| | - Ellen W McGinnis
- Department of Psychiatry, University of Vermont College of Medicine, 2 Colchester Ave, Burlington VT 05405, USA
| | - Ryan S McGinnis
- Department of Electrical and Biomedical Engineering, University of Vermont, 2 Colchester Ave, Burlington VT 05405, USA
| | - Richard Norton
- Department of Psychological Science, University of Vermont, 2 Colchester Ave, Burlington VT 05405, USA
| | - Vanessa Ramirez
- Department of Psychological Science, University of Vermont, 2 Colchester Ave, Burlington VT 05405, USA
| | - Kathryn Stanton
- Vermont Complex Systems Center, University of Vermont, 2 Colchester Ave, Burlington VT 05405, USA; MassMutual Center of Excellence in Complex Systems and Data Science, 2 Colchester Ave, Burlington VT 05405, USA
| | - Taylor H Ricketts
- Gund Institute for Environment, University of Vermont, 2 Colchester Ave, Burlington VT 05405, USA; Rubenstein School of Environment and Natural Resources, University of Vermont, 2 Colchester Ave, Burlington VT 05405, USA
| | - Christopher M Danforth
- Vermont Complex Systems Center, University of Vermont, 2 Colchester Ave, Burlington VT 05405, USA; MassMutual Center of Excellence in Complex Systems and Data Science, 2 Colchester Ave, Burlington VT 05405, USA; Gund Institute for Environment, University of Vermont, 2 Colchester Ave, Burlington VT 05405, USA; Department of Mathematics & Statistics, University of Vermont, 2 Colchester Ave, Burlington VT 05405, USA
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Cutuli D, Decandia D, Giacovazzo G, Coccurello R. Physical Exercise as Disease-Modifying Alternative against Alzheimer's Disease: A Gut-Muscle-Brain Partnership. Int J Mol Sci 2023; 24:14686. [PMID: 37834132 PMCID: PMC10572207 DOI: 10.3390/ijms241914686] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/18/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
Alzheimer's disease (AD) is a common cause of dementia characterized by neurodegenerative dysregulations, cognitive impairments, and neuropsychiatric symptoms. Physical exercise (PE) has emerged as a powerful tool for reducing chronic inflammation, improving overall health, and preventing cognitive decline. The connection between the immune system, gut microbiota (GM), and neuroinflammation highlights the role of the gut-brain axis in maintaining brain health and preventing neurodegenerative diseases. Neglected so far, PE has beneficial effects on microbial composition and diversity, thus providing the potential to alleviate neurological symptoms. There is bidirectional communication between the gut and muscle, with GM diversity modulation and short-chain fatty acid (SCFA) production affecting muscle metabolism and preservation, and muscle activity/exercise in turn inducing significant changes in GM composition, functionality, diversity, and SCFA production. This gut-muscle and muscle-gut interplay can then modulate cognition. For instance, irisin, an exercise-induced myokine, promotes neuroplasticity and cognitive function through BDNF signaling. Irisin and muscle-generated BDNF may mediate the positive effects of physical activity against some aspects of AD pathophysiology through the interaction of exercise with the gut microbial ecosystem, neural plasticity, anti-inflammatory signaling pathways, and neurogenesis. Understanding gut-muscle-brain interconnections hold promise for developing strategies to promote brain health, fight age-associated cognitive decline, and improve muscle health and longevity.
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Affiliation(s)
- Debora Cutuli
- Department of Psychology, University of Rome La Sapienza, 00185 Rome, Italy;
- European Center for Brain Research, Santa Lucia Foundation IRCCS, 00143 Rome, Italy;
| | - Davide Decandia
- Department of Psychology, University of Rome La Sapienza, 00185 Rome, Italy;
- European Center for Brain Research, Santa Lucia Foundation IRCCS, 00143 Rome, Italy;
| | - Giacomo Giacovazzo
- European Center for Brain Research, Santa Lucia Foundation IRCCS, 00143 Rome, Italy;
- Facoltà di Medicina Veterinaria, Università degli Studi di Teramo (UniTE), 64100 Teramo, Italy
| | - Roberto Coccurello
- European Center for Brain Research, Santa Lucia Foundation IRCCS, 00143 Rome, Italy;
- Institute for Complex Systems (ISC), National Council of Research (CNR), 00185 Rome, Italy
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Accardo AL, Pontes NMH, Pontes MCF. Greater Physical Activity is Associated with Lower Rates of Anxiety and Depression Among Autistic and ADHD Youth: National Survey of Children's Health 2016-2020. J Autism Dev Disord 2023:10.1007/s10803-023-06117-0. [PMID: 37751090 DOI: 10.1007/s10803-023-06117-0] [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: 08/15/2023] [Indexed: 09/27/2023]
Abstract
Data from the National Survey of Children's Health 2016-2020 was used to examine the association between physical activity and anxiety and depression among autistic youth, non-autistic youth with ADHD, and non-autistic non-ADHD youth. There was a significant negative association between physical activity and anxiety among all groups. Reduction in anxiety or depression associated with greater physical activity was at least as large or larger among autistic or nonautistic youth with ADHD than among non-autistic non-ADHD youth. Unfortunately, even autistic youth who were physically active 4 to 7 days a week showed very high rates of anxiety (54.5%) and depression (23.1%). Very high levels of dual diagnosis of anxiety and depression in autistic youth and youth with ADHD also emerged. Findings highlight a need to determine the cause-and-effect relationships among physical activity, anxiety, and depression across groups and to prioritize mental health screenings and support for autistic youth and youth with ADHD.
