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Li J, Schaeffer EK, Miller S, Schreiber VM, Hailer YD, Clohisy JC, Kim HK, Mulpuri K. Surgeon Recommendations for Physical Activity in Patients With Pediatric Hip Conditions. J Pediatr Orthop 2024; 44:468-475. [PMID: 38835293 PMCID: PMC11299903 DOI: 10.1097/bpo.0000000000002732] [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: 06/06/2024]
Abstract
BACKGROUND While physical activity (PA) is important during youth, it is unclear if children and adolescents with developmental dysplasia of the hip (DDH), Legg-Calvé-Perthes disease (LCPD), or slipped capital femoral epiphysis (SCFE) are expected or encouraged to return to PA once they have healed. This study examines the orthopaedic surgeons' role in advising pediatric hip patients on the PA they should engage in, assessing their practice, opinions, and consensus when making recommendations. METHODS Orthopaedic surgeons were invited from member lists of 4 hip study groups. The survey included demographics, opinions regarding PA, and 10 case scenarios that queried respondents on the duration and intensity of PA as well as the restrictions on activity type that they would recommend for DDH, LCPD, or SCFE patients. Consensus was evaluated on a scale ranging from 0 to 1, with a value of 0 indicating no agreement among respondents and a value of 1 indicating complete agreement. RESULTS A total of 51 orthopaedic surgeons responded. While 94% agreed that it is important for school-aged hip patients to return to PA after they have healed, 53% believed that PA may compromise the hip and contribute to the development of osteoarthritis. Average standardized consensus was 0.92 for suggesting the patient engage in some amount of PA, 0.44 for suggesting the recommended daily minimum of 60 minutes of moderate-to-vigorous physical activity (MVPA), and 0.33 for suggesting restrictions on activity type. The most frequently selected restrictions included avoiding impact activities (93%, 235/254) and contact activities (58%, 147/254), followed by weight-bearing activities (24%, 62/254). Respondents were not aware of existing PA guidelines, although 57% expressed interest in following guidelines and 39% were uncertain. CONCLUSIONS While there is consensus among orthopaedic surgeons that children with chronic hip conditions should engage in PA, there is considerable variation when recommending the recommended daily MVPA minimum and placing restrictions on activity type. This study suggests interest among orthopaedic surgeons in developing PA guidelines that optimize outcomes for pediatric hip patients. LEVEL OF EVIDENCE Level II-Survey study.
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Affiliation(s)
- Jacqueline Li
- Departments of Orthopaedics
- Departments of Orthopaedic Surgery
| | | | - Stacey Miller
- Physical Therapy, University of British Columbia
- Physiotherapy, BC Children’s Hospital, Vancouver, British Columbia, Canada
| | - Verena M. Schreiber
- Orthopedic, Sports Medicine and Spine Institute, Nicklaus Children’s Hospital, Miami, FL
| | - Yasmin D. Hailer
- Section of Orthopaedics, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - John C. Clohisy
- Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO
| | - Harry K.W. Kim
- Scottish Rite for Children
- University of Texas Southwestern Medical Center, Dallas, TX
| | - Kishore Mulpuri
- Departments of Orthopaedics
- Departments of Orthopaedic Surgery
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Unger A, Schwarzenlander A, Wilke J. Policies and opportunities for physical activity engagement in Austrian schools: a census survey. PeerJ 2024; 12:e17794. [PMID: 39157767 PMCID: PMC11328834 DOI: 10.7717/peerj.17794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 07/01/2024] [Indexed: 08/20/2024] Open
Abstract
Background Compelling evidence suggests that schools' infrastructure and policy represent potential predictors of health and physical activity (PA) in children and adolescents. However, the translation of these findings into practice has not been examined. This study investigated the activity friendliness of Austrian schools. Methods Using a census sampling method, principals of Austrian schools (n = 342) were invited to participate in an online survey assessing 1) the availability of PA facilities (e.g. playgrounds, sports courts, swimming halls) and 2) applied PA policies (e.g. cooperation with sports clubs and involvement in PA projects). Results A total of 130 principals answered the survey which corresponds to a minimal response rate of 38%. While most schools (87.4%, n = 111) had a gymnastic hall, only one third (37%, n = 47) had access to a swimming hall. On average, the schools had 4.2 ± 2 PA facilities with significant variation between school types (i.e., high schools: 5 ± 2 vs. primary schools: 3.5 ± 2, p < 0.05). The most common facilities were meadow areas (89%, n = 113), sports fields (71.7%, n = 91), and playgrounds (64.6%, n = 82). Almost half of the schools were part of a PA project (e.g. "active break", 45%, n = 56) and offered extracurricular PA programs and courses (54%, n = 67), but only one in five (22%, n = 27) regularly conducted fitness tests. PA policies varied between school types (p < 0.05) but almost all principals (94%, n = 117) would welcome a stronger promotion of activity friendliness at their school. Conclusion Schools are mostly activity-friendly regarding infrastructure although the limited possibilities for swimming lessons seem worrisome. PA promotion through projects, extracurricular PA offerings and fitness tests may be expanded.
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Affiliation(s)
- Alexandra Unger
- Department of Sport Science, University of Klagenfurt, Klagenfurt, Carinthia, Austria
- Department of Secondary Level, University of Teacher Education, Klagenfurt, Carinthia, Austria
| | | | - Jan Wilke
- Department of Sport Science, University of Klagenfurt, Klagenfurt, Carinthia, Austria
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Dell'Acqua C, Messerotti Benvenuti S, Cellini N, Brush CJ, Ruggerone A, Palomba D. Familial risk for depression is associated with reduced physical activity in young adults: evidence from a wrist-worn actigraphy study. Transl Psychiatry 2024; 14:219. [PMID: 38806490 PMCID: PMC11133440 DOI: 10.1038/s41398-024-02925-9] [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: 11/23/2023] [Revised: 05/08/2024] [Accepted: 05/10/2024] [Indexed: 05/30/2024] Open
Abstract
Depression is characterized by reduced physical activity and sleep-wake cycle disturbances, often considered important features of the disease. While a few studies have suggested that self-reported reduced physical activity and sleep-wake cycle disturbances might both be linked to depression vulnerability, actigraphy-based measures in vulnerable samples remain largely unexplored. This study relied on actigraphy-based parameters to test whether these disturbances characterize depression vulnerability. Seven-day actigraphy data were collected from 20 (13 female) university students with a high vulnerability to depression, which was determined by the presence of a family history of the condition but no current symptoms, and 32 (21 female) controls with neither a family history of depression nor current depressive symptoms. Daily physical activity, namely gross motor activity, was quantified as average daily acceleration and time spent engaging in moderate-vigorous physical activity (MVPA). The sleep-wake cycle and circadian rhythms were assessed as total sleep duration per night (in hours), sleep within sleep period time (in hours), sleep efficiency (%), and relative amplitude (i.e., the difference between the activity during the day and the night, which reflects circadian rhythms amplitude). Results showed that individuals with a familial risk for depression exhibited reduced daily acceleration and time spent in MVPA relative to the control group, particularly on the weekend during their free time away from scheduled activities. On the other hand, the two groups were comparable in terms of sleep estimates. Taken together, reduced physical activity, but not sleep-wake disturbances, seem to be associated with vulnerability to depression and might be a viable target for identification and prevention efforts.
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Affiliation(s)
- Carola Dell'Acqua
- Department of General Psychology, University of Padua, Padua, Italy.
| | - Simone Messerotti Benvenuti
- Department of General Psychology, University of Padua, Padua, Italy
- Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
- Hospital Psychology Unit, Padua University Hospital, Padua, Italy
| | - Nicola Cellini
- Department of General Psychology, University of Padua, Padua, Italy
- Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
| | - C J Brush
- Department of Movement Sciences, University of Idaho, Moscow, ID, USA
| | | | - Daniela Palomba
- Department of General Psychology, University of Padua, Padua, Italy
- Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
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Zhao W, Zhu DM, Li S, Cui S, Jiang P, Wang R, Zhang Y, Zhu J, Yu Y. The reduction of vitamin D in females with major depressive disorder is associated with worse cognition mediated by abnormal brain functional connectivity. Prog Neuropsychopharmacol Biol Psychiatry 2022; 118:110577. [PMID: 35605842 DOI: 10.1016/j.pnpbp.2022.110577] [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: 11/17/2021] [Revised: 05/01/2022] [Accepted: 05/17/2022] [Indexed: 11/26/2022]
Abstract
Low vitamin D is linked to major depressive disorder (MDD) through affecting the brain. Gender difference is apparent in MDD and vitamin D level. We aimed to examine the association between gender, vitamin D, clinical presentations, and brain functional connectivity in a large cohort of MDD patients and comparison subjects. Resting-state functional MRI data from 122 patients and 119 controls were collected to perform a combined analysis of functional connectivity density (FCD) and seed-based functional connectivity (FC). Peripheral venous blood samples were obtained to measure serum concentration of vitamin D (SCVD). Clinical presentations (symptoms profiles and cognition) were also assessed. We found an interaction of group and gender on SCVD in which MDD patients demonstrated lower SCVD than controls in females rather than males. Concurrently, lower SCVD was associated with worse cognitive performance (prospective memory and sustained attention). Compared with controls, female MDD patients showed reduced FCD and FC of the left middle frontal gyrus, which were related to lower SCVD. Importantly, these FCD and FC changes mediated the relationship between lower SCVD and cognitive dysfunction. Our findings suggest that functional connectivity abnormalities may serve as neural substrates underlying the associations between low vitamin D and cognitive impairments in female MDD patients, providing unique insight into treatment and prevention of MDD and its related cognitive dysfunction from the perspective of regulating circulating vitamin D.
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Affiliation(s)
- Wenming Zhao
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Research Center of Clinical Medical Imaging, Anhui Province, Hefei 230032, China; Anhui Provincial Institute of Translational Medicine, Hefei 230032, China
| | - Dao-Min Zhu
- Department of Sleep Disorders, Affiliated Psychological Hospital of Anhui Medical University, Hefei 230022, China; Hefei Fourth People's Hospital, Hefei 230022, China; Anhui Mental Health Center, Hefei 230022, China
| | - Shoubin Li
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Research Center of Clinical Medical Imaging, Anhui Province, Hefei 230032, China; Anhui Provincial Institute of Translational Medicine, Hefei 230032, China
| | - Shunshun Cui
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Research Center of Clinical Medical Imaging, Anhui Province, Hefei 230032, China; Anhui Provincial Institute of Translational Medicine, Hefei 230032, China
| | - Ping Jiang
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Research Center of Clinical Medical Imaging, Anhui Province, Hefei 230032, China; Anhui Provincial Institute of Translational Medicine, Hefei 230032, China
| | - Rui Wang
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Research Center of Clinical Medical Imaging, Anhui Province, Hefei 230032, China; Anhui Provincial Institute of Translational Medicine, Hefei 230032, China
| | - Yu Zhang
- Department of Sleep Disorders, Affiliated Psychological Hospital of Anhui Medical University, Hefei 230022, China; Hefei Fourth People's Hospital, Hefei 230022, China; Anhui Mental Health Center, Hefei 230022, China
| | - Jiajia Zhu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Research Center of Clinical Medical Imaging, Anhui Province, Hefei 230032, China; Anhui Provincial Institute of Translational Medicine, Hefei 230032, China.
| | - Yongqiang Yu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Research Center of Clinical Medical Imaging, Anhui Province, Hefei 230032, China; Anhui Provincial Institute of Translational Medicine, Hefei 230032, China.
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Al-Mulla NA, Mahfoud ZR. The Impact of the COVID-19 Lockdown “Home Quarantine” on the Physical Activity and Lifestyle of Children in Qatar. Front Public Health 2022; 10:877424. [PMID: 35692309 PMCID: PMC9174584 DOI: 10.3389/fpubh.2022.877424] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 04/19/2022] [Indexed: 12/16/2022] Open
Abstract
Background Several studies have investigated how the coronavirus disease 2019 (COVID-19) pandemic impacted children's lifestyle. To our knowledge, this is the first study that assesses the impact of quarantine on physical activity, screen time, sleep, and diet in children aged 5 to 12 in Qatar. Methods Cross-sectional data from an online survey distributed in Qatar was analyzed. The survey measured the parents' or caregivers' assessment on the change in the child's physical activity, sleep, screen time, and diet between the two periods (before quarantine and during quarantine). The data was analyzed using frequency distributions, paired t-test and McNemar's test. Results Data from 144 respondents were analyzed. Due to the quarantine, the total weekly average hours of physical activity significantly decreased with a greatest reduction for the school and after school durations. Only 4.5% of the children were engaging in at least 60 minutes of physical activity per day (in contrast to 25.6% prior to quarantine). The reported barriers for physical activity were screen time for school (52.8%) and leisure (51.4%). There was a significant increase in the total number of main meals per day, with a higher consumption of unhealthy food. The majority of the children had their bedtime and waketime shifted to later because of the quarantine. The parents' or caregivers' satisfaction with the child's lifestyle during quarantine showed that 49.1% were disappointed or very disappointed. Also, 53.8% described their child's mental health as “better before quarantine.” Conclusions Quarantine had a negative impact on the lifestyle of children in Qatar. When implementing restrictions, authorities should consider some interventions to counterpart such impact.
