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Szuhany KL, Steinberg MH, McLaughlin NCR, Mancebo MC, Brown RA, Greenberg BD, Simon NM, Abrantes AM. Predictors of Long-Term Exercise Engagement in Patients With Obsessive-Compulsive Disorder: The Role of Physical Activity Enjoyment. Behav Ther 2023; 54:610-622. [PMID: 37330252 PMCID: PMC10279973 DOI: 10.1016/j.beth.2022.12.010] [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: 02/07/2022] [Revised: 12/19/2022] [Accepted: 12/29/2022] [Indexed: 01/07/2023]
Abstract
Most U.S. adults, even more so those with psychiatric conditions like obsessive-compulsive disorder (OCD), do not engage in the recommended amount of physical activity (PA), despite the wide array of physical and mental health benefits associated with exercise. Therefore, it is essential to identify mechanistic factors that drive long-term exercise engagement so they can be targeted. Using the science of behavior change (SOBC) framework, this study examined potential predictors of long-term exercise engagement as a first step towards identifying modifiable mechanisms, in individuals with OCD, such as PA enjoyment, positive or negative affect, and behavioral activation. Fifty-six low-active patients (mean age = 38.8 ± 13.0, 64% female) with a primary diagnosis of OCD were randomized to either aerobic exercise (AE; n = 28) or health education (HE; n = 28), and completed measures of exercise engagement, PA enjoyment, behavioral activation, and positive and negative affect at baseline, postintervention, and 3-, 6-, and 12-month follow-up. Significant predictors of long-term exercise engagement up to 6-months postintervention were baseline PA (Estimate = 0.29, 95%CI [0.09, 0.49], p = .005) and higher baseline PA enjoyment (Estimate = 1.09, 95%CI [0.30, 1.89], p = .008). Change in PA enjoyment from baseline to postintervention was greater in AE vs. HE, t(44) = -2.06, p = .046, d = -0.61, but endpoint PA enjoyment did not predict follow-up exercise engagement above and beyond baseline PA enjoyment. Other hypothesized potential mechanisms (baseline affect or behavioral activation) did not significantly predict exercise engagement. Results suggest that PA enjoyment may be an important modifiable target mechanism for intervention, even prior to a formal exercise intervention. Next steps aligned with the SOBC framework are discussed, including examining intervention strategies to target PA enjoyment, particularly among individuals with OCD or other psychiatric conditions, who may benefit most from long-term exercise engagement's effects on physical and mental health.
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Affiliation(s)
| | | | - Nicole C R McLaughlin
- Alpert Medical School-Brown University; COBRE Center for Neuromodulation, Butler Hospital
| | | | | | - Benjamin D Greenberg
- Alpert Medical School-Brown University; COBRE Center for Neuromodulation, Butler Hospital; RR&D Center for Neurorestoration and Neurotechnology VA Providence Healthcare System
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Borges AM, Uebelacker LA, Brown RA, Price LH, Abrantes AM. An examination of the effects of distress intolerance and rating of perceived exertion on changes in mood and anxiety following aerobic exercise among treatment-seeking smokers. PSYCHOL HEALTH MED 2023; 28:1720-1728. [PMID: 35642263 DOI: 10.1080/13548506.2022.2083201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 05/20/2022] [Indexed: 01/26/2023]
Abstract
Aerobic exercise is frequently used as an intervention for depression and smoking cessation because of its antidepressant and anxiolytic effects. Distress intolerance (DI) is a proposed individual difference factor that, coupled with a higher rating of perceived exertion during exercise, may significantly impact the acute mood and anxiolytic effects of exercise. The current study examined the interactive effect of maximum rating of perceived exertion (RPE) and DI on change in mood and anxiety. Treatment-seeking smokers (Mage = 45.32; 72% female) with elevated depressive symptoms completed a 1-mile treadmill walk at their preferred intensity and self-reported their RPE during the test. Analyses were conducted to examine whether there was an interactive effect of maximum RPE and DI on change in self-reported mood and anxiety from before to after the walk test. Findings indicate a significant moderating effect of RPE at lower ratings. Individuals reporting a low maximum RPE and higher DI exhibit a greater change in mood over the course of an exercise session, whereas individuals reporting a low maximum RPE and a lower DI exhibit smaller changes in mood. These results indicate that the subjective effects of exercise within a population of cigarette smokers could be improved by tailoring exercise intensity to individual characteristics. Mild to moderate-intensity exercise, as compared to high-intensity exercise, may result in greater changes in mood for individuals endorsing difficulty tolerating affective and physical distress.