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Affiliation(s)
- Amy L Accardo
- College of Education, Rowan University, 201 Mullica Hill Road, Glassboro, NJ, 08028, USA.
| | - Nancy M H Pontes
- School of Nursing, Rutgers University, 530 Federal Street, Camden, NJ, 08102, USA
| | - Manuel C F Pontes
- Rohrer College of Business, Rowan University, 201 Mullica Hill Road, Glassboro, NJ, 08028, USA
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Singh B, Olds T, Curtis R, Dumuid D, Virgara R, Watson A, Szeto K, O'Connor E, Ferguson T, Eglitis E, Miatke A, Simpson CE, Maher C. Effectiveness of physical activity interventions for improving depression, anxiety and distress: an overview of systematic reviews. Br J Sports Med 2023; 57:1203-1209. [PMID: 36796860 PMCID: PMC10579187 DOI: 10.1136/bjsports-2022-106195] [Citation(s) in RCA: 113] [Impact Index Per Article: 113.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2023] [Indexed: 02/18/2023]
Abstract
OBJECTIVE To synthesise the evidence on the effects of physical activity on symptoms of depression, anxiety and psychological distress in adult populations. DESIGN Umbrella review. DATA SOURCES Twelve electronic databases were searched for eligible studies published from inception to 1 January 2022. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Systematic reviews with meta-analyses of randomised controlled trials designed to increase physical activity in an adult population and that assessed depression, anxiety or psychological distress were eligible. Study selection was undertaken in duplicate by two independent reviewers. RESULTS Ninety-seven reviews (1039 trials and 128 119 participants) were included. Populations included healthy adults, people with mental health disorders and people with various chronic diseases. Most reviews (n=77) had a critically low A MeaSurement Tool to Assess systematic Reviews score. Physical activity had medium effects on depression (median effect size=-0.43, IQR=-0.66 to -0.27), anxiety (median effect size=-0.42, IQR=-0.66 to -0.26) and psychological distress (effect size=-0.60, 95% CI -0.78 to -0.42), compared with usual care across all populations. The largest benefits were seen in people with depression, HIV and kidney disease, in pregnant and postpartum women, and in healthy individuals. Higher intensity physical activity was associated with greater improvements in symptoms. Effectiveness of physical activity interventions diminished with longer duration interventions. CONCLUSION AND RELEVANCE Physical activity is highly beneficial for improving symptoms of depression, anxiety and distress across a wide range of adult populations, including the general population, people with diagnosed mental health disorders and people with chronic disease. Physical activity should be a mainstay approach in the management of depression, anxiety and psychological distress. PROSPERO REGISTRATION NUMBER CRD42021292710.
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Affiliation(s)
- Ben Singh
- Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Timothy Olds
- Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Rachel Curtis
- Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Dorothea Dumuid
- Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Rosa Virgara
- Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Amanda Watson
- Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Kimberley Szeto
- Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Edward O'Connor
- Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Ty Ferguson
- Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Emily Eglitis
- Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Aaron Miatke
- Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Catherine Em Simpson
- Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Carol Maher
- Health and Use of Time (HUT) Group, University of South Australia, Adelaide, South Australia, Australia
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Ren FF, Alderman BL, Wang WG, Chen FT, Zhou WS, Zong WJ, Liang WM, Chang YK. Effects of Exercise Training on Executive Functioning in Adults with Depression: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Sports Med 2023; 53:1765-1788. [PMID: 37369934 DOI: 10.1007/s40279-023-01869-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Exercise is a promising nonpharmacological intervention to improve executive function (EF). However, results from randomized trials and meta-analyses examining the effects of exercise on working memory in adults with depression are mixed, and the influence of exercise on EF, as well as the key moderators of the relationship, remain inconclusive. OBJECTIVE The present systematic review with meta-analysis examined the influence of exercise interventions on EF in adults with depression, and the influence of key moderating variables. METHODS Electronic searches were conducted using Embase, Cochrane Central, Scopus, Ovid MEDLINE, PubMed, Web of Science, China National Knowledge Infrastructure, Wanfang Database, and Weipu Database up to 25 June 2022, and updated on 16 January 2023. Randomized controlled trials (RCTs) examining the effects of exercise training on EF in adults with depression were included. A three-level meta-analysis based on a random-effects model was applied in R. Study quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. RESULTS A total of 14 RCTs that evaluated 1201 adults with depression were included. The results indicated that exercise significantly improved global EF [g = 0.180; 95% confidence intervals (CI) = 0.038, 0.323], and the subdomains of working memory (g = 0.182; 95% CI = 0.015, 0.350), cognitive flexibility (g = 0.222; 95% CI = 0.048, 0.395), and reasoning/planning (g = 0.889; 95% CI = 0.571, 1.206). In subgroup analyses, significant improvements in EF were only observed for aerobic exercise (g = 0.203; 95% CI = 0.023, 0.382), moderate-to-vigorous intensity exercise (g = 0.200; 95% CI = 0.022, 0.379), exercise performed three or more times per week (g = 0.207; 95% CI = 0.026, 0.388), in sessions ≤ 60 min (g = 0.173; 95% CI = 0.003, 0.343), and in program durations lasting at least 13 weeks (g = 0. 248; 95% CI = 0.034, 0.462). CONCLUSIONS This meta-analysis demonstrates the benefits of exercise training for improving EF and the subdomains of working memory, cognitive flexibility, and reasoning/planning in adults with depression. Future randomized clinical trials are warranted to determine the therapeutic effects of exercise training on EF and cognitive symptoms in depressed patients.
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Affiliation(s)
- Fei-Fei Ren
- Department of Physical Education, Beijing Language and Culture University, Beijing, China
| | - Brandon L Alderman
- Department of Kinesiology and Health, Center of Alcohol and Substance Use Studies, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Wei-Guang Wang
- Department of Physical Education, Beijing Language and Culture University, Beijing, China
| | - Feng-Tzu Chen
- Department of Sports Medicine, China Medical University, Taichung, Taiwan
| | - Wen-Sheng Zhou
- Department of Physical Education, Nanjing Xiao-Zhuang University, Jiangsu, China
| | - Wei-Jie Zong
- China Wushu School, Beijing Sport University, Beijing, China
| | - Wen-Ming Liang
- Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - Yu-Kai Chang
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, 162, Section 1, Heping East Road, Daan District, Taipei, 106209, Taiwan.
- Institute for Research Excellence in Learning Science, National Taiwan Normal University, Taipei, Taiwan.
- Social Emotional Education and Development Center, National Taiwan Normal University, Taipei, Taiwan.