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Affiliation(s)
- Nada A. Al-Mulla
- Department of Medical Education, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Ziyad R. Mahfoud
- Department of Medical Education, Weill Cornell Medicine - Qatar, Doha, Qatar
- Division of Epidemiology, Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States
- *Correspondence: Ziyad R. Mahfoud
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A Systematic Review of the Effects of Physical Activity on Specific Academic Skills of School Students. EDUCATION SCIENCES 2022. [DOI: 10.3390/educsci12020134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This systematic review examined the effects of distinct physical activity interventions on the academic achievement of school students based on an analysis of four distinct outcomes: mathematics, language, reading, and composite scores. This study was performed in accordance with the PRISMA guidelines and the QUORUM statement. A literature search was conducted using the PubMed-MEDLINE, Scopus, and Web of Science databases. Peer-reviewed studies published in English, Portuguese, and Spanish were considered. A random-effect meta-analysis was employed to determine the effect of interventions on academic performance. The effects between interventions and control groups were expressed as standardized mean differences. Thirty-one studies were included in the meta-analysis based on the inclusion and exclusion criteria. The exercise programs were not capable of significantly improving language, reading skills, and composite scores. Conversely, performance in math tests increased significantly after the interventions compared with the control groups. Regarding the overall effect, a significant improvement in academic achievement was detected after physical activity programs compared with controls. In conclusion, the positive effects of school-based physical education on academic performance are not uniform and may be higher for math skills. The implementation of evidence-based exercise programs in school settings emerges as a promising strategy to increase overall academic achievement in school-aged students.
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Redig L, Feter N, Dumith SC, Domingues MR, Rombaldi AJ. Physical Inactivity From Childhood to Adolescence and Incident Depression. Am J Prev Med 2022; 62:211-218. [PMID: 34702605 DOI: 10.1016/j.amepre.2021.09.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 08/06/2021] [Accepted: 09/13/2021] [Indexed: 01/06/2023]
Abstract
INTRODUCTION The long-term impact of physical activity during early life on the risk of depression in later stages of adulthood remains unclear. This study examines the association between physical activity during childhood and adolescence and the incidence of depressive symptoms in early, middle, and late adulthood. METHODS Data from a birth cohort (the 1958 National Child Development Survey), including births (N=17,415) in England, Wales, and Scotland, were used. After birth, 11 more follow-ups were carried out between ages 7 and 62 years (2020). Leisure-time physical activity was assessed through a self-reported questionnaire. Psychological measures were assessed with the teacher-rated Bristol Social Adjustment Guide, the teacher-rated Rutter scale, and the self-rated Malaise Inventory. Leisure-time physical activity and psychological symptoms were examined in all the 11 follow-up assessments included in this study. Best-fit model was used to obtain hazard ratios and 95% CIs of depression symptoms by physical activity status in different ages, including demographic, behavioral, and health-related variables as potential confounders. RESULTS After multivariate analysis, being physically active at age 16 years reduced the risk of incident elevated depressive symptoms (hazard ratio=0.73, 95% CI=0.62, 0.85) throughout adulthood. The long-term impacts of physical activity practiced at age 16 years persisted throughout adulthood up to age 62 years. CONCLUSIONS Adolescence is a critical early-life period to promote physical activity for reducing the incidence of elevated depressive symptoms throughout adulthood. Public health policies should promote healthy lifestyles during the lifespan to reduce both the burden of physical inactivity and depressive symptoms at the population level.
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Affiliation(s)
- Larissa Redig
- Superior School of Physical Education, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Natan Feter
- Superior School of Physical Education, Universidade Federal de Pelotas, Pelotas, Brazil; Centre of Research on Exercise, Physical Activity & Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.
| | - Samuel C Dumith
- Postgraduate Program in Health Sciences, Universidade Federal do Rio Grande, Rio Grande, Brazil; Postgraduate Program in Public Health, Universidade Federal do Rio Grande, Rio Grande, Brazil
| | - Marlos R Domingues
- Superior School of Physical Education, Universidade Federal de Pelotas, Pelotas, Brazil; Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Airton J Rombaldi
- Superior School of Physical Education, Universidade Federal de Pelotas, Pelotas, Brazil
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Mirzayi C, Ferris E, Ozcebe H, Swierad E, Arslan U, Ünlü H, Araz O, Yardim MS, Üner S, Bilir N, Huang TT. Structural equation model of physical activity in Turkish schoolchildren: an application of the integrated behavioural model. BMJ Open 2021; 11:e046317. [PMID: 34903531 PMCID: PMC8671916 DOI: 10.1136/bmjopen-2020-046317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES Childhood obesity is increasingly prevalent in the developing world including Turkey. This study examined constructs of the integrated behavioural model associated with physical activity in a sample of schoolchildren in Ankara, Turkey using structural equation modelling. DESIGN Cross-sectional survey by probability sampling. SETTING Fifteen schools of different socioeconomic strata in Ankara, Turkey with grade 4 students. PARTICIPANTS 2066 (969 girls and 1097 boys) grade 4 schoolchildren and their parents selected using a probability-based sampling frame. PRIMARY OUTCOME MEASURES Three primary outcomes were used: moderate-to-vigorous physical activity, team sport participation, sedentary behaviour. RESULTS Data were collected from 2066 fourth-grade children from schools of three socioeconomic strata. Missing data were imputed using multiple imputation. To examine the integrated behavioural model, a structural equation model containing latent constructs for physical activity outcome expectancies, self-efficacy, home environment and social norms were fitted with the three outcomes above. Adequate model fit was achieved in the structural equation model (χ2=1821.97, df=872, p<0.001, Comparative Fit Index=0.91, Tucker Lewis Index=0.91, root mean square error of approximation=0.02, standardised root mean square residual=0.04). All scale items were significantly associated with their respective latent constructs (all p<0.001). Several significant pathways between latent constructs and outcomes of interest were observed (p<0.05). Self-efficacy was positively associated with moderate-to-vigorous physical activity (p<0.001) and team sport participation (p<0.001) and negatively associated with sedentary behaviour (p<0.001). Negative outcome expectancies were negatively associated with moderate-to-vigorous physical activity (p<0.01) and sedentary behaviour (p<0.01) while positive outcome expectancies were positively associated with team sport behaviour (p<0.001) and negatively associated with sedentary behaviour (p<0.05). Home support was positively associated with moderate-to-vigorous physical activity (p<0.01) and team sport participation (p<0.05). Finally, physical activity social norms were negatively associated with sedentary behaviour only (p<0.05). CONCLUSIONS This study supported the extension to Turkish children of the integrated behavioural model in relation to physical activity behaviours. Results illustrate multiple targets for interventions to increase physical activity.
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Affiliation(s)
- Chloe Mirzayi
- Center for Systems and Community Design, Graduate School of Public Health and Health Policy, City University of New York, New York, New York, USA
| | - Emily Ferris
- Center for Systems and Community Design, Graduate School of Public Health and Health Policy, City University of New York, New York, New York, USA
| | - Hilal Ozcebe
- Department of Public Health, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Ewelina Swierad
- Center for Systems and Community Design, Graduate School of Public Health and Health Policy, City University of New York, New York, New York, USA
| | - Umut Arslan
- Department of Public Health, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Hande Ünlü
- Department of Public Health, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Ozgur Araz
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
- College of Business Administration, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Mahmut Saadi Yardim
- Department of Public Health, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Sarp Üner
- Department of Public Health, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Nazmi Bilir
- Department of Public Health, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Terry T Huang
- Center for Systems and Community Design, Graduate School of Public Health and Health Policy, City University of New York, New York, New York, USA
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
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Gilbert AS, Schmidt L, Beck A, Kepper MM, Mazzucca S, Eyler A. Associations of physical activity and sedentary behaviors with child mental well-being during the COVID-19 pandemic. BMC Public Health 2021; 21:1770. [PMID: 34583661 PMCID: PMC8478004 DOI: 10.1186/s12889-021-11805-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 09/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic resulted in public health and policy measures to reduce in-person contact and the transmission of the virus. These measures impacted daily life and mental well-being (MWB). The aims of this study were to explore the MWB impacts of COVID-19 on children and assess the associations among perceived changes in physical activity (PA) and sedentary behaviors (SB), with perceived MWB changes, using a mixed-methods approach. METHODS A convergent parallel mixed-methods design consisting of an online survey with a convenience sample and interviews was conducted from May through July 2020 with parents/caregivers of kindergarten through 5th graders in the St. Louis region. Survey domains assessed included child MWB, PA, and SB. Interviews were recorded, transcribed, and qualitatively analyzed using a code book developed to elicit themes. Survey data was analyzed with chi-squared tests and logistic regressions. The dependent variable was perceived change in child MWB due to the impact of COVID-19. Independent variables included perceived changes in PA, SB, and child concerns about COVID-19. RESULTS Sample size consisted of 144 surveys and 16 interviews. Most parents reported a perceived decrease in child MWB (74%), a decrease in child PA (61%), and an increase in child SB (91%). Discontentment with stay-at-home orders and concern about COVID-19 were associated with a perceived decrease in MWB. Children whose PA decreased were 53% less likely to have the same or better MWB (OR 0.47) and children whose outside PA decreased were 72% less likely to have the same or better MWB (OR 0.28). Common qualitative themes included difficulty in adjusting to COVID-19 restrictions due to school closures and lack of socializing, child concerns about family getting sick, and PA benefits for improving MWB. CONCLUSIONS Based on parent perceptions, MWB decreased with COVID-19. Maintained or increased child PA improved the chances MWB would remain the same or improve. Parent interviews provide context to these findings by showing how COVID-19 impacted MWB and the associations between PA and MWB. Understanding protective factors for child MWB during COVID-19 is important to offset negative long-term health outcomes from this ongoing pandemic.
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Affiliation(s)
- Amanda S Gilbert
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, St. Louis, MO, USA.
| | - Laurel Schmidt
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, St. Louis, MO, USA
| | - Alan Beck
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, St. Louis, MO, USA
| | - Maura M Kepper
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, St. Louis, MO, USA
| | - Stephanie Mazzucca
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, St. Louis, MO, USA
| | - Amy Eyler
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, St. Louis, MO, USA
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Raatikainen I, Mäntyselkä P, Heinonen A, Vanhala M, Kautiainen H, Koponen H, Korniloff K. Does baseline leisure-time physical activity level predict future depressive symptoms or physical activity among depressive patients? Findings from a Finnish five-year cohort study. Nord J Psychiatry 2021; 75:356-361. [PMID: 33380252 DOI: 10.1080/08039488.2020.1862296] [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] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The aims of this study were to investigate whether baseline leisure-time physical activity (LTPA) is associated with future recovery from depression among patients with a depression diagnosis and whether baseline LTPA is associated with total physical activity after five years of follow-up. METHODS A total of 258 patients aged ≥35 years with clinically confirmed depression at baseline participated. The study was conducted between 2008 and 2016 in municipalities within the Central Finland Hospital District. Depressive symptoms (DS) were determined with the Beck Depression Inventory (BDI) with a cutoff score ≥10, and depression diagnoses were confirmed by the Mini-International Neuropsychiatric Interview (MINI). Blood pressure and anthropometric parameters were measured and blood samples for glucose and lipid determinations were drawn at baseline. LTPA, physical activity, and other social and clinical factors were captured by standard self-administered questionnaires at baseline and the five-year follow-up point. RESULTS Of the 258 patients, 76 (29%) had DS at follow-up. Adjusted odds ratio (OR) for future DS was 1.43 (confidence interval [CI] 0.69-2.95) for participants with moderate LTPA and 0.92 (CI 0.42-2.00) for participants with high LTPA, compared with low LTPA at baseline. Higher baseline LTPA levels were associated with higher total physical activity in the future (β=0.14 [95% CI: 0.02-0.26] for linearity = 0.024). CONCLUSION Baseline LTPA did not affect the five-year prognosis of depression among depressed patients in a Finnish adult population. Because the baseline LTPA level predicted the future total physical activity, it could be included as a part of the overall health management and treatment of depression in clinical practices.