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Affiliation(s)
- Allison M Borges
- Behavioral Health, Corporeal Michael J. Crescenz VAMC, Philadelphia, PA, USA
| | - Lisa A Uebelacker
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Butler Hospital, Psychosocial Research, Providence, RI, USA
| | - Richard A Brown
- School of Nursing, University of Texas at Austin, Austin, Tx, USA
| | - Lawrence H Price
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Ana M Abrantes
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Butler Hospital, Behavioral Medicine and Addictions Research, Providence, RI, USA
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3
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Bradley T, Campbell E, Dray J, Bartlem K, Wye P, Hanly G, Gibson L, Fehily C, Bailey J, Wynne O, Colyvas K, Bowman J. Systematic review of lifestyle interventions to improve weight, physical activity and diet among people with a mental health condition. Syst Rev 2022; 11:198. [PMID: 36085250 PMCID: PMC9462072 DOI: 10.1186/s13643-022-02067-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 09/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND People with a mental health condition experience an elevated risk of chronic disease and greater prevalence of health and behaviours. Lifestyle interventions aim to reduce this risk by modifying health behaviours such as physical activity and diet. Previous reviews exploring the efficacy of such interventions for this group have typically limited inclusion to individuals with severe mental illness (SMI), with a focus of impact on weight. This review assessed the efficacy of lifestyle interventions delivered in community or outpatient settings to people with any mental health condition, on weight, physical activity and diet. METHODS Eligible studies were randomised or cluster-randomised controlled trials published between January 1999 and February 2019 aiming to improve weight, physical activity or diet, for people with any mental health condition. Two reviewers independently completed study screening, data extraction and assessment of methodological quality. Primary outcome measures were weight, physical activity and diet. Secondary outcome measures were body mass index (BMI), waist circumference, sedentary behaviour and mental health. Where possible, meta-analyses were conducted. Narrative synthesis using vote counting based on direction of effect was used where studies were not amenable to meta-analysis. RESULTS Fifty-seven studies were included (49 SMI only), with 46 contributing to meta-analyses. Meta-analyses revealed significant (< 0.05) effect of interventions on mean weight loss (-1.42 kg), achieving 5% weight loss (OR 2.48), weight maintenance (-2.05 kg), physical activity (IPAQ MET minutes: 226.82) and daily vegetable serves (0.51), but not on fruit serves (0.01). Significant effects were also seen for secondary outcomes of BMI (-0.48 units) and waist circumference (-0.87cm), but not mental health (depression: SMD -0.03; anxiety: SMD -0.49; severity of psychological symptoms: SMD 0.72). Studies reporting sedentary behaviour were not able to be meta-analysed. Most trials had high risk of bias, quality of evidence for weight and physical activity were moderate, while quality of evidence for diet was low. CONCLUSION Lifestyle interventions delivered to people with a mental health condition made statistically significant improvements to weight, BMI, waist circumference, vegetable serves and physical activity. Further high-quality trials with greater consistency in measurement and reporting of outcomes are needed to better understand the impact of lifestyle interventions on physical activity, diet, sedentary behaviour and mental health and to understand impact on subgroups. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019137197.
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Affiliation(s)
- Tegan Bradley
- University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
- Hunter Medical Research Institute, Lot 1, Kookaburra Cct, New Lambton Heights, NSW 2305 Australia
| | - Elizabeth Campbell
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW 2287 Australia
| | - Julia Dray
- University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
- Hunter Medical Research Institute, Lot 1, Kookaburra Cct, New Lambton Heights, NSW 2305 Australia
| | - Kate Bartlem
- University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
- Hunter Medical Research Institute, Lot 1, Kookaburra Cct, New Lambton Heights, NSW 2305 Australia
| | - Paula Wye
- University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
| | - Grace Hanly
- University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
- Hunter Medical Research Institute, Lot 1, Kookaburra Cct, New Lambton Heights, NSW 2305 Australia
| | - Lauren Gibson
- University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
- Hunter Medical Research Institute, Lot 1, Kookaburra Cct, New Lambton Heights, NSW 2305 Australia
| | - Caitlin Fehily
- University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
- Hunter Medical Research Institute, Lot 1, Kookaburra Cct, New Lambton Heights, NSW 2305 Australia
| | - Jacqueline Bailey
- University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
| | - Olivia Wynne
- University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
| | - Kim Colyvas
- University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
| | - Jenny Bowman
- University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
- Hunter Medical Research Institute, Lot 1, Kookaburra Cct, New Lambton Heights, NSW 2305 Australia
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de Abreu JM, de Souza RA, Viana-Meireles LG, Landeira-Fernandez J, Filgueiras A. Effects of physical activity and exercise on well-being in the context of the Covid-19 pandemic. PLoS One 2022; 17:e0260465. [PMID: 35081122 PMCID: PMC8791524 DOI: 10.1371/journal.pone.0260465] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 11/10/2021] [Indexed: 12/15/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) was discovered in China and characterized by the World Health Organization as a pandemic in March 2020. Many countries worldwide implemented stringent social isolation as a strategy to contain virus transmission. However, the same physical distancing that protects against the spread of COVID-19 may negatively impact mental health and well-being of the population. The present study sought to shed light on this phenomenon by assessing the relationship between physical activity and subjective well-being (SWB) among individuals who were subjected to social isolation during the COVID-19 pandemic. Data were collected in Brazil between March 31 and April 2, 2020. All of the volunteers agreed to participate by digitally checking the option of agreement after reading consent terms. The inclusion criteria were participants who had been in social isolation for at least 1 week and agreed to the consent terms. Three instruments were applied. A questionnaire was constructed for this study that assessed the participants’ exercise routines. The Psychosocial Aspects, Well-being, and Exercise in Confinement (PAWEC) scale was created by researchers of this study that assessed the relationship between well-being and physical activity during social isolation. The Brazilian Portuguese-adapted version of the Positive and Negative Affect Schedule (PANAS) was also used. A total of 592 participants (371 female, 220 male, 1 transgender), 14–74 years old (M = 32.39 years, SD = 10.5 years), reported being in social isolation for an average of 14.4 days (SD = 3.3 days). Well-being that was related to the practice of physical activity during quarantine was linked to an established routine of physical activity before the social isolation period. Participants who already practiced physical exercises previously and reported continuing the practice during the quarantine period had higher positive affect scores. Participants who engaged in physical activity without direct guidance only during the quarantine period had higher negative affect scores. Participants who already practiced physical activity felt more motivated to continue practicing physical activity during the social isolation period, resulting in positive affect, unlike participants who began exercising only during quarantine. Our results suggest that negative affect can occur among individuals who only just begin exercising during social isolation, indicating that physical activity should be habitual and not only occur during periods of social isolation. Engaging in exercise only during social isolation may contribute to an increase in malaise.