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Li Y, Shi DD, Wang Z. Adolescent nonpharmacological interventions for early-life stress and their mechanisms. Behav Brain Res 2023; 452:114580. [PMID: 37453516 DOI: 10.1016/j.bbr.2023.114580] [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: 04/18/2023] [Revised: 07/08/2023] [Accepted: 07/11/2023] [Indexed: 07/18/2023]
Abstract
Those with a negative experience of psychosocial stress during the early stage of life not only have a high susceptibility of the psychiatric disorder in all phases of their life span, but they also demonstrate more severe symptoms and poorer response to treatment compared to those without a history of early-life stress. The interventions targeted to early-life stress may improve the effectiveness of treating and preventing psychiatric disorders. Brain regions associated with mood and cognition develop rapidly and own heightened plasticity during adolescence. So, manipulating nonpharmacological interventions in fewer side effects and higher acceptance during adolescence, which is a probable window of opportunity, may ameliorate or even reverse the constantly deteriorating impact of early-life stress. The present article reviews animal and people studies about adolescent nonpharmacological interventions for early-life stress. We aim to discuss whether those adolescent nonpharmacological interventions can promote individuals' psychological health who expose to early-life stress.
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Affiliation(s)
- Yi Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dong-Dong Shi
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhen Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Institute of Psychological and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China.
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36
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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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Heissel A, Heinen D, Brokmeier LL, Skarabis N, Kangas M, Vancampfort D, Stubbs B, Firth J, Ward PB, Rosenbaum S, Hallgren M, Schuch F. Exercise as medicine for depressive symptoms? A systematic review and meta-analysis with meta-regression. Br J Sports Med 2023; 57:1049-1057. [PMID: 36731907 PMCID: PMC10423472 DOI: 10.1136/bjsports-2022-106282] [Citation(s) in RCA: 59] [Impact Index Per Article: 59.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2023] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To estimate the efficacy of exercise on depressive symptoms compared with non-active control groups and to determine the moderating effects of exercise on depression and the presence of publication bias. DESIGN Systematic review and meta-analysis with meta-regression. DATA SOURCES The Cochrane Central Register of Controlled Trials, PubMed, MEDLINE, Embase, SPORTDiscus, PsycINFO, Scopus and Web of Science were searched without language restrictions from inception to 13 September2022 (PROSPERO registration no CRD42020210651). ELIGIBILITY CRITERIA FOR SELECTING STUDIES Randomised controlled trials including participants aged 18 years or older with a diagnosis of major depressive disorder or those with depressive symptoms determined by validated screening measures scoring above the threshold value, investigating the effects of an exercise intervention (aerobic and/or resistance exercise) compared with a non-exercising control group. RESULTS Forty-one studies, comprising 2264 participants post intervention were included in the meta-analysis demonstrating large effects (standardised mean difference (SMD)=-0.946, 95% CI -1.18 to -0.71) favouring exercise interventions which corresponds to the number needed to treat (NNT)=2 (95% CI 1.68 to 2.59). Large effects were found in studies with individuals with major depressive disorder (SMD=-0.998, 95% CI -1.39 to -0.61, k=20), supervised exercise interventions (SMD=-1.026, 95% CI -1.28 to -0.77, k=40) and moderate effects when analyses were restricted to low risk of bias studies (SMD=-0.666, 95% CI -0.99 to -0.34, k=12, NNT=2.8 (95% CI 1.94 to 5.22)). CONCLUSION Exercise is efficacious in treating depression and depressive symptoms and should be offered as an evidence-based treatment option focusing on supervised and group exercise with moderate intensity and aerobic exercise regimes. The small sample sizes of many trials and high heterogeneity in methods should be considered when interpreting the results.
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Affiliation(s)
- Andreas Heissel
- Social and Preventive Medicine, Department of Sports and Health Sciences, Intra faculty unit "Cognitive Sciences", Faculty of Human Science and Faculty of Health Sciences Brandenburg, Research Area Services Research and e-Health, Potsdam, Brandenburg, Germany
| | - Darlene Heinen
- Social and Preventive Medicine, Department of Sports and Health Sciences, Intra faculty unit "Cognitive Sciences", Faculty of Human Science and Faculty of Health Sciences Brandenburg, Research Area Services Research and e-Health, Potsdam, Brandenburg, Germany
| | - Luisa Leonie Brokmeier
- Social and Preventive Medicine, Department of Sports and Health Sciences, Intra faculty unit "Cognitive Sciences", Faculty of Human Science and Faculty of Health Sciences Brandenburg, Research Area Services Research and e-Health, Potsdam, Brandenburg, Germany
| | - Nora Skarabis
- Social and Preventive Medicine, Department of Sports and Health Sciences, Intra faculty unit "Cognitive Sciences", Faculty of Human Science and Faculty of Health Sciences Brandenburg, Research Area Services Research and e-Health, Potsdam, Brandenburg, Germany
| | - Maria Kangas
- School of Psychological Sciences, Centre for Emotional Health, Macquarie University, Sydney, New South Wales, Australia
| | - Davy Vancampfort
- Department of Rehabilitation Sciences, University of Leuven, Leuven, Belgium
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK; NICM Health Research Institute, Western Sydney University, Westmead Australia; Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Philip B Ward
- Discipline of Psychiatry and Mental Health, UNSW Sydney, Sydney New South Wales, Australia; Ingham Institute of Applied Medical Research, UNSW, Liverpool BC, New South Wales, Australia
| | - Simon Rosenbaum
- School of Psychiatry, UNSW, Sydney, New South Wales, Australia
| | - Mats Hallgren
- Epidemiology of Psychiatric Conditions, Substance use and Social Environment (EPiCSS), Department of Public Health Sciences, Karolinska Institute Solna, Solna, Sverige, Sweden
| | - Felipe Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Universidad Autónoma de Chile, Providencia, Chile
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Morres ID, Metsios GS. Vigorous exercise in pragmatic settings leads to antidepressive, metabolic and cardiovascular health benefits in adult outpatients with major depression or anxiety disorders. Evid Based Nurs 2023:ebnurs-2023-103743. [PMID: 37451850 DOI: 10.1136/ebnurs-2023-103743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2023] [Indexed: 07/18/2023]
Affiliation(s)
- Ioannis D Morres
- Department of Nutrition and Dietetics, University of Thessaly, Trikala, Greece
| | - George S Metsios
- Department of Nutrition and Dietetics, University of Thessaly, Trikala, Greece
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Bozdarov J, Jones BDM, Daskalakis ZJ, Husain MI. Boxing as an Intervention in Mental Health: A Scoping Review. Am J Lifestyle Med 2023; 17:589-600. [PMID: 37426738 PMCID: PMC10328201 DOI: 10.1177/15598276221124095] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/17/2023] Open
Abstract
Introduction: Physical activity has been shown to have a multitude of mental health benefits. However, there is limited evidence on the specific mental health benefits of boxing. We conducted a scoping review of academic and grey literature to map research of boxing exercises as an intervention in mental health and to identify gaps in knowledge. Methods: The authors utilized the PRISMA-ScR methodological approach and guidelines from the Joanna Briggs Institute and a structured search was completed from inception until August 08, 2022. Results: We identified 16 documents that used non-contact boxing as an exercise intervention that improved various mental health difficulties. Non-contact boxing exercises, usually in a high-intensity-interval training group setting, provided significant reduction in symptoms of anxiety, depression, PTSD and negative symptoms of schizophrenia. Non-contact boxing provided a cathartic release of anger and stress, with evidence of improved mood, self-esteem, confidence, concentration, metabolic burden, strength and coordination. Conclusions: Preliminary evidence indicates that non-contact boxing exercises are a promising intervention to improve mental health burden. Further well designed randomized controlled trials using group, non-contact boxing exercises as an intervention for common mental disorders are warranted to confirm its benefits for mental health.
