Physical exercise and depression

Varsity athletes' fitness perceptions, fitness-related self-conscious emotions and depression when sidelined from play

OBJECTIVE

Explore the association between varsity athletes' fitness perceptions and symptoms of depression while sidelined from sport for an extended period, and test whether fitness-related self-conscious emotions (i.e., shame, guilt, authentic pride, and hubristic pride) mediate this relationship.

PARTICIPANTS

Varsity athletes (N = 124) from a large university in Canada where sports had been restricted for the past year due to the pandemic.

METHOD

Participants completed a cross-sectional self-report survey. Regression analyses testing mediation (i.e., direct and indirect effects) were used to explore the main research aim.

RESULTS

Controlling for age and gender, separate models demonstrated significant indirect effects of fitness perceptions on depression symptoms through shame, guilt, and authentic pride, but not through hubristic pride.

CONCLUSION

Self-conscious emotions may be used as a tool to mitigate depression symptoms when varsity athletes are sidelined from sport for an extended period. Further research is needed to understand how self-conscious emotions develop when athletes are injured or retired.

Antidepressant effect of Perilla frutescens essential oil through monoamine neurotransmitters and BDNF/TrkB signal pathway

ETHNOPHARMACOLOGICAL RELEVANCE

Traditional Chinese medicine posits that affect-mind ill-being is the primary cause of depression, with Qi movement stagnation as its pathogenesis. As such, clinical treatment for depression should prioritize regulating Qi and relieving depressive symptoms. The pharmacological properties of traditional Chinese medicine indicate that Perilla frutescens may have potential therapeutic effects on depression and other neuropsychiatric diseases due to its ability to regulate Qi and alleviate depressive symptoms. Although previous studies have reported the antidepressant effects of Perilla frutescens, the mechanism underlying PFEO inhalation-mediated antidepressant effect remains unclear.

AIM OF THE STUDY

The aim of this investigation is to elucidate the antidepressant mechanisms of PFEO by examining its effects on monoamine neurotransmitters and the BDNF/TrkB signaling pathway.

MATERIALS AND METHODS

The CUMS rat model of depression was established, and the depressive state of the animals was assessed through sucrose preference and forced swim tests. ELISA assays were conducted to determine monoamine neurotransmitter levels in the hippocampus and cerebral cortex of rats. Immunohistochemistry, western blotting, and RT-PCR experiments were employed to investigate the BDNF/TrkB signaling pathway's regulation of depression via PFEO inhalation.

RESULTS

It has been observed that inhalation administration of PFEO can significantly enhance the preference for sugar water in CUMS rats and reduce their immobility time during forced swimming. Additionally, there was an increase in the levels of monoamine transmitters in both the hippocampus and cerebral cortex of these rats. Furthermore, there was an upregulation in the expression levels of BDNF and TrkB positive cells as well as BDNF and TrkB proteins within both regions, along with increased BDNF mRNA and TrkB mRNA expression levels.

CONCLUSION

The antidepressant effect of PFEO via inhalation administration is speculated to be mediated through the monoamine neurotransmitters and BDNF/TrkB signaling pathway.

Evidence of the Effects of Dance Interventions on Adults Mental Health: A Systematic Review

BACKGROUND

Recent research has shown that dancing takes effect directly in improving mental health, by reducing rates of depression, anxiety, and enhancing the mood aspects in people of any age.

AIM

This systematic review aimed to search for evidence of the effects of dance interventions on adults' mental health.

METHODS

The eligibility criteria of the studies were defined by following the PICOS strategy, considering the population, intervention, comparison, result, and the study design. Only randomized clinical trials, conducted in adults of both sexes, with results related to mental health, including depression and/or anxiety and/or stress and/or mood disorder were considered eligible for this review. The search was conducted using 5 databases: PubMed, Cochrane Library, Web of Science, Scopus, and ScienceDirect from 2005 to 2020. The Cochrane Collaboration tool was used to assess the risk of bias in randomized clinical trials. The synthesis and presentation of results followed the guidelines of the PRISMA model.

RESULTS

Of 425 selected studies, 10 randomized clinical trials were included in the review with a total of 933 participants between 18 and 62 years old. Studies included Dance Movement Therapy, Latin dance, tango, rumba, waltz, Nogma, quadrille, and Biodanza. The results indicate that regardless of style, adults who participated in dance interventions showed a reduction in symptoms of depression, anxiety, and stress compared to groups that did not participate in any type of intervention.

DISCUSSION

In general, studies showed an unclear risk of bias in most items assessed. Based on these studies, it is possible to assume that the practice of dance contributes positively to the maintenance or improvement of mental health in adults.

Young adults with intellectual and developmental disabilities who participate in Special Olympics are less likely to be diagnosed with depression

PURPOSE

People with intellectual and developmental disabilities (IDD) experience high rates of depression. Evidence indicates that physical activity, or participation in a sports club, in a supportive social environment has mental and physical health benefits. Adults with IDD, on average, engage in low levels of physical activity. The purpose of this study was to compare the rates of depression among young adult Special Olympics participants with IDD compared to non-participants with IDD.

METHODS

This was a 20-year retrospective cohort study of young adults (19-29 years) with IDD in the province of Ontario, Canada that compared rates of depression among Special Olympics participants (n = 8710) to non-participants (n = 42,393) using administrative health databases housed at ICES (formerly the Institute for Clinical Evaluative Sciences). Using cox proportional hazard models, the crude hazard ratios were calculated for the association between each independent variable and the dependent variable.

RESULTS

After controlling for other variables, the hazard rate for depression among Special Olympics participants compared to the hazard rate for depression among non-participants generated an adjusted hazard ratio of 0.51. Over the 20-year follow-up, the participants were 0.51 times as likely to develop depression as non-participants; this represents a 49% reduction in risk among Special Olympics participants. This result was statistically significant and represents a medium effect size.

CONCLUSION

Future research is needed on how much of this risk reduction is related to a physiological response to physical activity/exercise, and how much is related to the social connectedness of being part of a group participating in Special Olympics.