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Affiliation(s)
| | | | | | - J. Landeira-Fernandez
- Departamento de Psicologia, Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Alberto Filgueiras
- Departamento de Cognição e Desenvolvimento, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
- * E-mail:
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Childhood adversity affects symptomatology via behavioral inhibition in patients with obsessive-compulsive disorder. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-02718-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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6
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West JL, Tremont G, Miller IW, Uebelacker LA. Yoga v. health education for attentional processes relevant to major depressive disorder. Mindfulness (N Y) 2020; 12:604-612. [PMID: 33777256 DOI: 10.1007/s12671-020-01519-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Objectives Research has shown that yoga may be an effective adjunctive treatment for persistent depression, the benefits of which may accumulate over time. The objectives of this study were to evaluate the following in a sample of persistently depressed individuals: whether yoga increases mindfulness and whether yoga attenuates rumination. Rumination and mindfulness both represent attentional processes relevant for onset and maintenance of depressive episodes. Methods One-hundred-ten individuals who were persistently depressed despite ongoing use of pharmacological treatment were recruited into an RCT comparing yoga with a health education class. Mindfulness and rumination were assessed at baseline and across 3 time points during the ten-week intervention. Results Findings demonstrate that, compared to health education, yoga was associated with higher mean levels of the observe facet of mindfulness relative to the control group during the intervention period (p =.004, d =0.38), and that yoga was associated with a faster rate of increase in levels of acting with awareness over the intervention period (p= .03, f2 =0.027). There were no differences between intervention groups with respect to rumination. Conclusions Results suggest a small effect of yoga on components of mindfulness during a 10-week intervention period. Previous research suggests that continued assessment after the initial 10 weeks may reveal continued improvement. Future research may also examine moderators of the impact of yoga on mindfulness and rumination, including clinical factors such as depression severity or depression chronicity, or demographic factors such as age.
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Affiliation(s)
| | - Geoffrey Tremont
- Alpert Medical School of Brown University, Providence, RI.,Rhode Island Hospital, Providence, RI
| | - Ivan W Miller
- Alpert Medical School of Brown University, Providence, RI.,Butler Hospital, Providence, RI
| | - Lisa A Uebelacker
- Alpert Medical School of Brown University, Providence, RI.,Butler Hospital, Providence, RI
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7
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Uebelacker LA, Sillice MA, Epstein-Lubow G, Battle CL, Anderson B, Caviness C, Miller IW, Abrantes AM. Combined intervention approaches for initiating and maintaining physical activity in depressed individuals: design and rationale of the Project MOVE randomized clinical trial. Contemp Clin Trials 2020; 91:105974. [PMID: 32151752 PMCID: PMC8017446 DOI: 10.1016/j.cct.2020.105974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 02/25/2020] [Accepted: 03/02/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Regular engagement in physical activity decreases risks for many chronic conditions, and may also improve depression symptoms. However, rates of physical activity and adherence to exercise interventions remain low among depressed individuals relative to non-depressed individuals. METHODS This is a study protocol for Project MOVE. This study is a theoretically-driven, 3-arm randomized controlled trial for increasing physical activity with depressed adults. Each successive arm includes an added component that may serve to increase and maintain physical activity. The arms are: 1) Brief advice (BA) to exercise alone (minimal treatment control condition); 2) BA + supervised and home-based exercise (SHE) + health education (HE; serves as contact control for CBEX); and 3) BA + SHE +cognitive-behavioral sessions focused on increasing and maintaining exercise (CBEX). The target sample size is 240. Assessments are conducted at baseline, Month 1.5, end of intervention (month 3), and at 6 and 9 months. The primary outcome is minutes of moderate-to-vigorous physical activity, assessed via an accelerometer. Secondary outcomes include cardiorespiratory fitness, body composition, and depression, and maintenance of moderate-vigorous physical activity through 6 and 9 month follow-ups. Mediators and moderators derived from behavior change theories, including the Health Behavior Model, Self-Determination Theory, and Social Ecological Theory, will be examined. CONCLUSION Project MOVE is designed to test primarily whether both a structured exercise program (SHE) and a cognitive-behavioral group (CBEX) increase physical activity in depressed adults during both a 3-month intervention period, and during the 6-months that follow.