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Affiliation(s)
- Johny Bozdarov
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health(CAMH), Toronto, ON, Canada; Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Brett D. M. Jones
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health(CAMH), Toronto, ON, Canada; Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Zafiris J. Daskalakis
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health(CAMH), Toronto, ON, Canada; Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - M. Ishrat Husain
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health(CAMH), Toronto, ON, Canada; Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
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Knappe F, Filippou K, Hatzigeorgiadis A, Morres ID, Tzormpatzakis E, Havas E, Seelig H, Colledge F, Ludyga S, Meier M, de Quervain D, Theodorakis Y, von Känel R, Pühse U, Gerber M. Psychological well-being, mental distress, metabolic syndrome, and associated factors among people living in a refugee camp in Greece: a cross-sectional study. Front Public Health 2023; 11:1179756. [PMID: 37397726 PMCID: PMC10311549 DOI: 10.3389/fpubh.2023.1179756] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 05/23/2023] [Indexed: 07/04/2023] Open
Abstract
Background Forcibly displaced people face various challenges and are therefore at higher risk of being affected by mental and physiological distress. The present study aimed to determine levels of psychological well-being, PTSD symptom severity, metabolic syndrome, and associated factors among forcibly displaced people in Greece in response to WHO's call for evidence-based public health policies and programs for forcibly displaced people. Methods We conducted a cross-sectional study among n = 150 (50% women) forcibly displaced people originating from Sub-Sahara Africa and Southwest Asia living in a Greek refugee camp. Self-report questionnaires were used to assess psychological well-being, symptoms of PTSD, depression, generalized anxiety disorder and insomnia, perceived stress, headache, and perceived fitness. Cardiovascular risk markers were assessed to determine metabolic syndrome, and cardiorespiratory fitness was measured with the Åstrand-Rhyming Test of Maximal Oxygen Uptake. Results The prevalence of mental distress and physiological disorders was overall elevated. Only 53.0% of participants rated their psychological well-being as high. Altogether, 35.3% scored above the clinical cut-off for PTSD, 33.3% for depression, 27.9% for generalized anxiety disorder, and 33.8% for insomnia. One in four (28.8%) participants met criteria for metabolic syndrome. While the prevalence of moderate or severe insomnia symptoms and metabolic syndrome differed little from the global population, the risk of being affected by mental distress was markedly increased. In multivariable analysis, higher perceived fitness was associated with higher psychological well-being (OR = 1.35, p = 0.003) and a decreased likelihood for metabolic syndrome (OR = 0.80, p = 0.031). Participants with elevated psychiatric symptoms were less likely to report high psychological well-being (OR = 0.22, p = 0.003) and had increased odds for higher PTSD severity (OR = 3.27, p = 0.034). Increased stress perception was associated with higher PTSD symptoms (OR = 1.13, p = 0.002). Conclusion There is an elevated risk for mental distress compared to the global population and an overall high mental and physiological burden among people living in a Greek refugee camp. The findings underpin the call for urgent action. Policies should aim to reduce post-migration stressors and address mental health and non-communicable diseases by various programs. Sport and exercise interventions may be a favorable add-on, given that perceived fitness is associated with both mental and physiological health benefits.
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Affiliation(s)
- Florian Knappe
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Konstantinia Filippou
- Department of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | - Antonis Hatzigeorgiadis
- Department of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | - Ioannis D. Morres
- Department of Nutrition and Dietetics, University of Thessaly, Trikala, Greece
| | - Emmanouil Tzormpatzakis
- Department of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | - Elsa Havas
- Department of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | - Harald Seelig
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Flora Colledge
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Sebastian Ludyga
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Marianne Meier
- Interdisciplinary Center for Gender Studies, University of Bern, Bern, Switzerland
| | | | - Yannis Theodorakis
- Department of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Uwe Pühse
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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Khoury R, Nagy C. Running from stress: a perspective on the potential benefits of exercise-induced small extracellular vesicles for individuals with major depressive disorder. Front Mol Biosci 2023; 10:1154872. [PMID: 37398548 PMCID: PMC10309045 DOI: 10.3389/fmolb.2023.1154872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/06/2023] [Indexed: 07/04/2023] Open
Abstract
Aerobic exercise promotes beneficial effects in the brain including increased synaptic plasticity and neurogenesis and regulates neuroinflammation and stress response via the hypothalamic-pituitary-adrenal axis. Exercise can have therapeutic effects for numerous brain-related pathologies, including major depressive disorder (MDD). Beneficial effects of aerobic exercise are thought to be mediated through the release of "exerkines" including metabolites, proteins, nucleic acids, and hormones that communicate between the brain and periphery. While the specific mechanisms underlying the positive effects of aerobic exercise on MDD have not been fully elucidated, the evidence suggests that exercise may exert a direct or indirect influence on the brain via small extracellular vesicles which have been shown to transport signaling molecules including "exerkines" between cells and across the blood-brain barrier (BBB). sEVs are released by most cell types, found in numerous biofluids, and capable of crossing the BBB. sEVs have been associated with numerous brain-related functions including neuronal stress response, cell-cell communication, as well as those affected by exercise like synaptic plasticity and neurogenesis. In addition to known exerkines, they are loaded with other modulatory cargo such as microRNA (miRNA), an epigenetic regulator that regulates gene expression levels. How exercise-induced sEVs mediate exercise dependent improvements in MDD is unknown. Here, we perform a thorough survey of the current literature to elucidate the potential role of sEVs in the context of neurobiological changes seen with exercise and depression by summarizing studies on exercise and MDD, exercise and sEVs, and finally, sEVs as they relate to MDD. Moreover, we describe the links between peripheral sEV levels and their potential for infiltration into the brain. While literature suggests that aerobic exercise is protective against the development of mood disorders, there remains a scarcity of data on the therapeutic effects of exercise. Recent studies have shown that aerobic exercise does not appear to influence sEV size, but rather influence their concentration and cargo. These molecules have been independently implicated in numerous neuropsychiatric disorders. Taken together, these studies suggest that concentration of sEVs are increased post exercise, and they may contain specifically packaged protective cargo representing a novel therapeutic for MDD.