Association between sports participation and overall health in children and adolescents

Emerging evidence revealed that participating in sports may have benefits for health, but the association between sports participation and self-rated overall health has not been clearly established in children and adolescents. The present study aimed to examine the cross-sectional relationships between sports participation and self-rated overall health. A national sample of 42,777 (mean age = 9.4 ± 5.2, 48.3% girls) United States children and adolescents completed self-administered questionnaires and were included in the final analysis. The crude and adjusted odds ratio (ORs) and 95% CI were used to analyze the association between sports participation and self-rated overall health. Results indicated that children and adolescents participated in sports were more likely to report better overall health (OR = 1.92, 95%CI: 1.83, 2.02) compared to those not participating in sports. This study found that sport participation was positively associated with self-rated overall health in children and adolescents. This study offers evidence concerning adolescents' health literacy promotion.

Winning Conditions for the Adoption and Maintenance of Long-Term Healthy Lifestyles According to Physical Activity Students

The literature has not yet well documented the relative elements of the adoption of healthy lifestyle habits (HLHs) over the long term. More especially, researchers are calling to complete the corpus with qualitative or mixed estimates that would allow them to better explain the conditions necessary for the adoption or maintenance of HLHs over the long term. The present study seeks to understand the winning conditions for the adoption and maintenance of HLHs. Semi-structured group interviews were conducted with three groups of university students (two in Bachelor’s degree in physical education (PE) and one in Master’s degree in physical activity science), all in favor with HLHs. The results identify some dominant winning conditions in the adoption and maintenance of HLHs, such as the role of the family environment, the role of diversity and choice in physical activities during youth, the physical and social environment, autonomy and also mental health, which is closely linked with physical health. Results were modelled in the form of an ideal pathway, which traces the impact of winning conditions from childhood to adulthood. The originality of this study stands out, among other things, because of its innovative methodology; therefore, this study opens the door to future qualitative research in the field. Investigating pathways, considering the different phases of development of children and adolescents to identify factors of change and maintenance of HLHs now seems to be an interesting and necessary avenue for research in the field.

Adult brain cytogenesis in the context of mood disorders: From neurogenesis to the emergent role of gliogenesis

Psychiatric disorders severely impact patients' lives. Motivational, cognitive and emotional deficits are the most common symptoms observed in these patients and no effective treatment is still available, either due to the adverse side effects or the low rate of efficacy of currently available drugs. Neurogenesis recovery has been one important focus in the treatment of psychiatric disorders, which undeniably contributes to the therapeutic action of antidepressants. However, glial plasticity is emerging as a new strategy to explore the deficits observed in mood disorders and the efficacy of therapeutic interventions. Thus, it is crucial to understand the mechanisms behind glio- and neurogenesis to better define treatments and preventive therapies, once adult cytogenesis is of pivotal importance to cognitive and emotional components of behavior, both in healthy and pathological contexts, including in psychiatric disorders. Here, we review the concepts and history of neuro- and gliogenesis, providing as well a reflection on the functional importance of cytogenesis in the context of disease.

Association between pattern of team sport participation from adolescence to young adulthood and mental health

We examined relationships between pattern of team sport participation during the transition from adolescence to young adulthood (ie, non-participants, initiators, discontinuers, sustainers) and indicators of mental health. Data on team sport participation and mental health from high school to young adulthood were drawn from the longitudinal NDIT study. After controlling for demographics, physical activity, and previous mental health, one-way MANCOVA and ANCOVAs indicated that pattern of team sport participation was associated with stress, F(2,706) =8.28, p < .01, and coping, F(2,706) = 10.66, p < .01 in young adulthood. Compared to non-participants (24% of sample) or those who discontinued team sport after adolescence (51%), individuals who sustained team sport participation from adolescence to young adulthood (22%) reported lower stress and better coping levels. Bivariate regression analysis indicated that, compared to non-participants, team sport sustainers were less likely to experience panic disorder symptoms (OR =0.57, 95% CI [0.34, 0.94], p = .03). There were too few team sport initiators (2%) to be included in analyses. Sustained team sport participation during the transition from adolescence to young adulthood may promote better mental health. Further research is needed to ascertain causality and develop strategies to encourage individuals to join sport teams during adolescence and sustain participation while transitioning to young adulthood.

The Protective Roles of Exercise and Maintenance of Daily Living Routines for Chinese Adolescents During the COVID-19 Quarantine Period

PURPOSE

Adolescents are particularly vulnerable during the COVID-19 quarantine periods and may be at risk for developing psychological distress symptoms that extend beyond a crisis, including depression. This study examined adolescents' postquarantine depressive symptoms associated with pandemic stressors. The primary aim was to identify potential protective factors that may buffer the association between the presence of COVID-19 cases in adolescents' communities and their postquarantine depressive symptoms.

METHODS

Adolescents from public schools were recruited from Zhengzhou city, Henan, China (N = 1,487, M_age=13.14 years, 50% girls). Adolescents reported the presence of confirmed or suspected COVID-19 cases in their communities, their daily activities and routines during the 2-month quarantine period, and depressive symptoms after the quarantine period.

RESULTS

The presence of cases in adolescents' communities during the quarantine contributed to more depressive symptoms in adolescents after the quarantine. This association was buffered by adolescents' spending more time on physical activities and better maintenance of daily living routines during the quarantine period. The presence of community infection was also more strongly associated with depressive symptoms in older adolescents.

CONCLUSIONS

The presence of COVID-19 cases in communities contributed to adolescents' poorer mental health, and the association was stronger for older adolescents. Spending time on physical activities and maintaining daily living routines during the quarantine appear to be practical strategies that can be used by adolescents to mitigate the association between pandemic stressors and their diminishing mental health.

Urinary incontinence in young women: Risk factors, management strategies, help-seeking behavior, and perceptions about bladder control

AIM

The aim was to describe the characteristics of young adult women who report urinary incontinence (UI), the types of UI they experience, the strategies they use or consider important for managing UI, and help-seeking behavior.

METHODS

Data were from the 1989-1995 Australian Longitudinal Study on Women's Health cohort (n = 8457) at age 22 to 27 (in 2017). Descriptive statistics were used to summarize: characteristics of young women who experience UI; the types of UI they experience; which strategies women use to manage UI; perceptions of bladder control; and the proportion of women who seek help (and reasons why not). Prevalence ratios for UI according to sample characteristics were calculated using Poisson regression models.