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Affiliation(s)
- Lisa A Uebelacker
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Psychosocial Research Program, Butler Hospital, Providence, RI, USA
| | - Marie A Sillice
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Psychosocial Research Program, Butler Hospital, Providence, RI, USA; Behavioral Medicine & Addiction Research, Butler Hospital, Providen,ce, RI, USA.
| | - Gary Epstein-Lubow
- Psychosocial Research Program, Butler Hospital, Providence, RI, USA; Department of Health Services, Policy and Practice of Brown University, Providence, RI, USA
| | - Cynthia L Battle
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Psychosocial Research Program, Butler Hospital, Providence, RI, USA; Center for Women's Behavioral Health, Women & Infants' Hospital of Rhode Island, Providence, RI, USA
| | - Bradley Anderson
- Behavioral Medicine & Addiction Research, Butler Hospital, Providen,ce, RI, USA
| | - Celeste Caviness
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Behavioral Medicine & Addiction Research, Butler Hospital, Providen,ce, RI, USA
| | - Ivan W Miller
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Psychosocial Research Program, Butler Hospital, Providence, RI, USA
| | - Ana M Abrantes
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Behavioral Medicine & Addiction Research, Butler Hospital, Providen,ce, RI, USA
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8
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Gaudiano BA, Davis CH, Miller IW, Uebelacker L. Pilot randomized controlled trial of a video self-help intervention for depression based on acceptance and commitment therapy: Feasibility and acceptability. Clin Psychol Psychother 2020; 27:396-407. [PMID: 32087610 DOI: 10.1002/cpp.2436] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 02/02/2020] [Accepted: 02/13/2020] [Indexed: 11/10/2022]
Abstract
A common setting where depression is identified and treated is in primary care, where there is a need for low-intensity and cost-effective interventions to be used as part of a stepped-care model. The current study involved a pilot, parallel-group, randomized controlled trial of a video self-help intervention for primary care patients based on acceptance and commitment therapy (ACT). The intervention, called LifeStories, consisted of storytelling vignettes of patients describing their use of ACT-consistent coping skills for depression. Primary care patients were recruited to determine feasibility, acceptability, and potential clinical effects of the intervention. Twenty-one participants were assigned to use LifeStories over a period of 4 weeks, and 19 participants were assigned to an attention-matched comparison group. Qualitative feedback indicated that participants using LifeStories found the intervention to be engaging and useful in transmitting key ACT principles. Furthermore, those receiving LifeStories rated their level of "transportation" or immersion in the videos higher than the control group. Both conditions showed large improvements in levels of depression at a 12-week follow-up. There were no significant differences in symptom outcomes between groups; however, because this was a pilot study, it was not powered to detect differences between interventions. Both conditions additionally showed smaller effect size changes in psychological flexibility, a key ACT mechanism. The results suggest LifeStories to be a feasible and acceptable psychological intervention that may improve depression, and further research is warranted to determine its effectiveness as part of a stepped-care approach to treating depression in primary care.
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Affiliation(s)
- Brandon A Gaudiano
- Psychosocial Research Program, Butler Hospital, Providence, Rhode Island.,Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Carter H Davis
- Department of Psychology, Utah State University, Logan, Utah
| | - Ivan W Miller
- Psychosocial Research Program, Butler Hospital, Providence, Rhode Island.,Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Lisa Uebelacker
- Psychosocial Research Program, Butler Hospital, Providence, Rhode Island.,Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
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9
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Ströhle A. Sports psychiatry: mental health and mental disorders in athletes and exercise treatment of mental disorders. Eur Arch Psychiatry Clin Neurosci 2019; 269:485-498. [PMID: 29564546 DOI: 10.1007/s00406-018-0891-5] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 03/19/2018] [Indexed: 12/11/2022]
Abstract
Sports psychiatry has developed for the past 3 decades as an emerging field within psychiatry and sports medicine. An International society has been established in 1994 and also national interest groups were implemented, mostly within the national organizations for psychiatry, some also containing the topic of exercise treatment of mental disorders. Where are we now 30 years later? We systematically but also selectively review the medical literature on exercise, sport, psychiatry, mental health and mental disorders and related topics. The number of publications in the field has increased exponentially. Most topics keep remaining on the agenda, e.g., head trauma and concussion, drug abuse and doping, performance enhancement, overtraining, ADHD or eating disorders. Supported by the growing literature, evidence-based recommendations have become available now in many clinical areas. A relatively new phenomenon is muscle dysmorphia, observed in weightlifters, bodybuilders but also in college students and gym users. Further, sports therapy of mental disorders has been studied by more and more high-quality randomized controlled clinical trials. Mostly as a complementary treatment, however, for some disorders already with a 1a evidence level, e.g., depression, dementia or MCI but also post-traumatic stress disorder. Being grown up and accepted nowadays, sports psychiatry still represents a fast-developing field. The reverse side of the coin, sport therapy of mental disorders has received a scientific basis now. Who else than sports psychiatry could advance sport therapy of mental disorders? We need this enthusiasm for sports and psychiatry for our patients with mental disorders and it is time now for a broadening of the scope. Optimized psychiatric prevention and treatment of athletes and ideal sport-related support for individuals with mental disorders should be our main purpose and goal.
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Affiliation(s)
- Andreas Ströhle
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, corporate member of the Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Charité Mitte, Charitéplatz 1, 10117, Berlin, Germany.
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10
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Anxiety Sensitivity is Associated with Lower Enjoyment and an Anxiogenic Response to Physical Activity in Smokers. COGNITIVE THERAPY AND RESEARCH 2019; 43:78-87. [PMID: 31073255 DOI: 10.1007/s10608-018-9948-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Background The subjective affective response to, and enjoyment of, physical activity are strong predictors of engagement in physical activity. Anxiety sensitivity, the fear of bodily sensations, is a cognitive factor that may inhibit the pleasurable affective experience of physical activity, possibly contributing to low levels of physical activity. The current study evaluated anxiety sensitivity in relation to PA enjoyment and affective experience before and after exercise in smokers. Method Participants were low-active treatment-seeking smokers (n = 201) enrolled in a smoking cessation intervention. At baseline, participants completed self -report assessments of anxiety sensitivity, cigarette dependence, and physical activity enjoyment. State affect was also reported before and after a submaximal exercise test to index pre-exercise activity affect and affective response to exercise. Results Anxiety sensitivity was significantly negatively correlated with physical activity enjoyment, specifically lower enjoyable physical feelings of physical activity. Anxiety sensitivity was significantly correlated with lower state mood and higher state anxiety prior to the submaximal exercise test, and higher anxiety immediately after the exercise test. Additionally, anxiety sensitivity predicted increased anxiety, but not lower mood, in response to the submaximal exercise test. Conclusions This is the first study to document an association of anxiety sensitivity with affective determinants of physical activity behavior in smokers. Anxiety sensitivity was associated with lower physical activity enjoyment, higher negative affect prior to after exercise testing, and an anxiogenic response to exercise. Future work is needed to understand how the current findings generalize beyond smokers.