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Affiliation(s)
- Ilkka Raatikainen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Assistive Technology Centre, Central Finland Health Care District, Jyväskylä, Finland
| | - Pekka Mäntyselkä
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland
| | - Ari Heinonen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Mauno Vanhala
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Hannu Kautiainen
- Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland.,Folkhälsan Research Center, Helsinki, Finland
| | - Hannu Koponen
- Old Age Psychiatry, Department of Psychiatry, Helsinki University and Helsinki University Hospital, Helsinki, Finland
| | - Katariina Korniloff
- School of Health and Social Studies, JAMK University of Applied Sciences, Jyväskylä, Finland
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11
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Ganjeh P, Meyer T, Hagmayer Y, Kuhnert R, Ravens-Sieberer U, von Steinbuechel N, Rothenberger A, Becker A. Physical Activity Improves Mental Health in Children and Adolescents Irrespective of the Diagnosis of Attention Deficit Hyperactivity Disorder (ADHD)-A Multi-Wave Analysis Using Data from the KiGGS Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2207. [PMID: 33668090 PMCID: PMC7967688 DOI: 10.3390/ijerph18052207] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/15/2021] [Accepted: 02/17/2021] [Indexed: 12/12/2022]
Abstract
Physical activity (PA) may have positive effects on mental health in children and adolescents. This post hoc study aimed to further investigate the relationship between different frequency levels of PA and general mental health as well as specific hyperactivity/inattention symptoms in children and adolescents. METHODS The analyses were based on data drawn from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) study, a regularly conducted large-scale, epidemiological investigation of somatic and mental health of children and adolescents in Germany. Parents were asked about their children's attention deficit hyperactivity disorder (ADHD) records and answered questionnaires concerning any mental health problem behavior of the children and adolescents using the Strengths and Difficulties Questionnaire (SDQ). The overall problem score as well as the hyperactivity/inattention symptoms subscale (SDQ-H/I) were entered as outcomes in a regression model controlling for parental socio-economic status and participants' sex, age, and body mass index (BMI). Cross-sectional analyses were conducted at three time points of the KiGGS study (baseline, wave 1, and wave 2) using general linear models (GLM). This was performed for different age groups (4-5, 6-9, 10-17 years). RESULTS Significant negative relationships were found between PA and general mental health problems. For the relationship between PA and SDQ-H/I, different patterns emerged at the three time points. There was no interaction between PA frequency levels and diagnosis of ADHD (ADHD vs. non-ADHD controls) regarding the SDQ total score. CONCLUSION This study underlines the importance of a high frequency level of PA for a good mental health status among children and adolescents, irrespective of the diagnosis of ADHD.
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Affiliation(s)
- Parisa Ganjeh
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, 37075 Göttingen, Germany; (A.R.); (A.B.)
| | - Thomas Meyer
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Göttingen, 37073 Göttingen, Germany;
- German Centre for Cardiovascular Research (DZHK), Partner Site Göttingen, 37073 Göttingen, Germany
| | - York Hagmayer
- Department of Cognitive Science and Decision Psychology, Georg Elias Müller Institute of Psychology, University of Göttingen, 37073 Göttingen, Germany;
| | - Ronny Kuhnert
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, 13353 Berlin, Germany;
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany;
| | - Nicole von Steinbuechel
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, 37073 Göttingen, Germany;
| | - Aribert Rothenberger
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, 37075 Göttingen, Germany; (A.R.); (A.B.)
| | - Andreas Becker
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, 37075 Göttingen, Germany; (A.R.); (A.B.)
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12
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Challenges in researching the immune pathways between early life adversity and psychopathology. Dev Psychopathol 2021; 32:1597-1624. [DOI: 10.1017/s0954579420001157] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
AbstractExposure to childhood adversity is a critical risk factor for the development of psychopathology. A growing field of research examines how exposure to childhood adversity is translated into biological risk for psychopathology through alterations in immune system functioning, most notably heightened levels of inflammation biomarkers. Though our knowledge about how childhood adversity can instantiate biological risk for psychopathology is growing, there remain many challenges and gaps in the field to understand how inflammation from childhood adversity contributes to psychopathology. This paper reviews research on the inflammatory outcomes arising from childhood adversity and presents four major challenges that future research must address: (a) the measurement of childhood adversity, (b) the measurement of inflammation, (c) the identification of mediators between childhood adversity and inflammation, and (d) the identification of moderators of inflammatory outcomes following childhood adversity. We discuss synergies and inconsistencies in the literature to summarize the current understanding of the association between childhood adversity, a proinflammatory phenotype, and the biological risk for psychopathology. We discuss the clinical implications of the inflammatory links between childhood adversity and psychopathology, including possibilities for intervention. Finally, this review conclude by delineates future directions for research, including issues of how best to detect, prevent, and understand these “hidden wounds” of childhood adversity.
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Gentile A, Boca S, Şahin FN, Güler Ö, Pajaujiene S, Indriuniene V, Demetriou Y, Sturm D, Gómez-López M, Bianco A, Alesi M. The Effect of an Enriched Sport Program on Children's Executive Functions: The ESA Program. Front Psychol 2020; 11:657. [PMID: 32411039 PMCID: PMC7198739 DOI: 10.3389/fpsyg.2020.00657] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 03/18/2020] [Indexed: 11/17/2022] Open
Abstract
PURPOSE The effects of physical exercise on executive functions (EFs) are well-documented. EFs are involved in daily activities, and their development determines the quality of people's future life, both in terms of mental health and quality of life. The purpose of the current paper is to evaluate the effects of a physical education program, elaborated within the Enriched Sports Activity Program (ESA Program), an Erasmus + Project, on EFs, namely, visuospatial working memory, inhibitory control, cognitive flexibility, and task switching. METHOD Data were collected on November 2017 (t1) and May 2018 (t2). At t1, a sample of 357 children from four European countries (Italy, Germany, Lithuania, and Turkey) performed a cognitive test battery made up of Digit Span Forward/Backward, Stroop Task, and Trail Making Test (TMT), whose order was randomized. From November until May, classrooms from the experimental group followed the ESA Program, while classrooms from the control continued with the ordinary physical education class. At t2, children from both experimental and control groups performed again the cognitive battery. RESULT The repeated measures ANOVA showed a significant effect of the ESA Program on the TMT B and on Digit Span Backward, but no significant effects were found on Digit Span Forward and Stroop Task. CONCLUSION The introduction of a sport program enriched with cognitive stimuli has beneficial effects for children working memory and cognitive flexibility.
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Affiliation(s)
- Ambra Gentile
- Ph.D. Program in Health Promotion and Cognitive Sciences, University of Palermo, Palermo, Italy
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | - Stefano Boca
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | | | - Özkan Güler
- Faculty of Sports Science, Ankara University, Ankara, Turkey
| | - Simona Pajaujiene
- Department of Coaching Science, Lithuanian Sports University, Kaunas, Lithuania
| | - Vinga Indriuniene
- Department of Physical and Social Education, Lithuanian Sports University, Kaunas, Lithuania
| | - Yolanda Demetriou
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - David Sturm
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Manuel Gómez-López
- Department of Physical Activity and Sport, Faculty of Sports Sciences, University of Murcia, Murcia, Spain
| | - Antonino Bianco
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | - Marianna Alesi
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
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Suetani S, Stubbs B, McGrath JJ, Scott JG. Physical activity of people with mental disorders compared to the general population: a systematic review of longitudinal cohort studies. Soc Psychiatry Psychiatr Epidemiol 2019; 54:1443-1457. [PMID: 31444516 DOI: 10.1007/s00127-019-01760-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 08/20/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE We investigated if (a) people with lower physical activity have an increased risk of subsequent mental disorders (compared to those with higher physical activity); and (b) people with mental disorders have reduced subsequent physical activity (compared to those without mental disorders). METHODS A systematic review of population-based longitudinal studies examining physical activity and mental disorders was conducted. Mental disorders were defined by International Classification of Diseases or Diagnostic and Statistical Manual of Mental Disorders. The results were described in a narrative summary. RESULTS Twenty-two studies were included. The majority (19) examined mood disorders and physical activity. Only two studies found consistent association between lower physical activity and a reduced risk of subsequent mental disorders. One study found the bidirectional association between physical activity and major depression. Twelve studies found mixed results (i.e., no consistency in direction and significance of the findings), and seven studies found no association between the variables of interest. CONCLUSIONS There is a lack of consistent evidence linking physical activity to be either a risk factor or consequence of mental disorders. PROSPERO REGISTRATION ID CRD42017071737.
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Affiliation(s)
- Shuichi Suetani
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, 4076, Australia. .,Queensland Brain Institute, The University of Queensland, St Lucia, Australia. .,Metro South Addiction and Mental Health Services, Brisbane, Australia.
| | - Brendon Stubbs
- Department of Health Service and Population Research, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK.,Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK
| | - John J McGrath
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, 4076, Australia.,Queensland Brain Institute, The University of Queensland, St Lucia, Australia.,National Centre for Register-based Research, The Aarhus University, Aarhus C, Denmark
| | - James G Scott
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, 4076, Australia.,School of Public Health, The University of Queensland, Herston, Australia.,Metro North Mental Health, Royal Brisbane and Women's Hospital, Herston, Australia
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15
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Berenbaum F, Wallace IJ, Lieberman DE, Felson DT. Modern-day environmental factors in the pathogenesis of osteoarthritis. Nat Rev Rheumatol 2018; 14:674-681. [DOI: 10.1038/s41584-018-0073-x] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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16
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Föcker M, Antel J, Grasemann C, Führer D, Timmesfeld N, Öztürk D, Peters T, Hinney A, Hebebrand J, Libuda L. Effect of an vitamin D deficiency on depressive symptoms in child and adolescent psychiatric patients - a randomized controlled trial: study protocol. BMC Psychiatry 2018; 18:57. [PMID: 29490621 PMCID: PMC5831612 DOI: 10.1186/s12888-018-1637-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Accepted: 02/21/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Depression is a significant health and economic burden worldwide affecting not only adults but also children and adolescents. Current treatment options for this group are scarce and show moderate effect sizes. There is emerging evidence that dietary patterns and specific nutritional components might play a role in the risk for developing depression. This study protocol focusses on the role of vitamin D which is for long known to be relevant for calcium and phosphorous homeostasis and bone health but might also impact on mental health. However, the assessment of the vitamin D status of depressed juvenile patients, or supplementation of vitamin D is currently not part of routine treatment. Controlled intervention studies are indispensable to prove whether a vitamin D deficiency ameliorates depressive symptoms. METHODS/DESIGN This double blinded, randomized controlled trial will enroll 200 inpatients from a child and adolescent psychiatric department with a vitamin D deficiency defined by a 25(OH)-vitamin D-level < 30 nmol/l (12 ng/ml) and a Beck Depressions Inventory (BDI-II) score > 13 (indicating at least: mild depression). Upon referral, all patients will be screened, checked for inclusion criteria, and those eligible will be randomized after written consent into a supplementation or placebo group. Both study-arms will receive treatment-as-usual for their psychiatric disorder according to established clinical guidelines. The participants of the vitamin D supplementation group will receive 2640 I.E. vitamin D3 q.d. for 28 days in accordance with best practice in pediatric endocrinology. We hypothesize that delaying supplementation of vitamin D in the placebo arm will affect the treatment success of the depressive symptomatology in comparison to the vitamin D supplementation group. Patients will be enrolled for a period of 28 days based on the mean length of hospitalization of juveniles with depression. DISCUSSION Randomized controlled trials in children and adolescents with depression are needed to elucidate the role of a vitamin D deficiency for mental disorders and to investigate the relevance of a routine assessment and supplementation of vitamin D deficits. TRIAL REGISTRATION DRKS00009758, 16/06/2016 (retrospectively registered).