RESULTS

At age 22 to 27, 11% (n = 986) of young women reported UI in the past month. Compared with women who did not have UI, those reporting UI were 7 kg heavier on average and were more likely to be in the obese body mass index category, report high psychological distress, and have at least one child. Most women with UI reported mixed symptoms of UI (stress and urge), and used a combination of strategies to self-manage UI symptoms. Only one in five women had sought help or advice from a healthcare professional.

CONCLUSIONS

Obesity, parity, and high psychological distress are strong correlates of UI in young women. As the majority of women with UI do not seek help, the antenatal period may be a critical time for healthcare providers to identify those at risk, and encourage early prevention or effective management strategies. As physical activity is positively associated with better outcomes for obesity and psychological distress, there may also be concurrent improvements in UI if these issues are addressed.

Enhancement of Hippocampal Plasticity by Physical Exercise as a Polypill for Stress and Depression: A Review

Generation of newborn neurons that form functional synaptic connections in the dentate gyrus of adult mammals, known as adult hippocampal neurogenesis, has been suggested to play critical roles in regulating mood, as well as certain forms of hippocampus-dependent learning and memory. Environmental stress suppresses structural plasticity including adult neurogenesis and dendritic remodeling in the hippocampus, whereas physical exercise exerts opposite effects. Here, we review recent discoveries on the potential mechanisms concerning how physical exercise mitigates the stressrelated depressive disorders, with a focus on the perspective of modulation on hippocampal neurogenesis, dendritic remodeling and synaptic plasticity. Unmasking such mechanisms may help devise new drugs in the future for treating neuropsychiatric disorders involving impaired neural plasticity.

Consistent participation in organized physical activity predicts emotional adjustment in children

BACKGROUND

The objectives of this study were to derive trajectories of childhood participation in organized physical activity (PA) and to examine how these trajectories are associated with pre-existing and subsequent emotional adjustment.

METHODS

Trajectories of mother-reported participation in organized PA were derived from age 6 to 10 for 1492 children from the Québec Longitudinal Study of Child Development birth cohort. Parents and teachers reported on internalizing behavior (emotional distress, anxiety, shyness, social withdrawal) at ages 4 and 12, respectively.

RESULTS

Longitudinal latent class analysis identified two typical trajectories of participation in organized PA. The Consistent Participation trajectory (61%) included children with elevated probability of participation at all ages. The Low-Inconsistent Participation trajectory (39%) included children who did not participate or participated only once or twice, generally in late childhood. Pre-existing internalizing behavior at age 4 did not predict trajectory membership. However, children in the Low-Inconsistent Participation trajectory showed higher subsequent emotional distress (B = 0.87, 95% confidence interval [CI] = 0.46-1.28), anxiety (B = 0.61, 95% CI = 0.18-1.04), shyness (B = 0.92, 95% CI = 0.39-1.44), and social withdrawal (B = 0.86, 95% CI = 0.37-1.34) at age 12 than those in the Consistent Participation trajectory.

CONCLUSIONS

Our findings suggest that early and sustained involvement in organized PA is beneficial for children's emotional development.

The effects of acute aerobic exercise on mood and inflammation in individuals with multiple sclerosis and incomplete spinal cord injury

BACKGROUND

Spinal cord injury (SCI) and multiple sclerosis (MS) are associated with increased risks of depression. Acute exercise may improve mood in these populations via its affect on inflammation.

OBJECTIVE

To determine if acute exercise can positively affect mood in individuals with SCI and MS, and whether exercise-induced changes in inflammation contribute to such improvements.

METHODS

Thirteen participants completed 30 minutes of moderate-intensity exercise. Mood data (POMS questionnaire) and blood samples were taken before and after exercise, and blood was analyzed for inflammatory mediators and kynurenine pathway metabolites.

RESULTS

There was a significant reduction in total mood disturbance (TMD) pre to post-exercise, and pre to one-hour post-exercise. There was a significant decrease in TNF-α from pre to post-exercise, with further reductions one-hour post-exercise. There were no correlations between changes in TMD and changes in inflammation. However, changes in certain cytokines showed significant or trending correlations with changes in subsets of the POMS. Likewise, there was a trend for a correlation between exercise-induced changes in KYN/TRP and depression (p = 0.096).

CONCLUSIONS

Acute exercise can positively affect mood after SCI and MS, and this change may be partially accounted for by exercise-induced changes in inflammation. This relationship may be, in part, kynurenine pathway-dependent.

Comparison of surf and hike therapy for active duty service members with major depressive disorder: Study protocol for a randomized controlled trial of novel interventions in a naturalistic setting

Many active duty service members suffer from major depressive disorder (MDD). Although traditional treatments exist, alternative approaches may also be effective in treating depressive symptoms. Previous research has shown that physical activity has significant positive effects on depression symptoms in individuals with MDD, and that these benefits may be enhanced when physical activity occurs in a natural environment. Even though physical activity (i.e., hiking, walking) in natural environments has been shown to reduce depressive symptoms, water-based activity occurring in a natural environment (e.g., surfing) may produce even greater improvements in depressive symptoms. We detail an ongoing randomized controlled trial (RCT) comparing the efficacy of surf therapy and hike therapy with respect to immediate and longer-term psychological, physical, and functional outcomes in active duty service members with MDD. We describe the methodological development of this RCT evaluating novel treatment approaches and discuss considerations for evaluating physical activity interventions in a naturalistic setting.