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Affiliation(s)
- Reine Khoury
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Verdun, QC, Canada
| | - Corina Nagy
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Verdun, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
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Scriven M, McSweeney A, O'Carroll T, Morkl S, Butler MI. The Muscle-Gut-Brain Axis and Psychiatric Illness. Adv Biol (Weinh) 2023; 7:e2200214. [PMID: 37080945 DOI: 10.1002/adbi.202200214] [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: 08/03/2022] [Revised: 02/07/2023] [Indexed: 04/22/2023]
Abstract
The microbiota-gut-brain axis (MGBA) has been the subject of much research over the past decade, offering an exciting new paradigm for the treatment of psychiatric disorders. In this review, the MGBA is extended to include skeletal muscle and the potential role of an expanded "muscle-gut-brain axis" (MuGBA) in conditions such as anxiety and depression is discussed. There is evidence, from both preclinical and human studies, of bidirectional links between the gut microbiome and skeletal muscle function and structure. The therapeutic role of exercise in reducing depressive and anxiety symptoms is widely recognised, and the potential role of the gut microbiota-skeletal muscle link is discussed within this context. Potential pathways of communication involved in the MuGBA including the tryptophan-kynurenine pathway, intestinal permeability, immune modulation, and bacterial metabolites such as short-chain-fatty-acids are explored.
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Affiliation(s)
- Mary Scriven
- St Loman's Psychiatric Hospital, Delvin Road, Mullingar, County Westmeath, N91T3PR, Ireland
| | - Angela McSweeney
- Department of Psychiatry, Cork University Hospital, Wilton Road, Cork, T12DC4A, Ireland
| | | | - Sabrina Morkl
- Medical University of Graz, Department of Psychiatry and Psychotherapeutic Medicine, Graz, 8010, Austria
| | - Mary I Butler
- Department of Psychiatry, Cork University Hospital, Wilton Road, Cork, T12DC4A, Ireland
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Kim DW, Kwon HW, Kim SH. Efficacy and safety of Banxia-Houpo-Tang (Banha-Hubak-Tang) for depression: A systematic review and meta-analysis. Complement Ther Clin Pract 2023; 52:101769. [PMID: 37224584 DOI: 10.1016/j.ctcp.2023.101769] [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: 09/08/2022] [Revised: 05/07/2023] [Accepted: 05/08/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND and purpose: Banxia-Houpo-Tang (Banha-Hubak-Tang, BHT) is an East Asian traditional herbal medicine used for treating depression. Hence, this review aimed to provide reliable evidence on the efficacy and safety of BHT for depression. METHODS Overall, 15 electronic databases were searched until July 31, 2022, and randomized controlled trials (RCTs) of BHT for depression were reviewed. The cochrane risk of bias tool version 2.0 was used for quality assessment. A meta-analysis was conducted to evaluate the efficacy and safety of BHT for depression. RESULTS Fifteen RCTs (1,714 participants) were included. The pooled results suggested that the efficacy of BHT alone (standardized mean difference [SMD], -0.39; 95% confidence interval [CI], -0.79 to 0.00; P = 0.05) was similar to that of antidepressants alone in terms of the Hamilton depression scale (HAMD) scores. Their combination led to a more significant improvement in HAMD scores (SMD, -0.91; 95% CI, -1.21 to 0.60; P < 0.00001). Moreover, compared with antidepressants alone, BHT alone had a lower risk of causing adverse events, but the combination therapy exhibited a similar risk. No severe adverse events were reported. The overall risk of bias was high. The quality of evidence was very low to moderate. CONCLUSION The study results indicate that BHT may be beneficial for treating depression. However, due to the clinical heterogeneity and low methodological quality of the included studies, the obtained findings should be interpreted with caution. Hence, further studies on this topic are warranted.
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Affiliation(s)
- Da-Woon Kim
- Department of Neuropsychiatry of Korean Medicine, Pohang Korean Medicine Hospital Affiliated to Daegu Haany University, Republic of Korea.
| | - Hye-Won Kwon
- College of Korean Medicine, Daegu Haany University, Republic of Korea.
| | - Sang-Ho Kim
- Department of Neuropsychiatry of Korean Medicine, Pohang Korean Medicine Hospital Affiliated to Daegu Haany University, Republic of Korea.