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Affiliation(s)
- Manuel Föcker
- Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg-Essen, Wickenburgstr. 21, D-45147, Essen, Germany.
| | - Jochen Antel
- Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg-Essen, Wickenburgstr. 21, D-45147 Essen, Germany
| | - Corinna Grasemann
- Pediatric Endocrinology and Diabetology, Kinderklinik II, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Dagmar Führer
- Department of Endocrinology and Metabolism, Medical Center and Central Laboratory, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Nina Timmesfeld
- 0000 0004 1936 9756grid.10253.35Institute for Medical Biometry und Epidemiology, Philipps-University Marburg, Marburg, Germany
| | - Dana Öztürk
- Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg-Essen, Wickenburgstr. 21, D-45147 Essen, Germany
| | - Triinu Peters
- Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg-Essen, Wickenburgstr. 21, D-45147 Essen, Germany
| | - Anke Hinney
- Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg-Essen, Wickenburgstr. 21, D-45147 Essen, Germany
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg-Essen, Wickenburgstr. 21, D-45147 Essen, Germany
| | - Lars Libuda
- Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg-Essen, Wickenburgstr. 21, D-45147 Essen, Germany
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Dipnall JF, Pasco JA, Berk M, Williams LJ, Dodd S, Jacka FN, Meyer D. Getting RID of the blues: Formulating a Risk Index for Depression (RID) using structural equation modeling. Aust N Z J Psychiatry 2017; 51:1121-1133. [PMID: 28856902 DOI: 10.1177/0004867417726860] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE While risk factors for depression are increasingly known, there is no widely utilised depression risk index. Our objective was to develop a method for a flexible, modular, Risk Index for Depression using structural equation models of key determinants identified from previous published research that blended machine-learning with traditional statistical techniques. METHODS Demographic, clinical and laboratory variables from the National Health and Nutrition Examination Study (2009-2010, N = 5546) were utilised. Data were split 50:50 into training:validation datasets. Generalised structural equation models, using logistic regression, were developed with a binary outcome depression measure (Patient Health Questionnaire-9 score ⩾ 10) and previously identified determinants of depression: demographics, lifestyle-environs, diet, biomarkers and somatic symptoms. Indicative goodness-of-fit statistics and Areas Under the Receiver Operator Characteristic Curves were calculated and probit regression checked model consistency. RESULTS The generalised structural equation model was built from a systematic process. Relative importance of the depression determinants were diet (odds ratio: 4.09; 95% confidence interval: [2.01, 8.35]), lifestyle-environs (odds ratio: 2.15; 95% CI: [1.57, 2.94]), somatic symptoms (odds ratio: 2.10; 95% CI: [1.58, 2.80]), demographics (odds ratio:1.46; 95% CI: [0.72, 2.95]) and biomarkers (odds ratio:1.39; 95% CI: [1.00, 1.93]). The relationships between demographics and lifestyle-environs and depression indicated a potential indirect path via somatic symptoms and biomarkers. The path from diet was direct to depression. The Areas under the Receiver Operator Characteristic Curves were good (logistic:training = 0.850, validation = 0.813; probit:training = 0.849, validation = 0.809). CONCLUSION The novel Risk Index for Depression modular methodology developed has the flexibility to add/remove direct/indirect risk determinants paths to depression using a structural equation model on datasets that take account of a wide range of known risks. Risk Index for Depression shows promise for future clinical use by providing indications of main determinant(s) associated with a patient's predisposition to depression and has the ability to be translated for the development of risk indices for other affective disorders.
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Affiliation(s)
- Joanna F Dipnall
- 1 IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia.,2 Department of Statistics, Data Science and Epidemiology, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Julie A Pasco
- 1 IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia.,3 Western Clinical School, The University of Melbourne, St Albans, VIC, Australia.,4 Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,5 University Hospital Geelong, Barwon Health, Geelong, VIC, Australia
| | - Michael Berk
- 1 IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia.,5 University Hospital Geelong, Barwon Health, Geelong, VIC, Australia.,6 Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia.,7 The Florey Institute of Neuroscience & Mental Health, Parkville, VIC, Australia.,8 Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
| | - Lana J Williams
- 1 IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia.,5 University Hospital Geelong, Barwon Health, Geelong, VIC, Australia
| | - Seetal Dodd
- 1 IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia.,5 University Hospital Geelong, Barwon Health, Geelong, VIC, Australia.,6 Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia.,8 Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
| | - Felice N Jacka
- 1 IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia.,6 Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia.,9 The Centre for Adolescent Health, Murdoch Childrens Research Institute, Melbourne, VIC, Australia.,10 Black Dog Institute, Sydney, NSW, Australia
| | - Denny Meyer
- 2 Department of Statistics, Data Science and Epidemiology, Swinburne University of Technology, Melbourne, VIC, Australia
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18
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de Melo LGP, Nunes SOV, Anderson G, Vargas HO, Barbosa DS, Galecki P, Carvalho AF, Maes M. Shared metabolic and immune-inflammatory, oxidative and nitrosative stress pathways in the metabolic syndrome and mood disorders. Prog Neuropsychopharmacol Biol Psychiatry 2017; 78:34-50. [PMID: 28438472 DOI: 10.1016/j.pnpbp.2017.04.027] [Citation(s) in RCA: 107] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 03/27/2017] [Accepted: 04/08/2017] [Indexed: 02/08/2023]
Abstract
This review examines the shared immune-inflammatory, oxidative and nitrosative stress (IO&NS) and metabolic pathways underpinning metabolic syndrome (MetS), bipolar disorder (BD) and major depressive disorder (MDD). Shared pathways in both MetS and mood disorders are low grade inflammation, including increased levels of pro-inflammatory cytokines and acute phase proteins, increased lipid peroxidation with formation of malondialdehyde and oxidized low density lipoprotein cholesterol (LDL-c), hypernitrosylation, lowered levels of antioxidants, most importantly zinc and paraoxonase (PON1), increased bacterial translocation (leaky gut), increased atherogenic index of plasma and Castelli risk indices; and reduced levels of high-density lipoprotein (HDL-c) cholesterol. Insulin resistance is probably not a major factor associated with mood disorders. Given the high levels of IO&NS and metabolic dysregulation in BD and MDD and the high comorbidity with the atherogenic components of the MetS, mood disorders should be viewed as systemic neuro-IO&NS-metabolic disorders. The IO&NS-metabolic biomarkers may have prognostic value and may contribute to the development of novel treatments targeting neuro-immune, neuro-oxidative and neuro-nitrosative pathways.
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Affiliation(s)
- Luiz Gustavo Piccoli de Melo
- Department of Clinical Medicine, Londrina State University (UEL), Health Sciences Centre, Londrina, Paraná, Brazil; Center of Approach and Treatment for Smokers, University Hospital, Londrina State University, University Campus, Londrina, Paraná, Brazil; Health Sciences Graduation Program, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
| | - Sandra Odebrecht Vargas Nunes
- Department of Clinical Medicine, Londrina State University (UEL), Health Sciences Centre, Londrina, Paraná, Brazil; Center of Approach and Treatment for Smokers, University Hospital, Londrina State University, University Campus, Londrina, Paraná, Brazil; Health Sciences Graduation Program, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
| | | | - Heber Odebrecht Vargas
- Department of Clinical Medicine, Londrina State University (UEL), Health Sciences Centre, Londrina, Paraná, Brazil; Center of Approach and Treatment for Smokers, University Hospital, Londrina State University, University Campus, Londrina, Paraná, Brazil; Health Sciences Graduation Program, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
| | - Décio Sabbattini Barbosa
- Health Sciences Graduation Program, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil; Department of Clinical and Toxicological Analysis, State University of Londrina, Londrina, Paraná, Brazil
| | - Piotr Galecki
- Department of Adult Psychiatry, University of Lodz, Lodz, Poland
| | - André F Carvalho
- Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Michael Maes
- Health Sciences Graduation Program, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil; Department of Psychiatry, Chulalongkorn University, Bangkok, Thailand; Department of Psychiatry, Plovdiv University, Plovdiv, Bulgaria; Revitalis, Waalre, The Netherlands; Impact Strategic Research Center, Deakin University, Geelong, Australia.
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Breistøl S, Clench-Aas J, Van Roy B, Kjærsti Raanaas R. Association Between Participating in Noncompetitive or Competitive Sports and Mental Health among Adolescents – a Norwegian Population-based Cross-sectional Study. Scand J Child Adolesc Psychiatr Psychol 2017. [DOI: 10.21307/sjcapp-2017-003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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20
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Askari J, Saberi-Kakhki A, Taheri H, Yassini SM. The Effect of Aerobic Exercise on Different Symptoms of Depression: An Investigation of Psychological Mechanisms of Stress and Coping. ACTA ACUST UNITED AC 2017. [DOI: 10.4236/ojmp.2017.62007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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21
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Dipnall JF, Pasco JA, Berk M, Williams LJ, Dodd S, Jacka FN, Meyer D. Why so GLUMM? Detecting depression clusters through graphing lifestyle-environs using machine-learning methods (GLUMM). Eur Psychiatry 2016; 39:40-50. [PMID: 27810617 DOI: 10.1016/j.eurpsy.2016.06.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 05/31/2016] [Accepted: 06/04/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Key lifestyle-environ risk factors are operative for depression, but it is unclear how risk factors cluster. Machine-learning (ML) algorithms exist that learn, extract, identify and map underlying patterns to identify groupings of depressed individuals without constraints. The aim of this research was to use a large epidemiological study to identify and characterise depression clusters through "Graphing lifestyle-environs using machine-learning methods" (GLUMM). METHODS Two ML algorithms were implemented: unsupervised Self-organised mapping (SOM) to create GLUMM clusters and a supervised boosted regression algorithm to describe clusters. Ninety-six "lifestyle-environ" variables were used from the National health and nutrition examination study (2009-2010). Multivariate logistic regression validated clusters and controlled for possible sociodemographic confounders. RESULTS The SOM identified two GLUMM cluster solutions. These solutions contained one dominant depressed cluster (GLUMM5-1, GLUMM7-1). Equal proportions of members in each cluster rated as highly depressed (17%). Alcohol consumption and demographics validated clusters. Boosted regression identified GLUMM5-1 as more informative than GLUMM7-1. Members were more likely to: have problems sleeping; unhealthy eating; ≤2 years in their home; an old home; perceive themselves underweight; exposed to work fumes; experienced sex at ≤14 years; not perform moderate recreational activities. A positive relationship between GLUMM5-1 (OR: 7.50, P<0.001) and GLUMM7-1 (OR: 7.88, P<0.001) with depression was found, with significant interactions with those married/living with partner (P=0.001). CONCLUSION Using ML based GLUMM to form ordered depressive clusters from multitudinous lifestyle-environ variables enabled a deeper exploration of the heterogeneous data to uncover better understandings into relationships between the complex mental health factors.