Anti-depressant effects of oil from fructus gardeniae via PKA-CREB-BDNF signaling

The dried ripe fruit of Gardenia jasminoides Ellis was usually applied as an herb medicine in Traditional Chinese Medicine. It was suggested that the Gardenia jasminoides oil extract (oil from Fructus Gardeniae [OFG]) might serve as a potential treatment for depression, whereas its pathogenesis still remained not fully understood. The present research was conducted to evaluate the anti-depressive effect of OFG in mice and explore its potential mechanism. The OFG and ketamine (KET) were intragastrically and intraperitoneally treated, respectively. Thereafter, the animals were subjected to the behavior tests. The expressions of protein kinase A (PKA), brain derived neurotrophic factor (BDNF), cAMP response element-binding protein (CREB) in hippocampus were detected by Western blot. The selective PKA inhibitor H-89 was also applied to confirm the mechanism. As a result, OFG and KET treatment improved the behavior performance. Furthermore, the administrations of OFG effectively enhanced the expressions of PKA, p-CREB, and BDNF. With the application of selective PKA inhibitor H-89, the ameliorated effects caused by OFG were blocked, but not by KET. In conclusion, the presented work indicated that OFG-exerted protective effect on depression through PKA-CREB-BDNF signaling.

Role of Chronic Stress and Exercise on Microvascular Function in Metabolic Syndrome

PURPOSE

The present study examined the effect of unpredictable chronic mild stress (UCMS) on peripheral microvessel function in healthy and metabolic syndrome (MetS) rodents and whether exercise training could prevent the vascular dysfunction associated with UCMS.

METHODS

Lean and obese (model of MetS) Zucker rats (LZR and OZR) were exposed to 8 wk of UCMS, exercise (Ex), UCMS + Ex, or control conditions. At the end of the intervention, gracilis arterioles (GA) were isolated and hung in a pressurized myobath to assess endothelium-dependent (EDD) and endothelium-independent (EID) dilation. Levels of nitric oxide (NO) and reactive oxygen species (ROS) were measured through 4-amino-5-methylamino-2',7'-difluorofluorescein diacetate and dihydroethidium staining, respectively.

RESULTS

Compared with LZR controls, EDD and EID were lower (P = 0.0001) in LZR-UCMS. The OZR-Ex group had a higher EDD (P = 0.0001) and EID (P = 0.003) compared with OZR controls, whereas only a difference in EDD (P = 0.01) was noted between the LZR-control and LZR-Ex groups. Importantly, EDD and EID were higher in the LZR (P = 0.0001; P = 0.02) and OZR (P = 0.0001; P = 0.02) UCMS + Ex groups compared with UCMS alone. Lower NO bioavailability and higher ROS were noted in the LZR-UCMS group (P = 0.0001), but not OZR-UCMS, compared with controls. The Ex and UCMS-Ex groups had higher NO bioavailability (P = 0.0001) compared with the control and UCMS groups, but ROS levels remained high.

CONCLUSIONS

The comorbidity between UCMS and MetS does not exacerbate the effects of one another on GA EDD responses, but does lead to the development of other vasculopathy adaptations, which can be partially explained by alterations in NO and ROS production. Importantly, exercise training alleviates most of the negative effects of UCMS on GA function.

Immediate and persistent antidepressant-like effects of Chaihu-jia-Longgu-Muli-tang are associated with instantly up-regulated BDNF in the hippocampus of mice

Conventional antidepressants have a disadvantage in delayed onset of efficacy. Here, we aimed to evaluate the immediate and persistent antidepressant-like action of a classic herbal medicine Chaihu-jia-Longgu-Muli decoction (CLM) as well as the action of CLM on hippocampal brain-derived neurotrophic factor (BDNF) over time. CLM consists of Xiaochaihu decoction (XchD), Longgu-Muli (LM) and several other herbs. The contribution of constituent herbal formula XchD and other parts of CLM was also assessed. Following a single dose of CLM, tail suspension test (TST), forced swim test (FST), and novelty-suppressed feeding test (NSF) were performed. The antidepressant activity of XchD, its interaction with LM or remaining parts of CLM was also examined after a single administration. BDNF expression in the hippocampus was examined at 30 min and 24 hr post a single CLM. A single administration of half of clinical dose of CLM elicited antidepressant effects at TST 30 min post administration, and lasted for 72 hr. Furthermore, CLM also reduced the latency to eat in NSF test. A single proportional dose of XchD induced antidepressant effects at 30 min and lasted for 48 hr, whereas the effect lasted for 72 hr when combined with either LM or the remaining parts of CLM. BDNF expression increased at 30 min and persisted at least for 24 hr after a single dose of CLM. The results support that Chaihu-jia-Longgu-Muli decoction was capable to immediately and enduringly elicit antidepressant activity via enhancement of hippocampal BDNF expression, in which the constituent Xiaochaihu decoction played the primary role.

Prospective associations between sport participation and psychological adjustment in adolescents

BACKGROUND

Engaging in sport has been suggested to be mitigate against psychological distress. Using a prospective-longitudinal design, we examine whether sport participation is associated with reduced psychological difficulties in adolescents and whether associations differ by sport and personal characteristics.

METHODS

17 550 adolescents from grade 7 to 10 (mean age=14.4 years old) self-reported on sport participation, depressive symptoms, social anxiety symptoms and loneliness in Spring 2007 and 1 year later. Analyses tested the association between sport participation and subsequent psychological difficulties using linear regression, while adjusting for pre-existing psychological and sociodemographic characteristics. Analyses also verified whether associations differed by sport frequency (weekly/more than weekly) and type (team/individual) using Wald tests of parameter constraints, as well as sex, age and pre-existing psychological difficulties using interaction terms.

RESULTS

After adjusting for potential confounders, sport participation predicted lower social anxiety symptoms (beta=-0.02 (-0.04, -0.01)) and loneliness (beta=-0.04 (-0.05, -0.02)), but not depressive symptoms. Moderation analyses showed that sport participation predicted greater reductions in depressive symptoms, social anxiety symptoms and loneliness in adolescents with higher baseline scores on each outcome. Associations did not differ by sport frequency and type, sex and age. Post hoc analyses revealed bidirectional associations between sport participation and social anxiety symptoms and loneliness.

CONCLUSIONS

Sport participation predicts small reductions in adolescent psychological distress. Reductions seem most important in youth experiencing greater pre-existing psychological difficulty. Our findings suggest that sport participation represents a protective factor that supports psychological resilience in at-risk youth.