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Li R, Wang W, Guo J, Liu W, Huang X, Qiao Y, Jia S, Tian L, Zhou J, Wang G. Efficacy and acceptability of supervised group exercise for mild to moderate major depressive disorder: A feasibility study. J Affect Disord 2023; 329:96-104. [PMID: 36841307 DOI: 10.1016/j.jad.2023.02.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 02/11/2023] [Accepted: 02/19/2023] [Indexed: 02/26/2023]
Abstract
BACKGROUND Exercise can efficiently reduce the symptoms of major depression disorder (MDD). This study aims to examine the efficacy and acceptability of supervised group exercise intervention among patients in an acute phase of mild to moderate MDD. METHODS We enrolled patients in the psychiatric clinic of Beijing Anding Hospital affiliated to Capital Medical University in a prospective, single-arm objective performance criteria (OPC) trial. A total of 40 adults aged 18-50 who had a diagnosis of an episode of depression and the 17-item Hamilton Rating Scale for Depression (HRSD-17) score of 7-20 were recruited. Supervised exercise group intervention was applied on participants with a new episode of mild to moderate depression 3 times a week for 8 weeks without any other treatment. Every exercise session should meet the standard of moderate intensity, defined as approximately equal to 50 %-80 % of the maximal heart rate for 150 min every week. The primary end point was the clinical response at week 8, defined as a 50 % reduction in the baseline HRSD-17 score. Meanwhile, the secondary end points included the acceptability of the supervised group exercise intervention for both patients and investigators, remission rate (defined as an HRSD-17 score of 7 or less), the change of Patient Health Questionnaire (PHQ-9) and the Quality of Life, Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF). RESULTS Among the 46 screened patients, 40 were enrolled. Of them, 4 people dropped out, while 36 received all the planned sessions of the supervised group exercise therapy and completed the week-8 assessment. At week 8, the response rate was 89 % (95 % confidence interval [CI] 74 % to 97 %) and the remission rate was 83 % (95%CI 67 % to 94 %). The overall acceptance of the supervised group exercise based on the VAS score (range 0-10) was 9.19 ± 1.27 for patients and 9.67 ± 0.62 for investigators. The least-squares mean (±SE) change from baseline at week 8 was-9.99 in the PHQ-9 score and 25.15 in the Q-LES-Q-SF score. No serious adverse events were reported during this trial. The percentage of any adverse event was 5 %. CONCLUSION Supervised group exercise intervention is effective in patients with acute mild to moderate MDD and has good acceptance rate among both patients and investigators.
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Affiliation(s)
- Ruinan Li
- National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China
| | - Weiwei Wang
- National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Jianjun Guo
- Capital University of Physical Education And Sports, Beijing 100192, China
| | - Wenyang Liu
- National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China
| | - Xiaohan Huang
- National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China
| | - Yu Qiao
- National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China
| | - Shengtao Jia
- National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China
| | - Lu Tian
- National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China
| | - Jingjing Zhou
- National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China.
| | - Gang Wang
- National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China.
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Fiedler DV, Rosenstiel S, Zeibig JM, Seiffer B, Welkerling J, Frei AK, Studnitz T, Baur J, Helmhold F, Ray A, Herzog E, Takano K, Nakagawa T, Kropp S, Franke S, Peters S, Flagmeier AL, Zwanzleitner L, Sundmacher L, Ramos-Murguialday A, Hautzinger M, Ehring T, Sudeck G, Wolf S. Concept and study protocol of the process evaluation of a pragmatic randomized controlled trial to promote physical activity in outpatients with heterogeneous mental disorders-the ImPuls study. Trials 2023; 24:330. [PMID: 37189210 DOI: 10.1186/s13063-023-07331-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 04/28/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Evidence suggests that patients suffering from different mental disorders benefit from exercise programs combined with behavior change techniques. Based on this evidence, we have developed an exercise program (ImPuls) specifically designed to provide an additional treatment option in the outpatient mental health care system. The implementation of such complex programs into the outpatient context requires research that goes beyond the evaluation of effectiveness, and includes process evaluation. So far, process evaluation related to exercise interventions has rarely been conducted. As part of a current pragmatic randomized controlled trial evaluating ImPuls treatment effects, we are therefore carrying out comprehensive process evaluation according to the Medical Research Council (MRC) framework. The central aim of our process evaluation is to support the findings of the ongoing randomized controlled trial. METHODS The process evaluation follows a mixed-methods approach. We collect quantitative data via online-questionnaires from patients, exercise therapists, referring healthcare professionals and managers of outpatient rehabilitative and medical care facilities before, during, and after the intervention. In addition, documentation data as well as data from the ImPuls smartphone application are collected. Quantitative data is complemented by qualitative interviews with exercise therapists as well as a focus-group interview with managers. Treatment fidelity will be assessed through the rating of video-recorded sessions. Quantitative data analysis includes descriptive as well as mediation and moderation analyses. Qualitative data will be analyzed via qualitative content analysis. DISCUSSION The results of our process evaluation will complement the evaluation of effectiveness and cost-effectiveness and will, for example, provide important information about mechanisms of impact, structural prerequisites, or provider qualification that may support the decision-making process of health policy stakeholders. It might contribute to paving the way for exercise programs like ImPuls to be made successively available for patients with heterogeneous mental disorders in the German outpatient mental health care system. TRIAL REGISTRATION The parent clinical study was registered in the German Clinical Trials Register (ID: DRKS00024152, registered 05/02/2021, https://drks.de/search/en/trial/DRKS00024152 ).
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Affiliation(s)
- David Victor Fiedler
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany.