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Affiliation(s)
- J F Dipnall
- Impact strategic research centre, school of medicine, Deakin university, PO Box 281, Geelong, Victoria 3220, Australia; Department of statistics, data science and epidemiology, Swinburne university of technology, Swinburne, Australia.
| | - J A Pasco
- Impact strategic research centre, school of medicine, Deakin university, PO Box 281, Geelong, Victoria 3220, Australia; Melbourne clinical school-western campus, the university of Melbourne, Saint-Albans, VIC, Australia; Department of epidemiology and preventive medicine, Monash university, Melbourne, VIC, Australia; University hospital of Geelong, Geelong, VIC, Australia
| | - M Berk
- Impact strategic research centre, school of medicine, Deakin university, PO Box 281, Geelong, Victoria 3220, Australia; University hospital of Geelong, Geelong, VIC, Australia; Department of psychiatry, the university of Melbourne, Parkville, VIC, Australia; Florey institute of neuroscience and mental health, Parkville, VIC, Australia; Orygen, the National centre of excellence in youth mental health, Parkville, VIC, Australia
| | - L J Williams
- Impact strategic research centre, school of medicine, Deakin university, PO Box 281, Geelong, Victoria 3220, Australia
| | - S Dodd
- Impact strategic research centre, school of medicine, Deakin university, PO Box 281, Geelong, Victoria 3220, Australia; University hospital of Geelong, Geelong, VIC, Australia; Department of psychiatry, the university of Melbourne, Parkville, VIC, Australia
| | - F N Jacka
- Impact strategic research centre, school of medicine, Deakin university, PO Box 281, Geelong, Victoria 3220, Australia; Department of psychiatry, the university of Melbourne, Parkville, VIC, Australia; Centre for adolescent health, Murdoch children's research institute, Melbourne, Australia; Black Dog institute, Sydney, Australia
| | - D Meyer
- Department of statistics, data science and epidemiology, Swinburne university of technology, Swinburne, Australia
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Hoegh Poulsen P, Biering K, Andersen JH. The association between leisure time physical activity in adolescence and poor mental health in early adulthood: a prospective cohort study. BMC Public Health 2016; 16:3. [PMID: 26729243 PMCID: PMC4700625 DOI: 10.1186/s12889-015-2658-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 12/21/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The incidence of poor mental health (MH) is increasing in Denmark and worldwide, especially among 16-24 year olds. Low physical activity (PA) during adolescence seems to be a risk factor for poor MH in early adulthood. Among adults, it appears that a high level of PA may be protective against poor MH. We aimed to examine whether high levels of leisure time physical activity (LTPA) during adolescence reduced the risk of poor MH at age 20/21. METHODS Prospective cohort study with data collected during 2004-2010 in the western part of Denmark. The study population was 3031 young people (age 14/15 in 2004). LTPA was the exposure variable and originates from questionnaires in 2004/2007. MH was the outcome variable and was measured at age 20/21 in 2010. MH was evaluated using a short version of the CES-DC. Logistic regression was used to analyse the associations between levels of LTPA and MH. All analyses were stratified by gender. RESULTS 1,589 adolescents were included in the final analyses. Girls at 14/15 years of age with a low level of LTPA had an Adjusted Odds Ratio(AOR) of 1.63 (95% CI = 1.23-2.17) for poor MH as 20/21 year olds, compared to girls with a high level of LTPA. Among boys, the corresponding AOR = 1.19 (95% CI = 0.85-1.66). We found an exposure-response relationship between levels of LTPA and MH among girls, but not among boys. Girls with a reduction/persistent low level of LTPA between the ages of 15-18 had an increased risk for poor MH at age 20/21 compared to the reference group. CONCLUSIONS Among girls, we found an association between a low level of LTPA among 14/15 year olds as well as a reduction/persistent low level of LTPA over time with poor MH at 20/21 years. We found no association between low levels of LTPA and poor MH among 14/15 year olds boys however it appears that a reduction/persistent low level of LTPA over time may have some influence on the risk of poor MH at 20/21 years. It is important to address the change in habits of LTPA during adolescence to prevent poor MH.
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Affiliation(s)
- Per Hoegh Poulsen
- Danish Ramazzini Centre, Department of Occupational Medicine, University Research Clinic, Hospital West Jutland, Gl. Landevej 61, Herning, 7400, Denmark.
| | - Karin Biering
- Danish Ramazzini Centre, Department of Occupational Medicine, University Research Clinic, Hospital West Jutland, Gl. Landevej 61, Herning, 7400, Denmark.
| | - Johan Hviid Andersen
- Danish Ramazzini Centre, Department of Occupational Medicine, University Research Clinic, Hospital West Jutland, Gl. Landevej 61, Herning, 7400, Denmark.
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Martínez-López E, Hita-Contreras F, Moral-García J, Grao-Cruces A, Ruiz J, Redecillas-Peiró M, Martínez-Amat A. Association of low weekly physical activity and sedentary lifestyle with self-perceived health, pain, and well-being in a Spanish teenage population. Sci Sports 2015. [DOI: 10.1016/j.scispo.2015.04.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Proudfoot J, Fogarty AS, McTigue I, Nathan S, Whittle EL, Christensen H, Player MJ, Hadzi-Pavlovic D, Wilhelm K. Positive strategies men regularly use to prevent and manage depression: a national survey of Australian men. BMC Public Health 2015; 15:1135. [PMID: 26573270 PMCID: PMC4647287 DOI: 10.1186/s12889-015-2478-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 11/07/2015] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Men are at greater risk than women of dying by suicide. One in eight will experience depression--a leading contributor to suicide--in their lifetime and men often delay seeking treatment. Previous research has focused on men's use of unhelpful coping strategies, with little emphasis on men's productive responses. The present study examines the positive strategies men use to prevent and manage depression. METHOD A national online survey investigated Australian men's use of positive strategies, including 26 strategies specifically nominated by men in a previous qualitative study. Data were collected regarding frequency of use or openness to using untried strategies, depression risk, depression symptoms, demographic factors, and other strategies suggested by men. Multivariate regression analyses explored relationships between regular use of strategies and other variables. RESULTS In total, 465 men aged between 18 and 74 years participated. The mean number of strategies used was 16.8 (SD 4.1) for preventing depression and 15.1 (SD 5.1) for management. The top five prevention strategies used regularly were eating healthily (54.2 %), keeping busy (50.1 %), exercising (44.9 %), humour (41.1 %) and helping others (35.7 %). The top five strategies used for management were taking time out (35.7 %), rewarding myself (35.1 %), keeping busy (35.1 %), exercising (33.3 %) and spending time with a pet (32.7 %). With untried strategies, a majority (58 %) were open to maintaining a relationship with a mentor, and nearly half were open to using meditation, mindfulness or gratitude exercises, seeing a health professional, or setting goals. In multivariate analyses, lower depression risk as measured by the Male Depression Risk Scale was associated with regular use of self-care, achievement-based and cognitive strategies, while lower scores on the Patient Health Questionnaire-9 was associated with regular use of cognitive strategies. CONCLUSIONS The results demonstrate that the men in the study currently use, and are open to using, a broad range of practical, social, emotional, cognitive and problem-solving strategies to maintain their mental health. This is significant for men in the community who may not be in contact with professional health services and would benefit from health messages promoting positive strategies as effective tools in the prevention and management of depression.
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Affiliation(s)
| | | | | | - Sally Nathan
- School of Public Health and Community Medicine, UNSW, Sydney, Australia.
| | | | | | | | - Dusan Hadzi-Pavlovic
- Black Dog Institute, UNSW, Sydney, Australia.
- School of Psychiatry, UNSW, Sydney, Australia.
| | - Kay Wilhelm
- School of Psychiatry, UNSW, Sydney, Australia.
- Faces in the Street, St Vincent's Urban Mental Health and Wellbeing Research Institute, Sydney, Australia.
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Yang X, Hirvensalo M, Hintsanen M, Hintsa T, Pulkki-Råback L, Jokela M, Telama R, Tammelin T, Hutri-Kähönen N, Viikari JSA, Raitakari OT. Longitudinal associations between changes in physical activity and depressive symptoms in adulthood: the young Finns study. Int J Behav Med 2015; 21:908-17. [PMID: 24362904 DOI: 10.1007/s12529-013-9376-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Although previous studies have associated physical activity (PA) with lower depressive symptoms, the combined effects of the (1) frequency, (2) intensity, and (3) duration of long-term PA have not been examined in detail. PURPOSE We examined the dose-response association between changes in frequency, intensity, and duration of PA and depressive symptoms in men and women over 6 years. METHODS Participants comprised 1,959 healthy adults (833 men and 1,126 women), aged 24-39 years in 2001, drawn from the ongoing Young Finns Study. PA was assessed using a self-report questionnaire completed in connection with a medical examination in 2001 and 2007. Depressive symptoms were simultaneously assessed using a modified version of Beck's Depression Inventory in both phases. RESULTS High doses of PA at baseline were prospectively associated with fewer depressive symptoms in men, while moderate doses of PA at baseline were inversely associated with the prevalence of depressive symptoms in women. Associations between baseline PA and depressive symptom changes were mediated by social and health-related factors which differed between men and women. Long-term participation in regular PA in all dimensions remained remarkably stable (all p < 0.001). Compared to those who remained inactive, the persistently active participants in all dimensions, with the exception of women's intensity group, were more likely to show decreases in depressive symptoms independent of the included confounders. An increase in PA in certain groups was also independently associated with fewer depressive symptoms, particularly in women. CONCLUSIONS Regular and persistent participation in different doses of PA may provide short-term and long-term beneficial effects on depressive symptom changes. The results imply that the moderate to high doses of PA may serve as a buffer against depression in early midlife.
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Affiliation(s)
- Xiaolin Yang
- LIKES-Research Center for Sport and Health Sciences, Viitaniementie 15a, 40720, Jyväskylä, Finland,
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Bussing R, Reid AM, McNamara JPH, Meyer JM, Guzick AG, Mason DM, Storch EA, Murphy TK. A pilot study of actigraphy as an objective measure of SSRI activation symptoms: results from a randomized placebo controlled psychopharmacological treatment study. Psychiatry Res 2015; 225:440-5. [PMID: 25535011 PMCID: PMC4428142 DOI: 10.1016/j.psychres.2014.11.070] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 09/15/2014] [Accepted: 11/29/2014] [Indexed: 11/18/2022]
Abstract
Selective serotonin reuptake inhibitors (SSRIs) are an efficacious and effective treatment for pediatric obsessive-compulsive disorder (OCD) but have received scrutiny due to a potential side effect constellation called activation syndrome. While recent research introduced a subjective measure of activation syndrome, objective measures have not been tested. This pilot study, using data from a larger randomized-controlled trial, investigated the potential of actigraphy to provide an objective measure of activation symptoms in 44 youths with OCD beginning an SSRI medication regimen. Data were collected over the first four weeks of a multi-site, parallel, double-blind, randomized, placebo controlled psychopharmacological treatment study and statistical modeling was utilized to test how activation syndrome severity predicts daily and nightly activity levels. Results indicated that youths with higher activation symptoms had lower daytime activity levels when treatment averages were analyzed; in contrast youths who experienced onset of activation symptoms one week were more likely to have higher day-time and night-time activity ratings that week. Results support actigraphy as a potential objective measure of activation symptoms. Subsequent studies are needed to confirm these findings and test clinical applications for use by clinicians to monitor activation syndrome during SSRI treatment. National Institutes of Health (5UO1 MH078594-01); NCT00382291.
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Affiliation(s)
- Regina Bussing
- Department of Psychiatry, University of Florida, Gainesville, FL, United States; Department of Pediatrics, University of Florida, Gainesville, FL, United States; Department of Clinical & Health Psychology, University of Florida, Gainesville, FL, United States
| | - Adam M Reid
- Department of Psychiatry, University of Florida, Gainesville, FL, United States; Department of Clinical & Health Psychology, University of Florida, Gainesville, FL, United States.
| | - Joseph P H McNamara
- Department of Psychiatry, University of Florida, Gainesville, FL, United States
| | - Johanna M Meyer
- Department of Psychology, University of Wyoming, Laramie, WY, United States
| | - Andrew G Guzick
- Department of Psychiatry, University of Florida, Gainesville, FL, United States; Department of Clinical & Health Psychology, University of Florida, Gainesville, FL, United States
| | - Dana M Mason
- Department of Psychiatry, University of Florida, Gainesville, FL, United States
| | - Eric A Storch
- Department of Pediatrics, University of South Florida, St. Petersburg, FL, United States; Department of Psychiatry and Behavioral Neurosciences, University of South Florida, St. Petersburg, FL, United States
| | - Tanya K Murphy
- Department of Pediatrics, University of South Florida, St. Petersburg, FL, United States; Department of Psychiatry and Behavioral Neurosciences, University of South Florida, St. Petersburg, FL, United States
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27
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Jacka FN, Berk M. Depression, diet and exercise. Med J Aust 2014; 199:S21-3. [PMID: 25370279 DOI: 10.5694/mja12.10508] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2012] [Accepted: 08/16/2012] [Indexed: 11/17/2022]
Abstract
Unhealthy lifestyle behaviour is driving an increase in the burden of chronic non-communicable diseases worldwide. Recent evidence suggests that poor diet and a lack of exercise contribute to the genesis and course of depression. While studies examining dietary improvement as a treatment strategy in depression are lacking, epidemiological evidence clearly points to diet quality being of importance to the risk of depression. Exercise has been shown to be an effective treatment strategy for depression, but this is not reflected in treatment guidelines, and increased physical activity is not routinely encouraged when managing depression in clinical practice. Recommendations regarding dietary improvement, increases in physical activity and smoking cessation should be routinely given to patients with depression. Specialised and detailed advice may not be necessary. Recommendations should focus on following national guidelines for healthy eating and physical activity.