Potential Mechanisms Underlying Centralized Pain and Emerging Therapeutic Interventions

Centralized pain syndromes are associated with changes within the central nervous system that amplify peripheral input and/or generate the perception of pain in the absence of a noxious stimulus. Examples of idiopathic functional disorders that are often categorized as centralized pain syndromes include fibromyalgia, chronic pelvic pain syndromes, migraine, and temporomandibular disorder. Patients often suffer from widespread pain, associated with more than one specific syndrome, and report fatigue, mood and sleep disturbances, and poor quality of life. The high degree of symptom comorbidity and a lack of definitive underlying etiology make these syndromes notoriously difficult to treat. The main purpose of this review article is to discuss potential mechanisms of centrally-driven pain amplification and how they may contribute to increased comorbidity, poorer pain outcomes, and decreased quality of life in patients diagnosed with centralized pain syndromes, as well as discuss emerging non-pharmacological therapies that improve symptomology associated with these syndromes. Abnormal regulation and output of the hypothalamic-pituitary-adrenal (HPA) axis is commonly associated with centralized pain disorders. The HPA axis is the primary stress response system and its activation results in downstream production of cortisol and a dampening of the immune response. Patients with centralized pain syndromes often present with hyper- or hypocortisolism and evidence of altered downstream signaling from the HPA axis including increased Mast cell (MC) infiltration and activation, which can lead to sensitization of nearby nociceptive afferents. Increased peripheral input via nociceptor activation can lead to “hyperalgesic priming” and/or “wind-up” and eventually to central sensitization through long term potentiation in the central nervous system. Other evidence of central modifications has been observed through brain imaging studies of functional connectivity and magnetic resonance spectroscopy and are shown to contribute to the widespreadness of pain and poor mood in patients with fibromyalgia and chronic urological pain. Non-pharmacological therapeutics, including exercise and cognitive behavioral therapy (CBT), have shown great promise in treating symptoms of centralized pain.

Behavioral activation versus physical activity via the internet: A randomized controlled trial

BACKGROUND

A major problem today is that only about fifty percent of those affected by depression seeks help. One way to reach more sufferers would be by offering easily accessible internet based treatments. The purpose of this study was to compare/evaluate four therapist supported internet administered treatments.

METHOD/RESULTS

Two hundred eighty six participants were included. The treatment period lasted twelve weeks, consisting of the following treatments: 1) physical activity without treatment rational, 2) physical activity with treatment rational, 3) behavioral activation without treatment rational and 4) behavioral activation with treatment rational. All groups (including a control-group) showed a significant decrease in depressive symptoms. When the treatment groups were pooled and compared to the control group, there were significant differences from pretest to posttest (Hedges g_av treatment =1.01, control group =0.47). This held true also when each of the four treatment groups was compared to the control group, with one exception: Physical activity without treatment rationale.

LIMITATIONS

The differences between how many modules the participants completed could indicate that there are other factors than the treatments that caused the symptom reduction, however, the dose-response analysis did not detect any significant differences on account of modules completed.

CONCLUSIONS

The results support the positive effects of internet administered treatments for depression, and highlights the importance of psychoeducation, which tends to affect both the treatment outcome and the probability of remaining in treatment. These aspects need to be considered when developing and conducting new treatments for depression, since they would increase the likelihood of positive treatment outcomes.

Depression, Social Isolation, and the Lived Experience of Dancing in Disadvantaged Adults

This qualitative study described the lived experience of dancing as it related to depression and social isolation in 16 disadvantaged adults who completed a 12-week dance intervention. It is the first qualitative study to explore the experience of dance as an adjunct therapy, depression, and social isolation. A descriptive phenomenological framework consisted of two focus groups using semi-structured interviews. A Giorgian approach guided thematic analysis. Four themes emerged: (1) dance for myself and health, (2) social acceptance, (3) connection with others: a group, and (4) not wanting to stop: unexpected benefits from dancing. As the participants continued to dance, they developed a sense of belonging and group identity, which may have maintained group involvement and contributed to reducing depression and social isolation. Thus, dancing is a complementary therapy that should be considered when working with adults with depression and social isolation.

Synthesis of Chlorinated Tetracyclic Compounds and Testing for Their Potential Antidepressant Effect in Mice

The synthesis of the tetracyclic compounds 1-(4,5-dichloro-9,10-dihydro-9,10-ethanoanthracen-11-yl)-N-methylmethanamine (5) and 1-(1,8-dichloro-9,10-dihydro-9,10-ethanoanthracen-11-yl)-N-methylmethanamine (6) as a homologue of the anxiolytic and antidepressant drugs benzoctamine and maprotiline were described. The key intermediate aldehydes (3) and (4) were successfully synthesized via a [4 + 2] cycloaddition between acrolein and 1,8-dichloroanthracene. The synthesized compounds were investigated for antidepressant activity using the forced swimming test. Compounds (5), (6) and (3) showed significant reduction in the mice immobility indicating significant antidepressant effects. These compounds significantly reduced the immobility times at a dose 80 mg/kg by 84.0%, 86.7% and 71.1% respectively.

Trazodone treatment protects neuronal-like cells from inflammatory insult by inhibiting NF-κB, p38 and JNK