| | - Stephanie Rosenstiel
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
| | - Johanna-Marie Zeibig
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
- Faculty of Science, Psychological Institute, Department of Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Britta Seiffer
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
- Faculty of Science, Psychological Institute, Department of Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Jana Welkerling
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
- Faculty of Science, Psychological Institute, Department of Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Anna Katharina Frei
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
- Faculty of Science, Psychological Institute, Department of Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Thomas Studnitz
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
- Faculty of Science, Psychological Institute, Department of Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Julia Baur
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
- Faculty of Science, Psychological Institute, Department of Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Florian Helmhold
- Medical Faculty, Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
| | - Andreas Ray
- Medical Faculty, Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
| | - Eva Herzog
- Department of Psychology, Clinical Psychology and Psychotherapy, LMU Munich, Munich, Germany
| | - Keisuke Takano
- Department of Psychology, Clinical Psychology and Psychotherapy, LMU Munich, Munich, Germany
| | - Tristan Nakagawa
- Department of Psychology, Clinical Psychology and Psychotherapy, LMU Munich, Munich, Germany
| | - Saskia Kropp
- Chair of Health Economics, Technical University Munich (TUM), Munich, Germany
| | - Sebastian Franke
- Chair of Health Economics, Technical University Munich (TUM), Munich, Germany
| | - Stefan Peters
- German Association for health-related Fitness and Exercise Therapy (German: DVGS), Hürth-Efferen, Germany
| | | | | | - Leonie Sundmacher
- Chair of Health Economics, Technical University Munich (TUM), Munich, Germany
| | - Ander Ramos-Murguialday
- Medical Faculty, Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
| | - Martin Hautzinger
- Faculty of Science, Psychological Institute, Department of Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Thomas Ehring
- Department of Psychology, Clinical Psychology and Psychotherapy, LMU Munich, Munich, Germany
| | - Gorden Sudeck
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
| | - Sebastian Wolf
- Faculty of Economics and Social Sciences, Institute of Sports Science, Department of Education & Health Research, University of Tübingen, Tübingen, Germany
- Faculty of Science, Psychological Institute, Department of Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany
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Cody R, Kreppke JN, Fischer X, Faude O, Beck J, Brand S, Hatzinger M, Imboden C, Kügerl N, Lang UE, Mans S, Maurer R, Mikoteit T, Oswald A, Rhodius LS, Schweinfurth N, Wechsler L, Gerber M. An implementation evaluation of the physical activity counseling for in-patients with major depressive disorder (PACINPAT) intervention: a randomized controlled trial. BMC Psychiatry 2023; 23:316. [PMID: 37143013 PMCID: PMC10161407 DOI: 10.1186/s12888-023-04834-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 04/28/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND The physical activity counseling for in-patients with major depression (PACINPAT) randomized controlled trial was launched to tackle physical inactivity for in-patients with major depressive disorder. Evidence shows that despite potential treatment effects, physical inactivity is prevalent in this population. To contribute to the assessment of how this in-person and remote, theory-based, individually tailored intervention was designed, received and effected behavior, the aim of this study was to evaluate its implementation. METHODS This implementation evaluation was conducted within a multi-center randomized controlled trial according to the Process Evaluation Framework by the Medical Research Council including the analysis of reach, dose, fidelity and adaptation. Data were collected from the implementers and the participants randomized to the intervention group of the trial. RESULTS The study sample comprised 95 physically inactive in-patients (mean age: 42 years, 53% women) with diagnosed major depressive disorder. The intervention reached the intended population (N = 95 in-patients enrolled in the study). The intervention dose varied between early dropouts (counseling sessions, M = 1.67) and study completers with some participants receiving a low dose (counseling sessions, M = 10.05) and high dose (counseling sessions, M = 25.37). Differences in the attendance groups were recognizable in the first two counseling sessions (duration of counseling session about 45 min in early dropouts versus 60 min for study completers). Fidelity of the in-person counseling content was partly achieved and adapted, whereas that of the remote counseling content was well achieved. Participants (86% at follow up) reported satisfaction with the implementers of the intervention. Adaptations were made to content, delivery mode and dose. CONCLUSION The PACINPAT trial was implemented in the intended population, in varying doses and with adaptations made to in-person counseling content and remote counseling dose. These findings are key to understanding outcome analyses within the PACINPAT trial, further developing interventions and contributing to implementation research among in-patients with depressive disorders. TRIAL REGISTRATION ISRCTN, ISRCTN10469580 , registered on 3rd September 2018.
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Affiliation(s)
- Robyn Cody
- Department for Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland.
| | - Jan-Niklas Kreppke
- Department for Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
| | - Xenia Fischer
- Department for Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
| | - Oliver Faude
- Department for Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
| | | | - Serge Brand
- Department for Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
- Adult Psychiatric Clinics (UPKE), University of Basel, Basel, Switzerland
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, 6719851115, Iran
- Substance Use Prevention Research Center and Sleep Disorder Research Center, Kermanshah, University of Medical Sciences (KUMS), Kermanshah, 6715847141, Iran
- School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | | | | | - Nadine Kügerl
- Department for Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
| | - Undine E Lang
- Adult Psychiatric Clinics (UPKE), University of Basel, Basel, Switzerland
| | - Sarah Mans
- Private Clinic Wyss, Münchenbuchsee, Switzerland
| | - Reto Maurer
- Department for Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
| | | | - Anja Oswald
- Psychiatric Clinic Sonnenhalde, Riehen, Switzerland
| | - Lilja-Sophie Rhodius
- Department for Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
| | - Nina Schweinfurth
- Adult Psychiatric Clinics (UPKE), University of Basel, Basel, Switzerland
| | - Laura Wechsler
- Department for Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
| | - Markus Gerber
- Department for Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052, Basel, Switzerland
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Bates AT, Tse-Agha L, Agha A, Nunez JJ, Boyda HN, Jones AA, Barr AM, Honer WG, Vila-Rodriguez F. Reduction in Substance-Related Composite Harm Scores Through Street Soccer. Cureus 2023; 15:e39650. [PMID: 37388606 PMCID: PMC10306313 DOI: 10.7759/cureus.39650] [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] [Accepted: 05/28/2023] [Indexed: 07/01/2023] Open
Abstract
Introduction Street soccer makes the sport accessible to people affected by homelessness or precarious housing. There is overwhelming evidence that exercise improves physical and mental health. In addition, sport facilitates positive peer pressure that leads to beneficial life changes. Method To examine participants' accounts of the effects of street soccer in a sample of socially disadvantaged players from Western Canada, we collected 73 cross-sectional self-reports of life changes via a questionnaire. The questionnaire included questions on social, mental, and physical health, including substance use. This allowed the calculation of a modified composite harm score. Results Participants reported improved physical (46% of participants) and mental (43% of participants) health, reduced cigarette (50% of smokers), alcohol (45% of users), cannabis (42% of users), and other non-prescribed drug use, increased number of friends (88% of participants), improved housing (60% of participants), increased income (19% of participants), increased community medical supports (40% of participants), and decreased conflicts with police (47% of those with prior recent conflict). Perceived reductions in substance use were supported by significant changes in composite harm score. Conclusion Street soccer appears to promote improved physical, mental, and social health among people affected by homelessness or precarious housing, with reduction in substance use likely to be a key factor. This work builds upon past qualitative research showing the benefits of street soccer and supports future research which may help elucidate the mechanisms by which street soccer has beneficial effects.