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11
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Abrantes AM, Farris SG, Brown RA, Greenberg BD, Strong DR, McLaughlin NC, Riebe D. Acute effects of aerobic exercise on negative affect and obsessions and compulsions in individuals with obsessive-compulsive disorder. J Affect Disord 2019; 245:991-997. [PMID: 30699885 PMCID: PMC7037579 DOI: 10.1016/j.jad.2018.11.074] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 10/17/2018] [Accepted: 11/11/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND The acute effects of aerobic exercise on improved mood and anxiety reduction have been demonstrated across clinical and nonclinical populations. Limited work has evaluated the acute effects of aerobic exercise on negative affect, obsessions, and compulsions in patients with Obsessive Compulsive Disorder (OCD). METHOD Fifty-five patients (64% female) with treatment-resistant OCD were randomized to either 12 weeks of aerobic exercise (AE) or health education contact (HEC) control. Participants rated negative affect (i.e., mood and anxiety), obsessions and compulsions before and after each weekly AE or HEC session. Multilevel models were constructed to evaluate the effect of intervention condition, treatment week (time), and their interaction in terms of acute change in affect, obsession, and compulsions. RESULTS Results reflected a main effect of condition, such that AE resulted in significantly larger increases in positive mood, and reductions in anxiety and compulsions, as compared to HEC. There was also a main effect of time in predicting acute anxiety reduction, such that linear reductions in anxiety over the course of treatment were observed. No significant effects were observed for acute changes in obsessions. LIMITATIONS The sample was small and was limited in demographic heterogeneity. Bouts of aerobic exercise were not standardized in terms of duration and mode, which could impact affective response to exercise, and acute affective OCD effects were exclusively self-reported. DISCUSSION The current findings may help elucidate potential mechanisms of action of exercise on OCD outcomes. In addition, these results point toward the potential of designing exercise interventions that can teach patients to utilize individual bouts of physical activity, "in-the-moment" to improve mood and reduce anxiety and compulsions.
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Affiliation(s)
- Ana M. Abrantes
- Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior,Butler Hospital,Corresponding author: Ana M. Abrantes, Ph.D., Professor, Alpert Medical School of Brown University; Butler Hospital; 345 Blackstone Blvd., Providence, RI 02906; Tel: 401-455-6440;
| | | | | | - Benjamin D. Greenberg
- Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior,Butler Hospital,Veterans Affairs Medical Center of Providence
| | - David R. Strong
- University of California San Diego, Family Medicine and Public Health
| | - Nicole C. McLaughlin
- Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior,Butler Hospital
| | - Deborah Riebe
- University of Rhode Island, Department of Kinesiology
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12
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Fontenelle LF, Zeni-Graiff M, Quintas JN, Yücel M. Is There A Role For Lifestyle Interventions In Obsessive-Compulsive And Related Disorders? Curr Med Chem 2019; 25:5698-5711. [DOI: 10.2174/0929867325666180104150854] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Revised: 12/01/2017] [Accepted: 12/08/2017] [Indexed: 01/12/2023]
Abstract
Many of the currently available treatments for obsessive-compulsive and related
disorders (OCRDs) such as pharmacotherapy augmentation strategies, partial hospitalization
programs, deep brain stimulation, and neurosurgery are efficacious for individuals
suffering from more severe forms of these conditions. Unfortunately, the application
of these treatments in milder forms of illness and subclinical samples, which affect a
substantial portion of the population, is not justifiable by their costs (e.g. cognitivebehavioral
therapy) and/or potential for side effects (serotonin-reuptake inhibitors associated
sexual side effects). As such, there is an urgent need to develop simple yet effective
treatments, such as modifiable lifestyle interventions, that can be employed on a broader
scale. Here, we review the current state of evidence that supports or refutes the efficacy of
lifestyle approaches for OCRDs. We focus on dimensions of lifestyle that are deemed important
for cardiovascular diseases; namely, physical activity, stress, sleep, diet and eating
behaviors, alcohol consumption, and smoking. Despite the relative scarcity of welldesigned
randomized controlled trials targeting unhealthy life styles in OCRDs, we found
meditation-based therapies and interventions focusing on eliminating sedentarism to be
promising approaches. In the future, these strategies may represent valid alternative for
subjects with subthreshold symptoms or at risk for OCRDs or other “compulsive” disorders.