Growing evidence suggests that alterations of the inflammatory/immune system contribute to the pathogenesis of major depression and that inflammatory processes may influence the antidepressant treatment response. Depressed patients exhibit increased levels of inflammatory markers in both the periphery and brain, and high co-morbidity exists between depression and diseases associated with inflammatory alterations. Trazodone (TDZ) is a triazolopyridine derivative that belongs to the class of serotonin receptor antagonists and reuptake inhibitors. Although the trophic and protective properties of classic antidepressants have extensively been exploited, the effects of TDZ remain to be fully elucidated. In this study, the pharmacological activities of TDZ on human neuronal-like cells were investigated under both physiological and inflammatory conditions. An in vitro inflammatory model was established using lipopolysaccharide (LPS) and tumour necrosis factor-α (TNF-α), which efficiently mimic the stress-related changes in neurotrophic and pro-inflammatory genes. Our results showed that TDZ significantly increased the mRNA expression of both brain-derived nerve factor (BDNF) and cAMP response element-binding protein (CREB) and decreased the cellular release of the pro-inflammatory cytokine interferon gamma (IFN-γ) in neuronal-like cells. In contrast, neuronal cell treatment with LPS and TNF-α decreased the expression of CREB and BDNF and increased the expression of nuclear factor kappa B (NF-κB), a primary transcription factor that functions in inflammatory response initiation. Moreover, the two agents induced the release of pro-inflammatory cytokines (i.e., interleukin-6 and IFN-γ) and decreased the production of the anti-inflammatory cytokine interleukin-10. TDZ pre-treatment completely reversed the decrease in cell viability and counteracted the decrease in BDNF and CREB expression mediated by LPS-TNF-α. In addition, the production of inflammatory mediators was inhibited, and the release of interleukin-10 was restored to control levels. Furthermore, the intracellular signalling mechanism regulating TDZ-elicited effects was specifically investigated. TDZ induced extracellular signal-regulated kinase (ERK) phosphorylation and inhibited constitutive p38 activation. Moreover, TDZ counteracted the activation of p38 and c-Jun NH2-terminal kinase (JNK) elicited by LPS-TNF-α, suggesting that the neuro-protective role of TDZ could be mediated by p38 and JNK. Overall, our results demonstrated that the protective effects of TDZ under inflammation in neuronal-like cells function by decreasing pro-inflammatory signalling and by enhancing anti-inflammatory signalling.

Rapid Antidepressant Activity of Ethanol Extract of Gardenia jasminoides Ellis Is Associated with Upregulation of BDNF Expression in the Hippocampus

Ethanol extract of Yueju pill, a Traditional Chinese Medicine herbal formula widely used to treat mood disorders, demonstrates rapid antidepressant effects similar to ketamine, likely via instant enhancement of brain-derived neurotrophic factor (BDNF) expression in the hippocampus. Here we investigated ethanol extracts of the constituent herbs of Yueju responsible for rapid antidepressant effects. Screening with tail suspension test in Kunming mice at 24 hours after a single administration of five individual constituent herbs of Yueju, we found that only Gardenia jasminoides Ellis (GJ) showed a significant effect. The antidepressant response started at 2 hours after GJ administration. Similar to Yueju and ketamine, a single administration of GJ significantly reduced the number of escape failures in the learned helplessness test. Furthermore, GJ decreased latency of food consumption in the novelty suppressed-feeding test. Additionally, starting from 2 hours and continuing for over 20 hours after GJ administration, BDNF expression in the hippocampus was upregulated, temporally linked with the antidepressant response. These findings suggest that GJ has rapid antidepressant effects, which are associated with the elevated expression of BDNF in the hippocampus. In Yueju formula, Yue represents GJ, as thus our study demonstrates the primary role of GJ in rapid antidepressant efficacy of Yueju.

School sport participation during adolescence and mental health in early adulthood

PURPOSE

This longitudinal study examined the association between participation in school sport during adolescence and mental health in early adulthood.

METHODS

Adolescents (n = 853) reported participation in school sport in each grade throughout the 5 years of secondary school. In early adulthood, participants reported depressive symptoms, level of stress, and self-rated mental health.

RESULTS

Involvement in school sport during adolescence was a statistically significant predictor of lower depression symptoms, lower perceived stress, and higher self-rated mental health in young adulthood.

CONCLUSIONS

School sport participation may protect against poor mental health in early adulthood. Policies to increase school sport participation may be warranted as part of public health strategies to promote mental health.

Self-reported physical activity predicts pain inhibitory and facilitatory function

Considerable evidence suggests regular physical activity can reduce chronic pain symptoms. The dysfunction of endogenous facilitatory and inhibitory systems has been implicated in multiple chronic pain conditions. However, few studies have investigated the relationship between levels of physical activity and descending pain modulatory function.

PURPOSE

The purpose of this study was to determine whether self-reported levels of physical activity in healthy adults predicted 1) pain sensitivity to heat and cold stimuli, 2) pain facilitatory function as tested by temporal summation (TS) of pain, and 3) pain inhibitory function as tested by conditioned pain modulation (CPM) and offset analgesia.

METHODS

Forty-eight healthy adults (age range = 18-76 yr) completed the International Physical Activity Questionnaire (IPAQ) and the following pain tests: heat pain thresholds, heat pain suprathresholds, cold pressor pain, TS of heat pain, CPM, and offset analgesia. The IPAQ measured levels of walking, moderate, vigorous, and total physical activity over the past 7 d. Hierarchical linear regressions were conducted to determine the relationship between each pain test and self-reported levels of physical activity while controlling for age, sex, and psychological variables.

RESULTS

Self-reported total and vigorous physical activity predicted TS and CPM (P < 0.05). Individuals who self-reported more vigorous and total physical activity exhibited reduced TS of pain and greater CPM. The IPAQ measures did not predict any of the other pain measures.

CONCLUSIONS

These results suggest that healthy older and younger adults who self-report greater levels of vigorous and total physical activity exhibit enhanced descending pain modulatory function. Improved descending pain modulation may be a mechanism through which exercise reduces or prevents chronic pain symptoms.

Exercise Intervention to Reduce Depressive Symptoms in Adults with Intellectual Disabilities

People with intellectual disabilities are often reported as having depressive symptoms. Although the antidepressant effect of exercise has been systematically recognized, research concerning the role of exercise on depressive symptoms in people with intellectual disabilities is still scant. A 12-wk. exercise intervention for depressive symptoms in a group of adults with intellectual disabilities was conducted. Participants were 16 men and 11 women, randomly assigned to an exercise group ( n = 14) or to a control group ( n = 13). The Zung Self-Rating Depression Scale adapted for people with intellectual disabilities was administered at baseline, after 6 wk. and at the end of the intervention. There were statistically significant reductions in scores for the exercise group compared with the control group. Results support the notion that exercise can improve well-being in people with intellectual disabilities.

Impact of a fitness intervention on medical students

OBJECTIVE

It is known that regular exercise improves both physical and mental health. This study sought to determine the impact of a fitness intervention on the levels of exercise and well-being of medical students.