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Affiliation(s)
- Felice N Jacka
- School of Medicine, Deakin University, Geelong, VIC, Australia.
| | - Michael Berk
- School of Medicine, Deakin University, Geelong, VIC, Australia
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28
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Körperliches Training bei neurologischen und psychischen Erkrankungen. DER NERVENARZT 2014; 85:1521-8. [DOI: 10.1007/s00115-013-3978-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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29
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Moylan S, Berk M, Dean OM, Samuni Y, Williams LJ, O'Neil A, Hayley AC, Pasco JA, Anderson G, Jacka FN, Maes M. Oxidative & nitrosative stress in depression: why so much stress? Neurosci Biobehav Rev 2014; 45:46-62. [PMID: 24858007 DOI: 10.1016/j.neubiorev.2014.05.007] [Citation(s) in RCA: 268] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 04/17/2014] [Accepted: 05/13/2014] [Indexed: 12/29/2022]
Abstract
Many studies support a crucial role for oxidative & nitrosative stress (O&NS) in the pathophysiology of unipolar and bipolar depression. These disorders are characterized inter alia by lowered antioxidant defenses, including: lower levels of zinc, coenzyme Q10, vitamin E and glutathione; increased lipid peroxidation; damage to proteins, DNA and mitochondria; secondary autoimmune responses directed against redox modified nitrosylated proteins and oxidative specific epitopes. This review examines and details a model through which a complex series of environmental factors and biological pathways contribute to increased redox signaling and consequently increased O&NS in mood disorders. This multi-step process highlights the potential for future interventions that encompass a diverse range of environmental and molecular targets in the treatment of depression.
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Affiliation(s)
- Steven Moylan
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria, Australia; Barwon Health, Geelong, Victoria, Australia.
| | - Michael Berk
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria, Australia; Florey Institute for Neuroscience and Mental Health University of Melbourne, Parkville, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Prahran, Victoria, Australia; University of Melbourne, Department of Psychiatry, Level 1 North, Main Block, Royal Melbourne Hospital, Parkville 3052, Australia; Barwon Health, Geelong, Victoria, Australia; Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria, Australia
| | - Olivia M Dean
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria, Australia; Florey Institute for Neuroscience and Mental Health University of Melbourne, Parkville, Victoria, Australia; University of Melbourne, Department of Psychiatry, Level 1 North, Main Block, Royal Melbourne Hospital, Parkville 3052, Australia
| | - Yuval Samuni
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Lana J Williams
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria, Australia; University of Melbourne, Department of Psychiatry, Level 1 North, Main Block, Royal Melbourne Hospital, Parkville 3052, Australia
| | - Adrienne O'Neil
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Prahran, Victoria, Australia
| | - Amie C Hayley
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Julie A Pasco
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria, Australia; Northwest Academic Centre, University of Melbourne, St. Albans, Victoria, Australia
| | | | - Felice N Jacka
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Michael Maes
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria, Australia; Department of Psychiatry, Chulalongkorn University, Faculty of Medicine, Bangkok, Thailand; Department of Psychiatry, State University of Londrina, Londrina, Brazil
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Sarris J, O’Neil A, Coulson CE, Schweitzer I, Berk M. Lifestyle medicine for depression. BMC Psychiatry 2014; 14:107. [PMID: 24721040 PMCID: PMC3998225 DOI: 10.1186/1471-244x-14-107] [Citation(s) in RCA: 217] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 03/07/2014] [Indexed: 12/16/2022] Open
Abstract
The prevalence of depression appears to have increased over the past three decades. While this may be an artefact of diagnostic practices, it is likely that there are factors about modernity that are contributing to this rise. There is now compelling evidence that a range of lifestyle factors are involved in the pathogenesis of depression. Many of these factors can potentially be modified, yet they receive little consideration in the contemporary treatment of depression, where medication and psychological intervention remain the first line treatments. "Lifestyle Medicine" provides a nexus between public health promotion and clinical treatments, involving the application of environmental, behavioural, and psychological principles to enhance physical and mental wellbeing. This may also provide opportunities for general health promotion and potential prevention of depression. In this paper we provide a narrative discussion of the major components of Lifestyle Medicine, consisting of the evidence-based adoption of physical activity or exercise, dietary modification, adequate relaxation/sleep and social interaction, use of mindfulness-based meditation techniques, and the reduction of recreational substances such as nicotine, drugs, and alcohol. We also discuss other potential lifestyle factors that have a more nascent evidence base, such as environmental issues (e.g. urbanisation, and exposure to air, water, noise, and chemical pollution), and the increasing human interface with technology. Clinical considerations are also outlined. While data supports that some of these individual elements are modifiers of overall mental health, and in many cases depression, rigorous research needs to address the long-term application of Lifestyle Medicine for depression prevention and management. Critically, studies exploring lifestyle modification involving multiple lifestyle elements are needed. While the judicious use of medication and psychological techniques are still advocated, due to the complexity of human illness/wellbeing, the emerging evidence encourages a more integrative approach for depression, and an acknowledgment that lifestyle modification should be a routine part of treatment and preventative efforts.
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Affiliation(s)
- Jerome Sarris
- Department of Psychiatry, The University of Melbourne, 2 Salisbury Street, Richmond 3121 Victoria, Australia
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, Australia
| | - Adrienne O’Neil
- School of Medicine, Deakin University, Geelong, Australia
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | | | - Isaac Schweitzer
- Department of Psychiatry, The University of Melbourne, 2 Salisbury Street, Richmond 3121 Victoria, Australia
| | - Michael Berk
- Department of Psychiatry, The University of Melbourne, 2 Salisbury Street, Richmond 3121 Victoria, Australia
- School of Medicine, Deakin University, Geelong, Australia
- Florey Institute for Neuroscience and Mental Health, Parkville, Australia
- Orygen Youth Health Research Institute, Parkville, Australia
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Castelli risk indexes 1 and 2 are higher in major depression but other characteristics of the metabolic syndrome are not specific to mood disorders. Life Sci 2014; 102:65-71. [PMID: 24607777 DOI: 10.1016/j.lfs.2014.02.033] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2013] [Revised: 02/15/2014] [Accepted: 02/24/2014] [Indexed: 12/12/2022]
Abstract
AIMS This study examined whether Castelli risk indexes 1 (total/high-density lipoprotein (HDL) cholesterol) and 2 (low density lipoprotein (LDL)/HDL cholesterol) and other shared metabolic disorders might underpin the pathophysiology of the metabolic syndrome, major depression or bipolar disorder. MAIN METHODS This cross-sectional study examined 92 major depressed, 49 bipolar depressed and 201 normal controls in whom the Castelli risk indexes 1 and 2 and key characteristics of the metabolic syndrome, i.e. waist/hip circumference, body mass index (BMI), systolic/diastolic blood pressure, total cholesterol, low-density lipoprotein (LDL) and HDL cholesterol, triglycerides, insulin, glucose, hemoglobin A1c (HbA1c) and homocysteine were assessed. KEY FINDINGS Castelli risk indexes 1 and 2 were significantly higher in major depressed patients than in bipolar disorder patients and controls. There were no significant differences in waist or hip circumference, total and LDL cholesterol, triglycerides, plasma glucose, insulin, homocysteine and HbA1c between depression and bipolar patients and controls. Bipolar patients had a significantly higher BMI than major depressed patients and normal controls. SIGNIFICANCE Major depression is accompanied by increased Castelli risk indexes 1 and 2, which may be risk factors for cardiovascular disease. Other key characteristics of the metabolic syndrome, either metabolic biomarkers or central obesity, are not necessarily specific to major depression or bipolar disorder.
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Gomersall SR, Norton K, Maher C, English C, Olds TS. In search of lost time: When people undertake a new exercise program, where does the time come from? A randomized controlled trial. J Sci Med Sport 2014; 18:43-8. [PMID: 24602689 DOI: 10.1016/j.jsams.2014.01.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 12/10/2013] [Accepted: 01/23/2014] [Indexed: 11/18/2022]
Abstract
OBJECTIVES The objective of this study was to investigate changes in use of time when undertaking a structured exercise program. DESIGN This study used a randomized, multi-arm, controlled trial design. METHODS A total of 129 insufficiently active adults aged 18-60 years were recruited and randomly allocated to one of three groups, a Moderate or Extensive six-week exercise group (150 and 300 additional minutes of exercise per week, respectively) or a Control group. Prescribed exercise was accumulated through both group and individual sessions. Use of time was measured at baseline and end-program using the Multimedia Activity Recall for Children and Adults, a computerized 24-h recall instrument. Daily minutes of activity in activity domains and energy expenditure zones were determined. RESULTS Relative to changes in the control group, daily time spent in the physical activity [F (2, 108)=20.21, p<0.001] and Active Transport [F (2, 108)=3.71, p=0.03] time use domains significantly increased in the intervention groups by 21-45 min/day. Comparatively, the intervention groups spent significantly less time watching television [F (2, 108)=5.02, p=0.008; -50-52 min/day], relative to Controls. Additionally, time spent in the moderate to vigorous energy expenditure zone had significantly increased in the intervention groups by end-program [F (2, 108)=6.35, p=0.002; 48-50 min/day], relative to Controls. CONCLUSIONS This study is the first to comprehensively map changes in time use across an exercise program. The results suggest that exercise interventions should be mindful not only of compliance but also of "isotemporal displacement" of behaviors.
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Affiliation(s)
- Sjaan R Gomersall
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement Studies, The University of Queensland, St Lucia, Brisbane, Queensland, Australia; Health and Use of Time (HUT) Group, Sansom Institute for Health Research, University of South Australia, Australia.
| | - Kevin Norton
- Exercise for Health and Human Performance, Sansom Institute for Health Research, University of South Australia, Australia
| | - Carol Maher
- Health and Use of Time (HUT) Group, Sansom Institute for Health Research, University of South Australia, Australia
| | - Coralie English
- International Centre for Allied Health Evidence (iCAHE), School of Health Science, University of South Australia, Australia
| | - Tim S Olds
- Health and Use of Time (HUT) Group, Sansom Institute for Health Research, University of South Australia, Australia
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Rieck T, Jackson A, Martin SB, Petrie T, Greenleaf C. Health-related fitness, body mass index, and risk of depression among adolescents. Med Sci Sports Exerc 2014; 45:1083-8. [PMID: 23274614 DOI: 10.1249/mss.0b013e3182831db1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE The Centers for Disease Control and Prevention indicates that depression is a serious issue for teenagers, with 10% to 15% reporting some symptoms and 15% having considered attempting suicide in 2009. PURPOSE The objective of this study is to determine the relations between cardiorespiratory fitness and body mass index (BMI) and depressive symptoms among young adolescents. METHODS The sample included 531 females and 455 males in grades 6 to 8. The FITNESSGRAM physical fitness test battery was administered to the participants as part of required school activities. Two results from the test battery, cardiorespiratory fitness and BMI, were used to classify the students into meeting or not meeting the healthy fitness zones established for each test. The Center for Epidemiological Studies-Depression Scale for Children (CES-DC) was administered in the schools to assess behavioral and cognitive aspects of depression. Participants were classified as elevated depression (CES-DC ≥16, n = 295) or normal (<16, n = 691). RESULTS Logistic regression was used to assess the relations of Health Fitness Zone status for cardiorespiratory fitness and BMI with depression while controlling for age, ethnicity, sex, economic status (school lunch support), and other fitness factors (cardiorespiratory fitness or BMI). Children classified as not in the Health Fitness Zone for cardiorespiratory fitness had significantly higher odds of elevated depression (odds ratio = 1.71 (95% CI = 1.03-2.84)). BMI was not significantly related to depression. CONCLUSION These findings indicate that a healthy level of cardiorespiratory fitness was associated with a lower level of depression as measured by the CES-DC. Because of the cross-sectional nature of this study, no cause and effect relations can be assumed.
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Affiliation(s)
- Troy Rieck
- Department of Psychology, University of North Texas, Denton, TX 76203-0769, USA
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Walker AJ, Kim Y, Price JB, Kale RP, McGillivray JA, Berk M, Tye SJ. Stress, Inflammation, and Cellular Vulnerability during Early Stages of Affective Disorders: Biomarker Strategies and Opportunities for Prevention and Intervention. Front Psychiatry 2014; 5:34. [PMID: 24782789 PMCID: PMC3988376 DOI: 10.3389/fpsyt.2014.00034] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 03/17/2014] [Indexed: 12/27/2022] Open
Abstract
The mood disorder prodrome is conceptualized as a symptomatic, but not yet clinically diagnosable stage of an affective disorder. Although a growing area, more focused research is needed in the pediatric population to better characterize psychopathological symptoms and biological markers that can reliably identify this very early stage in the evolution of mood disorder pathology. Such information will facilitate early prevention and intervention, which has the potential to affect a person's disease course. This review focuses on the prodromal characteristics, risk factors, and neurobiological mechanisms of mood disorders. In particular, we consider the influence of early-life stress, inflammation, and allostatic load in mediating neural mechanisms of neuroprogression. These inherently modifiable factors have known neuroadaptive and neurodegenerative implications, and consequently may provide useful biomarker targets. Identification of these factors early in the course of the disease will accordingly allow for the introduction of early interventions which augment an individual's capacity for psychological resilience through maintenance of synaptic integrity and cellular resilience. A targeted and complementary approach to boosting both psychological and physiological resilience simultaneously during the prodromal stage of mood disorder pathology has the greatest promise for optimizing the neurodevelopmental potential of those individuals at risk of disabling mood disorders.