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Affiliation(s)
- Leonardo F. Fontenelle
- Obsessive, Compulsive, and Anxiety Spectrum Research Program. Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil
| | - Maiara Zeni-Graiff
- Obsessive, Compulsive, and Anxiety Spectrum Research Program. Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil
| | - Julliana N. Quintas
- Obsessive, Compulsive, and Anxiety Spectrum Research Program. Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil
| | - Murat Yücel
- Brain & Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences and School of Psychological Sciences, Monash University, Victoria, Australia
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13
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Vollbehr NK, Bartels-Velthuis AA, Nauta MH, Castelein S, Steenhuis LA, Hoenders HJR, Ostafin BD. Hatha yoga for acute, chronic and/or treatment-resistant mood and anxiety disorders: A systematic review and meta-analysis. PLoS One 2018; 13:e0204925. [PMID: 30273409 PMCID: PMC6166972 DOI: 10.1371/journal.pone.0204925] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 09/17/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The aim of this study was to systematically investigate the effectiveness of hatha yoga in treating acute, chronic and/or treatment-resistant mood and anxiety disorders. METHODS Medline, Cochrane Library, Current Controlled Trials, Clinical Trials.gov, NHR Centre for Reviews and Dissemination, PsycINFO and CINAHL were searched through June 2018. Randomized controlled trials with patients with mood and anxiety disorders were included. Main outcomes were continuous measures of severity of mood and anxiety symptoms. Cohen's d was calculated as a measure of effect size. Meta-analyses using a random effects model was applied to estimate direct comparisons between yoga and control conditions for depression and anxiety outcomes. Publication bias was visually inspected using funnel plots. RESULTS Eighteen studies were found, fourteen in acute patients and four in chronic patients. Most studies were of low quality. For depression outcomes, hatha yoga did not show a significant effect when compared to treatment as usual, an overall effect size of Cohen's d -0.64 (95% CI = -1.41, 0.13) or to all active control groups, Cohen's d -0.13 (95% CI = -0.49, 0.22). A sub-analysis showed that yoga had a significant effect on the reduction of depression compared to psychoeducation control groups, Cohen's d -0.52 (95% CI = -0.96, -0.08) but not to other active control groups, Cohen's d 0.28 (95% CI = -0.07, 0.63) For studies using a follow-up of six months or more, hatha yoga had no effect on the reduction of depression compared to active control groups, Cohen's d -0.14 (95% CI = -0.60, 0.33). Regarding anxiety, hatha yoga had no significant effect when compared to active control groups, Cohen's d -0.09 (95% CI = -0.47, 0.30). The I2 and Q-statistic revealed heterogeneity amongst comparisons. Qualitative analyses suggest some promise of hatha yoga for chronic populations. CONCLUSIONS The ability to draw firm conclusions is limited by the notable heterogeneity and low quality of most of the included studies. With this caveat in mind, the results of the current meta-analysis suggest that hatha yoga does not have effects on acute, chronic and/or treatment-resistant mood and anxiety disorders compared to treatment as usual or active control groups. However, when compared to psychoeducation, hatha yoga showed more reductions in depression. It is clear that more high-quality studies are needed to advance the field.
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Affiliation(s)
- Nina K. Vollbehr
- Lentis Psychiatric Institute, Center for Integrative Psychiatry, Groningen, the Netherlands
- University of Groningen, Faculty of Behavioral and Social Sciences, Department of Clinical Psychology and Experimental Psychopathology, Groningen, the Netherlands
| | - Agna A. Bartels-Velthuis
- Lentis Psychiatric Institute, Center for Integrative Psychiatry, Groningen, the Netherlands
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Groningen, the Netherlands
| | - Maaike H. Nauta
- University of Groningen, Faculty of Behavioral and Social Sciences, Department of Clinical Psychology and Experimental Psychopathology, Groningen, the Netherlands
| | - Stynke Castelein
- University of Groningen, Faculty of Behavioral and Social Sciences, Department of Clinical Psychology and Experimental Psychopathology, Groningen, the Netherlands
- Lentis Psychiatric Institute, Lentis Research, Groningen, the Netherlands
| | - Laura A. Steenhuis
- University of Groningen, Faculty of Behavioral and Social Sciences, Department of Clinical Psychology and Experimental Psychopathology, Groningen, the Netherlands
| | - H. J. Rogier Hoenders
- Lentis Psychiatric Institute, Center for Integrative Psychiatry, Groningen, the Netherlands
| | - Brian D. Ostafin
- University of Groningen, Faculty of Behavioral and Social Sciences, Department of Clinical Psychology and Experimental Psychopathology, Groningen, the Netherlands
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14
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Abrantes AM, Brown RA, Strong DR, McLaughlin N, Garnaat SL, Mancebo M, Riebe D, Desaulniers J, Yip AG, Rasmussen S, Greenberg B. A pilot randomized controlled trial of aerobic exercise as an adjunct to OCD treatment. Gen Hosp Psychiatry 2017; 49:51-55. [PMID: 29122148 PMCID: PMC5726421 DOI: 10.1016/j.genhosppsych.2017.06.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 06/14/2017] [Accepted: 06/20/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The purpose of the current study was to conduct a randomized controlled trial testing the efficacy of aerobic exercise for decreasing OCD symptom severity, other mental health outcomes, and increasing exercise behaviors and cardiorespiratory fitness among individuals with OCD. METHOD Fifty-six patients (64% female; mean age=38.8years) with OCD and a Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score of 16 or greater despite engaging in OCD treatment were randomized to 12-weeks of supervised plus home-based moderate-intensity aerobic exercise (AE; n=28) or to 12-weeks of health education sessions (HE; n=28). RESULTS Random intercepts mixed models examined differences between conditions at post-treatment. Though no difference between conditions on outcomes was observed, both AE and HE showed significant reduction in OCD symptom severity, depression and anxiety at post-treatment. Relative to HE, significant increases were noted in amount of exercise and cardiorespiratory fitness for those in the AE condition. At post-treatment, 30.4% of the AE condition (7 of 23) were treatment-responders (using the commonly accepted measure of 35% symptom reduction from baseline). In the HE condition, 7.7% of the sample (2 of 26) met this criterion at post-treatment. CONCLUSION The results of this preliminary study suggest that exercise and health-focused interventions may be beneficial adjuncts to existing OCD treatment. Future studies with larger samples are needed to more definitively answer questions the efficacy of AE for reducing OCD symptoms and improving related clinical outcomes.