METHODS

In 2011, the authors conducted a prospective cohort study involving medical students at the Johns Hopkins School of Medicine. Intervention students experienced a 7-week, team-based, fitness competition and recorded exercise data online. Incentives were given to teams reaching an average of 150 minutes per teammate per week, an exercise goal recommended by the US Department of Health and Human Services. Both groups completed baseline and follow-up surveys about physical activity and well-being, using validated scoring methods.

RESULTS

A total of 100 students (71 in the intervention group and 29 in the control group) participated fully, recording their exercise behaviors and completing both the pre- and postsurveys. In the intervention group, the percentage of individuals successfully reaching the exercise target of 150 minutes per week varied by week from 30% to 61%. Intervention students showed a significant improvement in their International Physical Activity Questionnaire scores (1669.4 ± 154.9 vs 2013.6 ± 174.6; P = 0.02) and levels of irritability on the subsection of the Positive Affect and Negative Affect Scale score (2.2 ± 0.1 vs 2.0 ± 0.1, P = 0.03). By contrast, the control group did not show any improvements in any of these measures across the same time period (all P > 0.05).

CONCLUSIONS

A well-orchestrated student-designed fitness intervention can effectively augment medical students' exercise practices and positively affect well-being.

Design and Rationale for a Randomized Controlled Trial Testing the Efficacy of Aerobic Exercise for Patients with Obsessive-Compulsive Disorder

BACKGROUND: Over the last two decades very few advances have been made in the development of new treatments for obsessive-compulsive disorder (OCD). While patients with OCD improve with available treatments (pharmacotherapy and/or cognitive-behavioral therapy), moderate levels of OCD symptoms often persist even with adequate doses and durations of these treatments. Building on the growing body of evidence for the efficacy of exercise in the treatment of other psychiatric disorders, interventions to increase aerobic exercise in patients with OCD represent a potentially useful yet relatively unexplored strategy in OCD. METHODS/DESIGN: One hundred and two (102) patients with clinically significant OCD symptoms despite current engagement in recommended treatments (pharmacotherapy and/or CBT) will be randomly assigned to receive either a 12-week moderate intensity aerobic exercise (AE) intervention or a health education control (HEC) intervention. Follow-up interviews will be conducted at the end of treatment and at 3-, 6- and 12-months post-intervention. They will assess OCD severity, nonspecific anxiety, depression, quality of life, cardiorespiratory fitness and cognition (executive function). DISCUSSION: If efficacy is established, patients with OCD who have clinically significant residual symptoms despite current pharmacotherapy or CBT would gain a valuable and practical treatment augmentation option.

Antidepressant-like effect of sodium butyrate (HDAC inhibitor) and its molecular mechanism of action in the rat hippocampus

OBJECTIVES

Epigenetic mechanisms, such as changes in gene expression resulting from chromatin remodeling through histone acetylation, have been implicated in the pathophysiology of depression. However, the antidepressant-like effect of the histone deacetylase inhibitor sodium butyrate (SB) has been inconclusive. The aim of this study was to examine the antidepressant-like effect of SB and elucidate its molecular mechanisms.

METHODS

We examined the antidepressant-like effect of SB in a forced swim test (FST) and a tail suspension test (TST). Hippocampal gene expression analyses using DNA microarray and real-time PCR were undertaken. Western blotting and ChIP assay were undertaken to examine whether histone acetylation was associated with changes in gene expression by SB.

RESULTS

Repeated administration of SB significantly reduced immobility on the FST and the TST, and significantly altered the levels of mRNA for several genes; e.g., upregulation of transthyretin (Ttr) and downregulation of serotonin 2A receptor (Htr2a). Western blotting and ChIP assay revealed selective increases in histone H4 acetylation at the promoter of the Ttr gene with a significant increase in Ttr immunoreactivity 24 h after the final administration of SB.

CONCLUSION

These findings suggest the possibility that alterations in gene expression, including upregulation of Ttr and downregulation of several other genes, including Htr2a, may be involved in antidepressant-like effect of SB.

Mood disorders in everyday life: a systematic review of experience sampling and ecological momentary assessment studies

In the past two decades, the study of mood disorder patients using experience sampling methods (ESM) and ecological momentary assessment (EMA) has yielded important findings. In patients with major depressive disorder (MDD), the dynamics of their everyday mood have been associated with various aspects of their lives. To some degree similar studies have been conducted in patients with bipolar disorder (BD). In this paper we present the results of a systematic review of all ESM/EMA studies in MDD and BD to date. We focus not only on the correlates of patients' everyday mood but also on the impact on treatment, residual symptoms in remitted patients, on findings in pediatric populations, on MDD/BD specificity, and on links with neuroscience. After reviewing these six topics, we highlight the benefits of ESM/EMA for researchers, clinicians, and patients, and offer suggestions for future studies.

Neuroimmunological effects of physical exercise in depression

The search for an extended understanding of the causes of depression, and for the development of additional effective treatments is highly significant. Clinical and pre-clinical studies suggest stress is a key mediator in the pathophysiology of depression. Exercise is a readily available therapeutic option, effective as a first-line treatment in mild to moderate depression. In pre-clinical models exercise attenuates stress-related depression-like behaviours. Cellular and humoral neuroimmune mechanisms beyond inflammation and oxidative stress are highly significant in understanding depression pathogenesis. The effects of exercise on such mechanisms are unclear. When clinical and pre-clinical data is taken together, exercise may reduce inflammation and oxidation stress via a multitude of cellular and humoral neuroimmune changes. Astrocytes, microglia and T cells have an antiinflammatory and neuroprotective functions via a variety of mechanisms. It is unknown whether exercise has effects on specific neuroimmune markers implicated in the pathogenesis of depression such as markers of immunosenescence, B or T cell reactivity, astrocyte populations, self-specific CD4+ T cells, T helper 17 cells or T regulatory cells.