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Affiliation(s)
- Adam J Walker
- Department of Psychiatry and Psychology, Mayo Clinic , Rochester, MN , USA ; School of Psychology, Deakin University , Melbourne, VIC , Australia
| | - Yesul Kim
- Department of Psychiatry and Psychology, Mayo Clinic , Rochester, MN , USA ; School of Psychology, Deakin University , Melbourne, VIC , Australia
| | - J Blair Price
- Department of Psychiatry and Psychology, Mayo Clinic , Rochester, MN , USA
| | - Rajas P Kale
- Department of Psychiatry and Psychology, Mayo Clinic , Rochester, MN , USA ; School of Engineering, Deakin University , Geelong, VIC , Australia
| | | | - Michael Berk
- School of Medicine, Deakin University , Geelong, VIC , Australia ; Department of Psychiatry, University of Melbourne , Melbourne, VIC , Australia ; Orygen Youth Health Research Centre , Melbourne, VIC , Australia ; The Florey Institute of Neuroscience and Mental Health , Melbourne, VIC , Australia
| | - Susannah J Tye
- Department of Psychiatry and Psychology, Mayo Clinic , Rochester, MN , USA ; School of Psychology, Deakin University , Melbourne, VIC , Australia ; Department of Psychiatry, University of Minnesota , Minneapolis, MN , USA
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Berk M, Sarris J, Coulson CE, Jacka FN. Lifestyle management of unipolar depression. Acta Psychiatr Scand Suppl 2013:38-54. [PMID: 23586875 DOI: 10.1111/acps.12124] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To be used in conjunction with 'Pharmacological management of unipolar depression' [Malhi et al. Acta Psychiatr Scand 2013;127(Suppl. 443):6-23] and 'Psychological management of unipolar depression' [Lampe et al. Acta Psychiatr Scand 2013;127(Suppl. 443):24-37]. To provide clinically relevant recommendations for lifestyle modifications in depression, derived from a literature review. METHOD A search of pertinent literature was conducted up to August 2012 in the area of lifestyle factors and depression. A narrative review was then conducted. RESULTS There is evidence that level of physical activity plays a role in the risk of depression, and there is a large and validated evidence base for exercise as a therapeutic modality. Smoking and alcohol and substance misuse appear to be independent risk factors for depression, while the new epidemiological evidence supports the contention that diet is a risk factor for depression; good quality diets appear protective and poor diets increase risk. CONCLUSION Lifestyle modification, with a focus on exercise, diet, smoking and alcohol, may be of substantial value in reducing the burden of depression in individuals and the community.
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Affiliation(s)
| | | | - C. E. Coulson
- Department of Psychiatry; The University of Melbourne; Melbourne; Vic; Australia
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Stavrakakis N, Roest AM, Verhulst F, Ormel J, de Jonge P, Oldehinkel AJ. Physical activity and onset of depression in adolescents: a prospective study in the general population cohort TRAILS. J Psychiatr Res 2013; 47:1304-8. [PMID: 23820109 DOI: 10.1016/j.jpsychires.2013.06.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 05/30/2013] [Accepted: 06/05/2013] [Indexed: 11/19/2022]
Abstract
Although it has often been suggested that physical activity and depression are intertwined, only few studies have investigated whether specific aspects of physical activity predict the incidence of major depression in adolescents from the general population. Therefore the aim of this study was to investigate the effects of nature, frequency, duration and intensity of physical activity during early adolescence on the onset of a major depressive episode in early adulthood. In a population sample of adolescents (N = 1396), various aspects of physical activity were assessed at early adolescence (mean age 13.02, SD = 0.61). Major depressive episode onset was assessed using the Composite International Diagnostic Interview. A Cox regression model was performed to investigate whether physical activity characteristics and their interactions with gender predicted a major depressive episode onset up until mean age 18.5 (SD = 0.61). The individual characteristics of physical activity (nature, frequency, duration and intensity) or their interactions with gender did not predict a major depressive episode onset (p values >0.05). So far, there is no prospective evidence that physical activity protects against the development of adolescent depressive episodes in either boys or girls.
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Affiliation(s)
- N Stavrakakis
- Interdisciplinary Centre Psychopathology and Emotion Regulation and Groningen Graduate School Medical Sciences, Department of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
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Berk M, Williams LJ, Jacka FN, O'Neil A, Pasco JA, Moylan S, Allen NB, Stuart AL, Hayley AC, Byrne ML, Maes M. So depression is an inflammatory disease, but where does the inflammation come from? BMC Med 2013; 11:200. [PMID: 24228900 PMCID: PMC3846682 DOI: 10.1186/1741-7015-11-200] [Citation(s) in RCA: 876] [Impact Index Per Article: 79.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Accepted: 05/31/2013] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND We now know that depression is associated with a chronic, low-grade inflammatory response and activation of cell-mediated immunity, as well as activation of the compensatory anti-inflammatory reflex system. It is similarly accompanied by increased oxidative and nitrosative stress (O&NS), which contribute to neuroprogression in the disorder. The obvious question this poses is 'what is the source of this chronic low-grade inflammation?' DISCUSSION This review explores the role of inflammation and oxidative and nitrosative stress as possible mediators of known environmental risk factors in depression, and discusses potential implications of these findings. A range of factors appear to increase the risk for the development of depression, and seem to be associated with systemic inflammation; these include psychosocial stressors, poor diet, physical inactivity, obesity, smoking, altered gut permeability, atopy, dental cares, sleep and vitamin D deficiency. SUMMARY The identification of known sources of inflammation provides support for inflammation as a mediating pathway to both risk and neuroprogression in depression. Critically, most of these factors are plastic, and potentially amenable to therapeutic and preventative interventions. Most, but not all, of the above mentioned sources of inflammation may play a role in other psychiatric disorders, such as bipolar disorder, schizophrenia, autism and post-traumatic stress disorder.
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Affiliation(s)
- Michael Berk
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia.
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Children and physical activity. J Sci Med Sport 2013; 16:291. [DOI: 10.1016/j.jsams.2013.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Mood disorders in youth: exercise, light therapy, and pharmacologic complementary and integrative approaches. Child Adolesc Psychiatr Clin N Am 2013; 22:403-41, v. [PMID: 23806312 DOI: 10.1016/j.chc.2013.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The therapeutic value of physical exercise, bright light therapy and dawn simulation, and several pharmacologic treatments, including hypericum (St. John's wort), S-adenosylmethionine, and 5-hydroxytryptophan, are reviewed, with a focus on their use for treating major depressive disorder in children and adolescents and also for alleviating depressed mood in the general (nonclinical) population of youth. For each treatment discussed, all published randomized, double-blind, placebo-controlled trials are summarized, along with some additional selected studies. Nutritional psychopharmacology and several other approaches to treating depression will be presented in an upcoming volume in the Child and Adolescent Psychiatric Clinics of North America.
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Pasco JA, Williams LJ, Jacka FN, Brennan SL, Berk M. Obesity and the relationship with positive and negative affect. Aust N Z J Psychiatry 2013; 47:477-82. [PMID: 23526473 DOI: 10.1177/0004867413483371] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To examine the cross-sectional association between overweight and obesity and positive and negative affect. METHOD Participants included 273 women, aged 29-84 years, who were enrolled in the Geelong Osteoporosis Study (GOS). Weight and height were measured and overweight and obesity determined from body mass index (BMI; kg/m(2)) according to WHO criteria. Medical history and lifestyle exposures were assessed by questionnaire. Positive and negative affect scores were derived using the validated 20-item Positive and Negative Affect Schedule (PANAS) and categorised into tertiles. RESULTS A pattern of greater negative affect scores was observed for increasing levels of BMI. Setting normal weight as the referent category, the odds for having a negative affect score in the highest tertile were sequentially increased for women who were overweight (OR = 1.31, 95% CI: 0.72-2.40) and obese (OR = 1.95, 95% CI: 1.02-3.73). The association between obesity and increased negative affect was diminished by adjusting for physical illness (adjusted OR = 1.76, 95% CI: 0.91-3.42). These associations were not substantially influenced by positive affect score or other exposures. No association was detected between BMI categories and positive affect scores. CONCLUSIONS We report data suggesting that obesity is associated with greater negative affect scores, reflecting emotions such as distress, anger, disgust, fear and shame, and that this association is attenuated by physical illness. Further investigations are now warranted to explore possible mechanistic interplay between pathological, neurobiological and psychosocial factors.
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Affiliation(s)
- Julie A Pasco
- School of Medicine, Deakin University, Geelong, VIC 3220, Australia.
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Moylan S, Eyre HA, Maes M, Baune BT, Jacka FN, Berk M. Exercising the worry away: how inflammation, oxidative and nitrogen stress mediates the beneficial effect of physical activity on anxiety disorder symptoms and behaviours. Neurosci Biobehav Rev 2013; 37:573-84. [PMID: 23415701 DOI: 10.1016/j.neubiorev.2013.02.003] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Revised: 11/27/2012] [Accepted: 02/05/2013] [Indexed: 12/11/2022]
Abstract
Regular physical activity exerts positive effects on anxiety disorder symptoms, although the biological mechanisms underpinning this effect are incompletely understood. Numerous lines of evidence support inflammation and oxidative and nitrogen stress (O&NS) as important in the pathogenesis of mood and anxiety disorders, and physical activity is known to influence these same pathways. This paper reviews the inter-relationships between anxiety disorders, physical activity and inflammation and O&NS, to explore whether modulation of inflammation and O&NS may in part underpin the positive effect of physical activity on anxiety disorders. Numerous studies support the notion that physical activity operates as an anti-inflammatory and anti-O&NS agent which potentially exerts positive effects on neuroplasticity, the expression of neurotrophins and normal neuronal functions. These effects may therefore influence the expression and evolution of anxiety disorders. Further exploration of this area may elicit a deeper understanding of the pathogenesis of anxiety disorders, and inform the development of integrated programmes including PA specifically suited to the treatment and prevention of anxiety disorders and symptoms.
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Affiliation(s)
- S Moylan
- School of Medicine, Deakin University, Melbourne, Australia.
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Svendal G, Berk M, Pasco JA, Jacka FN, Lund A, Williams LJ. The use of hormonal contraceptive agents and mood disorders in women. J Affect Disord 2012; 140:92-6. [PMID: 22537684 DOI: 10.1016/j.jad.2012.03.030] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 03/17/2012] [Accepted: 03/17/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Mood disorders are a major cause of disability in developed countries, and contraceptive agents among the most widely used medications. The relationship between contraceptive agents and mood is unclear. The aim of this study was therefore to investigate the association between current contraception use and mood disorders in a random population-based sample of women. METHODS This study examined epidemiological data obtained from 498 women aged 20-50year participating in the Geelong Osteoporosis Study (GOS). Mood disorders were diagnosed using a clinical interview (SCID-I/NP) and information on medication use and other lifestyle factors were documented. RESULTS After adjusting for age and socioeconomic status (SES), women taking progestin-only contraceptive agents had an increased likelihood of a current mood disorder (OR 3.0 95%CI: 1.1-7.8, p=0.03). In contrast, women taking combined contraceptive agents had a decreased likelihood of a current mood disorder, adjusting this for age and SES (OR 0.3 95%CI: 0.1, 0.9 p=0.03). These findings were not explained by weight, physical activity level, past depression, number of medical conditions or cigarette smoking. LIMITATIONS This study is cross-sectional, which precludes any determination regarding the direction of the relationships. CONCLUSIONS These data suggest a protective effect of the combined contraceptive pill, and a deleterious effect of progestin only agents in regards to mood disorders.