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Affiliation(s)
- Ana M. Abrantes
- Butler Hospital, Providence, RI 02906,Alpert Medical School of Brown University, Providence, RI 02906
| | - Richard A. Brown
- Alpert Medical School of Brown University, Providence, RI 02906,University of Texas at Austin, Austin, TX, 78712
| | | | - Nicole McLaughlin
- Butler Hospital, Providence, RI 02906,Alpert Medical School of Brown University, Providence, RI 02906
| | - Sarah L. Garnaat
- Butler Hospital, Providence, RI 02906,Alpert Medical School of Brown University, Providence, RI 02906
| | - Maria Mancebo
- Butler Hospital, Providence, RI 02906,Alpert Medical School of Brown University, Providence, RI 02906
| | | | | | | | | | - Benjamin Greenberg
- Butler Hospital, Providence, RI 02906,Alpert Medical School of Brown University, Providence, RI 02906,Providence Veterans Affairs Medical Center, Providence, RI 02908
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15
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Uebelacker LA, Tremont G, Gillette LT, Epstein-Lubow G, Strong DR, Abrantes AM, Tyrka AR, Tran T, Gaudiano BA, Miller IW. Adjunctive yoga v. health education for persistent major depression: a randomized controlled trial. Psychol Med 2017; 47:2130-2142. [PMID: 28382883 PMCID: PMC5548599 DOI: 10.1017/s0033291717000575] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND The objective of this study was to determine whether hatha yoga is an efficacious adjunctive intervention for individuals with continued depressive symptoms despite antidepressant treatment. METHOD We conducted a randomized controlled trial of weekly yoga classes (n = 63) v. health education classes (Healthy Living Workshop; HLW; n = 59) in individuals with elevated depression symptoms and antidepressant medication use. HLW served as an attention-control group. The intervention period was 10 weeks, with follow-up assessments 3 and 6 months afterwards. The primary outcome was depression symptom severity assessed by blind rater at 10 weeks. Secondary outcomes included depression symptoms over the entire intervention and follow-up periods, social and role functioning, general health perceptions, pain, and physical functioning. RESULTS At 10 weeks, we did not find a statistically significant difference between groups in depression symptoms (b = -0.82, s.e. = 0.88, p = 0.36). However, over the entire intervention and follow-up period, when controlling for baseline, yoga participants showed lower levels of depression than HLW participants (b = -1.38, s.e. = 0.57, p = 0.02). At 6-month follow-up, 51% of yoga participants demonstrated a response (⩾50% reduction in depression symptoms) compared with 31% of HLW participants (odds ratio = 2.31; p = 0.04). Yoga participants showed significantly better social and role functioning and general health perceptions over time. CONCLUSIONS Although we did not see a difference in depression symptoms at the end of the intervention period, yoga participants showed fewer depression symptoms over the entire follow-up period. Benefits of yoga may accumulate over time.
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Affiliation(s)
- Lisa A. Uebelacker
- Butler Hospital, Providence, RI
- Alpert Medical School of Brown University, Providence, RI
| | - Geoffrey Tremont
- Alpert Medical School of Brown University, Providence, RI
- Rhode Island Hospital, Providence, RI
| | | | - Gary Epstein-Lubow
- Butler Hospital, Providence, RI
- Alpert Medical School of Brown University, Providence, RI
| | | | - Ana M. Abrantes
- Butler Hospital, Providence, RI
- Alpert Medical School of Brown University, Providence, RI
| | - Audrey R. Tyrka
- Butler Hospital, Providence, RI
- Alpert Medical School of Brown University, Providence, RI
| | - Tanya Tran
- Alpert Medical School of Brown University, Providence, RI
- Rhode Island Hospital, Providence, RI
| | - Brandon A. Gaudiano
- Butler Hospital, Providence, RI
- Alpert Medical School of Brown University, Providence, RI
| | - Ivan W. Miller
- Butler Hospital, Providence, RI
- Alpert Medical School of Brown University, Providence, RI
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16
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Abrantes AM, Farris SG, Garnaat SL, Minto A, Brown RA, Price LH, Uebelacker LA. The Role of Physical Activity Enjoyment on the Acute Mood Experience of Exercise among Smokers with Elevated Depressive Symptoms. Ment Health Phys Act 2017; 12:37-43. [PMID: 28989344 PMCID: PMC5625337 DOI: 10.1016/j.mhpa.2017.02.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PROBLEM Depressive symptoms are consistently shown to be related to poor smoking cessation outcomes. Aerobic exercise is a potential treatment augmentation that, given its antidepressant and mood enhancing effect, may bolster cessation outcomes for smokers with elevated depressive symptoms. Lower enjoyment of physical activity may inhibit the acute mood enhancing effects of aerobic exercise. The current study investigated the associations between depressive symptoms, physical activity enjoyment and the acute mood experience from exercise among low-active smokers with elevated depressive symptoms. METHOD Daily smokers with elevated depressive symptoms (N=159; Mage = 45.1, SD = 10.79; 69.8% female) were recruited for a randomized controlled exercise-based smoking cessation trial. Participants self-reported levels of depressive symptoms, physical activity enjoyment, and rated their mood experience (assessed as "mood" and "anxiety") before and after a standardized aerobic exercise test. RESULTS Hierarchical regression analysis revealed that depressive symptom severity accounted for significant unique variance in physical activity enjoyment (R2 =.041, t = -2.61, p = .010), beyond the non-significant effects of gender and level of tobacco dependence. Additionally, physical activity enjoyment was a significant mediator of the association between depressive symptom severity and acute mood experience ("mood" and "anxiety") following the exercise test. CONCLUSIONS Physical activity enjoyment may explain, at least in part, how depressive symptom severity is linked to the acute mood experience following a bout of activity. Interventions that target increasing physical activity enjoyment may ultimately assist in enhancing the mood experience from exercise, and therefore improve smoking cessation likelihood, especially for smokers with elevated depressive symptoms.