LPS inhibits the effects of fluoxetine on depression-like behavior and hippocampal neurogenesis in rats

Depressed patients with increased inflammatory cytokines in peripheral blood have been reported to be more likely to exhibit treatment resistance. However, it is unknown whether the inflammation influences the action of antidepressant drugs. Here, we investigated the influence of lipopolysaccharide (LPS) on the antidepressant action of fluoxetine in depressive rats induced by chronic unpredictable mild stress (CUMS). In this study, we first modified the CUMS paradigm by administration of LPS daily before the stressor, and then investigated the influence of inflammation on the antidepressant action of fluoxetine. The effects of stress exposure and antidepressant treatment were assessed by behavioral testing (sucrose preference test, forced swimming test, novelty suppressed feeding test) and hippocampal BrdU labeling. The CUMS-induced behavioral changes can be reversed by 4-week fluoxetine treatment. Fluoxetine also increased the hippocampal neurogenesis in the depressive rats. Pretreatment with LPS, to mimic inflammation, had no significant effect on depressive behavior but attenuated the antidepressant action of fluoxetine significantly. Thus, our results suggest that the inflammation might play a certain role in the pathophysiology of antidepressant treatment resistance.

Moderate exercise improves depression parameters in treatment-resistant patients with major depressive disorder

BACKGROUND

Treatment-resistant major depressive disorder (MDD) is a complex condition, with very low remission rates. Physical exercise has been used, with some encouraging results, as an alternative therapy in other depressive disorders. This study assessed the impact on depression and functioning parameters of a moderate intensity exercise program, as an adjuvant to pharmacotherapy, in treatment-resistant MDD patients.

METHODS

150 individuals with treatment-resistant MDD, defined as taking combined therapy in doses considered adequate for 9-15 months, without showing clinical remission, were initially screened. 33 were randomized to one of two groups: usual pharmacotherapy (N = 11) and usual pharmacotherapy plus aerobic exercise (N = 22). The exercise program consisted of home-based 30-45 min/day walks, 5 days/week, for 12 weeks, being 1 walk per week supervised.

RESULTS

The exercise group showed improvement of all depression and functioning parameters, as indicated by lower HAMD17, BDI and CGI-S and higher GAF (p < 0.05) at last observation compared both to baseline values and to control group. At the end of the study none of the participants in the control group showed response or remission, whilst in the exercise group 21% of participants showed response and 26% remission, although these differences were not statistically significant.

CONCLUSION

A 12 week, home-based exercise program of 30-45 min/day walks, 5 days/week, improved depression and functioning parameters in treatment-resistant MDD patients, and contributed to remission of 26% of these patients. Moderate intensity exercise may be a helpful and effective adjuvant therapy for treatment-resistant MDD.

Cytokines mediated inflammation and decreased neurogenesis in animal models of depression

In patients with major depression or in animal models of depression, significantly increases in the concentrations of pro-inflammatory cytokines have been consistently reported. Proinflammatory cytokines can stimulate the hypothalamic-pituitary-adrenal (HPA) axis to release stress hormone, glucocorticoids. As a consequence of excessive inflammatory response triggered by pro-inflammatory cytokines in the periphery, free radicals, oxidants and glucocorticoids are over-produced, which can affect glial cell functions and damage neurons in the brain. Indeed, decreased neurogenesis and the dysfunction of neurotrophic system (up- or down-regulations of neurotrophins and their receptors) have been recently found. Effective treatments for depressive symptoms, such as antidepressants and omega-3 fatty acids can increase or modulate neurotrophic system and enhance neurogenesis. However, the relationship between glial cells; microglia (mostly involved in neuroinflammation) and astrocytes (producing neurotrophins), and the contribution of inflammation to decreased neurogenesis and dysfunction of neurotrophic system are almost unknown. This review first introduces changes in behavior, neurotransmitter, cytokine and neurogenesis aspects in depressed patients and several animal models of depression, secondly explores the possible relationship between pro- and anti-inflammatory cytokines and neurogenesis in these models, then discusses the effects of current treatments on inflammation, neurotrophic system and neurogenesis, and finally pointes out the limitations and future research directions.

Depressive symptom outcomes of physical activity interventions: meta-analysis findings

BACKGROUND

Physical activity (PA) is consistently linked to mental health outcomes.

PURPOSE

This meta-analysis synthesized depressive symptom outcomes of supervised and unsupervised PA interventions among healthy adults.

METHODS

Comprehensive searching and coding were applied to PA interventions among adults without clinical depression. Analyses included random-effects standardized means, Q, and moderator analysis using analysis of variance and regression meta-analytic analogues.

RESULTS

Treatment versus control comparisons yielded a standardized mean effect size of 0.372 among 38 supervised PA studies and 0.522 among 22 unsupervised PA studies. Preliminary moderator analyses suggested that supervised PA interventions may be more effective when they include flexibility/resistance and low-intensity exercise. Unsupervised PA interventions may be more effective when they recommend center-based PA. Methodological moderators (random assignment, control group management) were identified.

CONCLUSIONS

These findings document that PA interventions reduce depressive symptoms even in adults without clinical depression. Moderator analyses suggest directions for future research as well as practice.

High-intensity extended swimming exercise reduces pain-related behavior in mice: involvement of endogenous opioids and the serotonergic system

The present study examined the hyponociceptive effect of swimming exercise in a chemical behavioral model of nociception and the mechanisms involved in this effect. Male mice were submitted to swimming sessions (30 min/d for 5 days). Twenty-four hours after the last session, we noticed that swimming exercise decreased the number of abdominal constriction responses caused by acetic acid compared with the nonexercised group. The hyponociception caused by exercise in the acetic acid test was significantly attenuated by intraperitoneal (i.p.) pretreatment of mice with naloxone (a nonselective opioid receptor antagonist, 1 mg/kg), ρ-chlorophenylalanine methyl ester (PCPA, an inhibitor of serotonin synthesis, 100 mg/kg once a day for 4 consecutive days), and by bilateral adrenalectomy. Collectively, the present results provide experimental evidences indicating for the first time that high-intensity extended swimming exercise reduces pain-related behavior in mice. The mechanisms involve an interaction with opioid and serotonin systems. Furthermore, endogenous opioids released by adrenal glands probably are involved in this effect.

PERSPECTIVE

Our results indicate that high-intensity extended exercise endogenously controls acute pain by activation of opioidergic and serotonergic pathways. Furthermore, these results support the use of exercise as a nonpharmacological approach for the management of acute pain.