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Affiliation(s)
- Gjertrud Svendal
- Department of Clinical Medicine, Section of Psychiatry, University of Bergen, Norway
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Anderson RJ, Frye MA, Abulseoud OA, Lee KH, McGillivray JA, Berk M, Tye SJ. Deep brain stimulation for treatment-resistant depression: efficacy, safety and mechanisms of action. Neurosci Biobehav Rev 2012; 36:1920-33. [PMID: 22721950 DOI: 10.1016/j.neubiorev.2012.06.001] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2012] [Revised: 06/06/2012] [Accepted: 06/10/2012] [Indexed: 12/22/2022]
Abstract
Deep brain stimulation (DBS), a neuromodulation therapy that has been used successfully in the treatment of symptoms associated with movement disorders, has recently undergone clinical trials for individuals suffering from treatment-resistant depression (TRD). Although the small patient numbers and open label study design limit our ability to identify optimum targets and make definitive conclusions about treatment efficacy, a review of the published research demonstrates significant reductions in depressive symptomatology and high rates of remission in a severely treatment-resistant patient group. Despite these encouraging results, an incomplete understanding of the mechanisms of action underlying the therapeutic effects of DBS for TRD is highlighted, paralleling the incomplete understanding of the neuroanatomy of mood regulation and treatment resistance. Proposed mechanisms of action include short and long-term local effects of stimulation at the neuronal level, to modulation of neural network activity.
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Lifetime leisure-time physical activity and the risk of depressive symptoms at the ages of 65-74 years: the FIN-D2D survey. Prev Med 2012; 54:313-5. [PMID: 22381807 DOI: 10.1016/j.ypmed.2012.02.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Revised: 01/25/2012] [Accepted: 02/13/2012] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To investigate the association between lifetime leisure-time physical activity (LTPA) and depressive symptoms (DS) based on the population-based FIN-D2D cross-sectional survey conducted in 2007. METHODS Nine hundred twenty seven randomly selected Finnish men and women aged 65-74 years were included in this study. DS were determined with the Beck Depression Inventory (≥10 points), and lifetime historical LTPA frequency from age 15 years onwards was recalled retrospectively. RESULTS The frequency of LTPA was highest at the ages of 15-24 years in both the DS present and not present groups (14.6 times per month). LTPA frequency was significantly lower among those with DS compared with those without DS at the age of 45-54 (10.0 vs. 11.3, p=0.041), 55-64 (9.6 vs. 12.6, p<0.001), and 65-74 (8.6 vs. 11.9, p<0.001). Also the prevalence of somatic diseases was higher for those with DS compared with participants without DS. CONCLUSIONS This study reveals lifetime LTPA variation and its potential consequences. The relationship found between reduced lifetime LTPA and the occurrence of DS suggest that promoting LTPA throughout one's lifetime would be beneficial in terms of DS and somatic diseases in older age.
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Magalhães PV, Kapczinski F, Nierenberg AA, Deckersbach T, Weisinger D, Dodd S, Berk M. Illness burden and medical comorbidity in the Systematic Treatment Enhancement Program for Bipolar Disorder. Acta Psychiatr Scand 2012; 125:303-8. [PMID: 22098628 DOI: 10.1111/j.1600-0447.2011.01794.x] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Coexisting chronic medical conditions are common in bipolar disorder. Here, we report the prevalence and correlates of medical comorbidity in patients enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). We were particularly interested in associations between variables reflecting illness chronicity and burden with comorbid medical conditions. METHOD We used intake data from the open-label component of the STEP-BD. History of medical comorbidity was obtained from the affective disorders evaluation, and its presence was the outcome of interest. The sample size in analyses varied from 3399 to 3534. We used multiple Poisson regression to obtain prevalence ratios. RESULTS The prevalence of any medical comorbidity in the sample was 58.8%. In addition to demographic variable, several clinical characteristics were associated with the frequency of medical comorbidity. Having more than 10 previous mood episodes, childhood onset, smoking, lifetime comorbidity with anxiety, and substance use disorders were independently associated with having a medical comorbidity in the final multivariate model. CONCLUSION The results presented here reveal strong associations between variables related to illness chronicity and medical burden in bipolar disorder. This lends further support to recent multidimensional models incorporating medical morbidity as a core feature of bipolar disorder.
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Affiliation(s)
- P V Magalhães
- National Institute for Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil
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Kolt GS. Same tools, but a shift of context. J Sci Med Sport 2012; 15:1. [DOI: 10.1016/j.jsams.2011.11.258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Pasco JA, Jacka FN, Williams LJ, Brennan SL, Leslie E, Berk M. Don't worry, be active: positive affect and habitual physical activity. Aust N Z J Psychiatry 2011; 45:1047-52. [PMID: 22059484 DOI: 10.3109/00048674.2011.621063] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The aim of ths study was to examine the association between habitual physical activity and positive and negative affect. METHOD This cross-sectional study included 276 women aged 20 +, from the Geelong Osteoporosis Study. Habitual physical activity and other lifestyle exposures were assessed by questionnaire, concurrent with anthropometric assessments. Physical activity was categorized as very active, moderately active or sedentary. Positive and negative affect scores were derived from the validated 20 item Positive and Negative Affect Schedule (PANAS) self-report and were categorized into tertiles. RESULTS There was a pattern of lower positive affect scores for lower levels of physical activity. With very active as the reference category, the odds for having a positive affect score in the highest tertile were sequentially lower for those who were moderately active (OR = 0.53, 95%CI 0.28-1.01) and sedentary (OR = 0.28, 95%CI 0.10-0.75). Associations were sustained after adjusting for body mass index and polypharmacy (OR = 0.50, 95%CI 0.26-0.96 and OR = 0.25, 95%CI 0.09-0.72, respectively). These associations were not explained by age, negative affect score or other exposures. No association was detected between physical activity and negative affect scores. CONCLUSIONS This study reports that higher positive affect scores, encompassing emotions such as interest, excitement, enthusiasm and alertness, are associated with higher levels of habitual physical activity. These observations warrant further investigations into possible mechanistic interplay between neurobiological and psychosocial factors that underpin this association.
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Affiliation(s)
- Julie A Pasco
- Barwon Epidemiology and Biostatistics Unit, School of Medicine, Deakin University, PO Box 281, Geelong, Victoria 3220, Australia.
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Picard M. Pathways to aging: the mitochondrion at the intersection of biological and psychosocial sciences. J Aging Res 2011; 2011:814096. [PMID: 21961065 PMCID: PMC3180824 DOI: 10.4061/2011/814096] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2011] [Revised: 05/11/2011] [Accepted: 07/11/2011] [Indexed: 01/10/2023] Open
Abstract
Compelling evidence suggests that both biological and psychosocial factors impact the process of aging. However, our understanding of the dynamic interplay among biological and psychosocial factors across the life course is still fragmentary. For example, it needs to be established how the interaction of individual factors (e.g., genetic and epigenetic endowment and personality), behavioral factors (e.g., physical activity, diet, and stress management), and psychosocial experiences (e.g., social support, well-being, socioeconomic status, and marriage) in perinatal, childhood, and adulthood influence health across the aging continuum. This paper aims to outline potential intersection points serving as an interface between biological and psychosocial factors, with an emphasis on the mitochondrion. Mitochondria are cellular organelles which play a critical role in cellular senescence. Both chronic exposure to psychosocial stress and genetic-based mitochondrial dysfunction have strikingly similar biological consequences; both predispose individuals to adverse age-related health disorders and early mortality. Exploring the interactive nature of the factors resulting in pathways to normal healthy aging, as well as those leading to morbidity and early mortality, will continue to enhance our ability to translate research into effective practices that can be implemented throughout the life course to optimise the aging process.
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Affiliation(s)
- Martin Picard
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Avenue, Montreal, QC, Canada H2W 1S4
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Dodd S, Malhi GS, Tiller J, Schweitzer I, Hickie I, Khoo JP, Bassett DL, Lyndon B, Mitchell PB, Parker G, Fitzgerald PB, Udina M, Singh A, Moylan S, Giorlando F, Doughty C, Davey CG, Theodoras M, Berk M. A consensus statement for safety monitoring guidelines of treatments for major depressive disorder. Aust N Z J Psychiatry 2011; 45:712-25. [PMID: 21888608 PMCID: PMC3190838 DOI: 10.3109/00048674.2011.595686] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE This paper aims to present an overview of screening and safety considerations for the treatment of clinical depressive disorders and make recommendations for safety monitoring. METHOD Data were sourced by a literature search using MEDLINE and a manual search of scientific journals to identify relevant articles. Draft guidelines were prepared and serially revised in an iterative manner until all co-authors gave final approval of content. RESULTS Screening and monitoring can detect medical causes of depression. Specific adverse effects associated with antidepressant treatments may be reduced or identified earlier by baseline screening and agent-specific monitoring after commencing treatment. CONCLUSION The adoption of safety monitoring guidelines when treating clinical depression is likely to improve overall physical health status and treatment outcome. It is important to implement these guidelines in the routine management of clinical depression.
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Affiliation(s)
- Seetal Dodd
- School of Medicine, Deakin University, Geelong, Victoria, Australia; Department of Psychiatry, University of Melbourne, Victoria, Australia
| | - Gin S Malhi
- Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - John Tiller
- Department of Psychiatry, University of Melbourne, Victoria, Australia
| | - Isaac Schweitzer
- Department of Psychiatry, University of Melbourne, Victoria, Australia
| | - Ian Hickie
- Brain and Mind Research Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Jon Paul Khoo
- Toowong Specialist Clinic, Level 2/54 Jephson St, Toowong, Brisbane, Queensland, Australia
| | - Darryl L Bassett
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Australia; School of Medicine, University of Notre Dame, Western Australia, Australia
| | - Bill Lyndon
- Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, Sydney, Australia; Black Dog Institute, Sydney, Australia
| | - Gordon Parker
- School of Psychiatry, University of New South Wales, Sydney, Australia; Black Dog Institute, Sydney, Australia
| | - Paul B Fitzgerald
- Monash Alfred Psychiatry Research Centre, Alfred and Monash University School of Psychology and Psychiatry, Melbourne, Victoria, Australia
| | - Marc Udina
- Bipolar Disorders Program, Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Catalonia, Spain
| | - Ajeet Singh
- School of Medicine, Deakin University, Geelong, Victoria, Australia; Department of Psychiatry, University of Melbourne, Victoria, Australia
| | - Steven Moylan
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | | | - Carolyn Doughty
- Child and Family Specialty Service, Canterbury District Health Board; Department of Public Health and General Practice, University of Otago, Christchurch, New Zealand
| | | | - Michael Theodoras
- Eating Disorders Program, New Farm Clinic, Brisbane, Queensland, Australia
| | - Michael Berk
- School of Medicine, Deakin University, Geelong, Victoria; Department of Psychiatry, University of Melbourne, Victoria; Mental Health Research Institute, Parkville, Victoria; Orygen Youth Health Research Centre, Parkville, Victoria, Australia
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Does dog-ownership influence seasonal patterns of neighbourhood-based walking among adults? A longitudinal study. BMC Public Health 2011; 11:148. [PMID: 21375754 PMCID: PMC3087680 DOI: 10.1186/1471-2458-11-148] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2010] [Accepted: 03/04/2011] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND In general dog-owners are more physically active than non-owners, however; it is not known whether dog-ownership can influence seasonal fluctuations in physical activity. This study examines whether dog-ownership influences summer and winter patterns of neighbourhood-based walking among adults living in Calgary, Canada. METHODS A cohort of adults, randomly sampled from the Calgary metropolitan area, completed postal surveys in winter and summer 2008. Both winter and summer versions of the survey included questions on dog-ownership, walking for recreation, and walking for transportation in residential neighbourhoods. Participation in neighbourhood-based walking was compared, among dog-owners and non-owners, and in summer and winter, using general linear modeling. Stability of participation in neighbourhood-based walking across summer and winter among dog-owners and non-owners was also assessed, using logistic regression. RESULTS A total of 428 participants participated in the study, of whom 115 indicated owning dogs at the time of both surveys. Dog-owners reported more walking for recreation in their neighbourhoods than did non-owners, both in summer and in winter. Dog-owners were also more likely than non-owners to report participation in walking for recreation in their neighbourhoods, in summer as well as in winter. Dog-owners and non-owners did not differ in the amount of walking that they reported for transportation, either in summer or in winter. CONCLUSIONS By acting as cues for physical activity, dogs may help their owners remain active across seasons. Policies and programs related to dog-ownership and dog-walking, such as dog-supportive housing and dog-supportive parks, may assist in enhancing population health by promoting physical activity.
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