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Affiliation(s)
- Ana M. Abrantes
- Butler Hospital, Providence, Rhode Island
- Alpert Medical School of Brown University, Providence, Rhode
Island
| | - Samantha G. Farris
- Butler Hospital, Providence, Rhode Island
- Alpert Medical School of Brown University, Providence, Rhode
Island
- The Miriam Hospital, Providence, Rhode Island
| | - Sarah L. Garnaat
- Butler Hospital, Providence, Rhode Island
- Alpert Medical School of Brown University, Providence, Rhode
Island
| | | | - Richard A. Brown
- Alpert Medical School of Brown University, Providence, Rhode
Island
- University of Texas at Austin, Austin, Texas
| | - Lawrence H. Price
- Butler Hospital, Providence, Rhode Island
- Alpert Medical School of Brown University, Providence, Rhode
Island
| | - Lisa A. Uebelacker
- Butler Hospital, Providence, Rhode Island
- Alpert Medical School of Brown University, Providence, Rhode
Island
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17
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Nyström MBT, Neely G, Hassmén P, Carlbring P. Treating Major Depression with Physical Activity: A Systematic Overview with Recommendations. Cogn Behav Ther 2015; 44:341-52. [PMID: 25794191 DOI: 10.1080/16506073.2015.1015440] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
UNLABELLED The purpose of this systematic overview was to determine the most effective mode and dose of physical activity (PA) for treating major depressive disorder (MDD), and to suggest guidelines and recommendations for clinicians. The selection process consisted of a comprehensive search that was conducted up until April 2014 in the following databases: PsycINFO, Medline, PubMed and Scopus. The inclusion criteria were: (1) a randomized controlled trial (RCT) design, (2) complete description of intensity, duration and frequency of the PA, (3) the participants had to be diagnosed with MDD according to Diagnostic Statistical Manual 4 th edition (DSM-IV) or International Classification of Disease tenth Revision (ICD-10) criteria (4) if the controls received any treatment, it had to be specified, (5) published after 1990, (6) consist of aerobic or anaerobic treatment PA, and (7) not be a pilotor preliminary study. A quality assessment of each study was conducted independently by two reviewers; this stringent selection process resulted in 12 reviewed studies. CONCLUSION individually customized PA, for at least 30 minutes, preferably performed under supervision and with a frequency of at least three times per week is recommended when treating MDD. These recommendations must be viewed in light of the relatively few studies matching the inclusion criteria.
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18
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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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Abstract
This review summarizes the extant evidence of the effects of exercise training on anxiety among healthy adults, adults with a chronic illness, and individuals diagnosed with an anxiety disorder. A brief discussion of selected proposed mechanisms that may underlie relations of exercise and anxiety is also provided. The weight of the available empirical evidence indicates that exercise training reduces symptoms of anxiety among healthy adults, chronically ill patients, and patients with panic disorder. Preliminary data suggest that exercise training can serve as an alternative therapy for patients with social anxiety disorder, generalized anxiety disorder, and obsessive–compulsive disorder. Anxiety reductions appear to be comparable to empirically supported treatments for panic and generalized anxiety disorders. Large trials aimed at more precisely determining the magnitude and generalizability of exercise training effects appear to be warranted for panic and generalized anxiety disorders. Future well-designed randomized controlled trials should (a) examine the therapeutic effects of exercise training among understudied anxiety disorders, including specific phobias, social anxiety disorder and posttraumatic stress disorder; (b) focus on understudied exercise modalities, including resistance exercise training and programs that combine exercise with cognitive-behavioral therapies; and (c) elucidate putative mechanisms of the anxiolytic effects of exercise training.
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Affiliation(s)
- Matthew P. Herring
- Department of Epidemiology, University of Alabama at Birmingham, Alabama (MPH)
- Department of Kinesiology, The University of Georgia, Athens, Georgia (JBL, PJO)
| | - Jacob B. Lindheimer
- Department of Epidemiology, University of Alabama at Birmingham, Alabama (MPH)
- Department of Kinesiology, The University of Georgia, Athens, Georgia (JBL, PJO)
| | - Patrick J. O’Connor
- Department of Epidemiology, University of Alabama at Birmingham, Alabama (MPH)
- Department of Kinesiology, The University of Georgia, Athens, Georgia (JBL, PJO)
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