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Affiliation(s)
- Alan T Bates
- Psychiatry, The University of British Columbia, Vancouver, CAN
- Psychiatry, BC Cancer, Vancouver, CAN
| | | | - Arun Agha
- Palliative Medicine, Queen's University, Kingston, CAN
| | - John-Jose Nunez
- Psychiatry, The University of British Columbia, Vancouver, CAN
| | - Heidi N Boyda
- Pharmacology and Therapeutics, The University of British Columbia, Vancouver, CAN
| | - Andrea A Jones
- Neurology, The University of British Columbia, Vancouver, CAN
| | - Alasdair M Barr
- Pharmacology and Therapeutics, The University of British Columbia, Vancouver, CAN
| | - William G Honer
- Psychiatry, The University of British Columbia, Vancouver, CAN
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48
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Zhang X, Yang H, Zhang K, Zhang J, Lu X, Guo H, Yuan G, Zhu Z, Du J, Shi H, Jin G, Hao J, Sun Y, Su P, Zhang Z. Effects of exercise or tai chi on Internet addiction in college students and the potential role of gut microbiota: A randomized controlled trial. J Affect Disord 2023; 327:404-415. [PMID: 36754096 DOI: 10.1016/j.jad.2023.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 02/09/2023]
Abstract
OBJECTIVE This study aimed to explore the effect of exercise or tai chi on Internet addiction disorder (IAD) among college students and clarified the abundance and population changes of gut microbiota in different groups. Thus explore the potential role of gut microbiota between exercise and IAD. METHODS A total of 93 subjects diagnosed with mild IAD were randomly assigned to the exercise group, the tai chi group, and the control group. The intervention groups received exercise or tai chi for 8 weeks and the control group was evaluated without any intervention. Fecal samples were collected after the intervention. RESULTS 1) Analysis found a significant intervention effect with the exercise group showing an average decrease of 8.84 points on the Internet addiction test (IAT) compared with the control group (95%CI -15.41 to-2.27, P = 0.004). But there was no significant difference between the control group and the tai chi group. 2) Both exercise (P = 0.018) and tai chi (P = 0.026) could significantly relieve fatigue symptoms. 3) The relative abundance of the Betaproteobacteria, Porphyromonadaceae, Sutterellaceae, and Alistipes were significantly decreased in the exercise group compared with the control group, and the relative abundance of Escherichia was significantly increased in the exercise group. 4) The relative abundance of Betaproteobacteria, Sutterellaceae, and Escherichia had significant differences between the improved group and the no-improved group. CONCLUSION Exercise intervention has a considerable effect on treating IAD. Exercise and tai chi might have effectiveness in relieving the symptoms of fatigue. Exercise intervention regulates the gut microflora and changes the abundance of microflora to improve IAD. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, identifier NCT05529368.
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Affiliation(s)
- Xueqing Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Huayu Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Kexin Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Jianghui Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Xiaoyan Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Haiyun Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Guojing Yuan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Zhihui Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Jun Du
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Haiyan Shi
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Guifang Jin
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Jiahu Hao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Ying Sun
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Puyu Su
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Zhihua Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China.
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49
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Caviness CM, Abrantes AM, O’Keeffe BJ, Legasse AJ, Uebelacker LA. Effects of a bout of exercise on mood in people with depression with and without physical pain. PSYCHOL HEALTH MED 2023; 28:1068-1075. [PMID: 36315041 PMCID: PMC10006325 DOI: 10.1080/13548506.2022.2141276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 10/23/2022] [Indexed: 03/11/2023]
Abstract
Physical and mental health symptoms can reduce participation in physical activity. The current study assessed the impact of a bout of exercise on mood state in depressed participants with and without current physical pain. We enrolled a community sample of 147 participants (Mage = 45.5; SD = 11.98; 87.1% female) with elevated depressive symptoms. Individuals rated their mood state, completed a 1-mile walk test on a treadmill, and rated their mood state again. Pairwise comparisons between pre- and post-exercise mood ratings were statistically significant (p < .001) and showed improved mood state. People with at least moderate pain showed greater decreases in sadness and irritability from pre- to post- exercise bout. A single bout of exercise was associated with decreased sadness, anxiety, and irritability, and increased energy in a sample of adults with depression. The changes in sadness and irritability were greatest in those who reported at least moderate physical pain.
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Affiliation(s)
- Celeste M. Caviness
- Alpert Medical School of Brown University, Providence, Rhode Island, United States of America
- Butler Hospital, Providence, Rhode Island, United States of America
| | - Ana M. Abrantes
- Alpert Medical School of Brown University, Providence, Rhode Island, United States of America
- Butler Hospital, Providence, Rhode Island, United States of America
| | | | | | - Lisa A. Uebelacker
- Alpert Medical School of Brown University, Providence, Rhode Island, United States of America
- Butler Hospital, Providence, Rhode Island, United States of America
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50
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Garvey L, Benson AC, Benger D, Short T, Banyard H, Edward KL. The perceptions of mental health clinicians integrating exercise as an adjunct to routine treatment of depression and anxiety. Int J Ment Health Nurs 2023; 32:502-512. [PMID: 36369663 DOI: 10.1111/inm.13089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/18/2022] [Indexed: 11/15/2022]
Abstract
Individuals with depressive symptoms often experience changes in physical activity and lifestyle factors. Despite the benefits of exercise, mental health clinicians often do not refer for or prescribe exercise as part of traditionally accepted models of care for consumers with depression and anxiety. The aims were to investigate: (i) mental health clinicians' understanding of the relationship between exercise and mental health, (ii) if and how exercise is used by mental health clinicians in treatment for depression and anxiety, and (iii) the barriers to prescription of exercise. A descriptive qualitative method was used, and data were collected via individual semi-structured interviews. Ten mental health clinicians with varying backgrounds participated in this study. The data driven inductive analysis of participants views identified three themes: (i) knowing and not knowing, (ii) consumer comorbidities - the risk and benefit dilemma, and (iii) protecting vulnerable consumers. Enhancing clinicians' knowledge of the beneficial role of exercise in treatment for consumers' experiencing depression and anxiety is an important step. Mental health services can support integration of exercise by implementing policies and training for staff to support exercise prescription, and the role and referral of exercise and physical activity specialists, as part of routine care to improve clinical outcomes for consumers. Additional considerations should be given to fiscal support to access exercise as an adjunct therapy.
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Affiliation(s)
- Loretta Garvey
- Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Amanda Clare Benson
- Department of Health and Biostatistics, School of Health Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Debra Benger
- Access Health and Community, Melbourne, Victoria, Australia
| | - Tamsin Short
- Access Health and Community, Melbourne, Victoria, Australia
| | - Harry Banyard
- Department of Health and Biostatistics, School of Health Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Karen-Leigh Edward
- Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
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