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Chokroverty L. Depression Part 2: Treatment. Pediatr Rev 2024; 45:494-504. [PMID: 39217118 DOI: 10.1542/pir.2024-006479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 03/21/2024] [Accepted: 03/21/2024] [Indexed: 09/04/2024]
Abstract
Depression treatment strategies are within the scope of pediatric practice and among the competencies recommended by the Academy of Pediatrics and The American Board of Pediatrics. Treatments that may be provided through collaborative care include nonpharmacologic therapies such as psychosocial treatments and evidence-based psychotherapies, and pharmacotherapy and monitoring processes for depression. Abundant support and guidance are available to pediatricians in depression care, including mental health consultation and online materials.
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Affiliation(s)
- Linda Chokroverty
- Departments of Psychiatry and Behavioral Sciences and Pediatrics, Montefiore Health Systems/Albert Einstein College of Medicine, Bronx, NY
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2
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Chokroverty L. Depression Part 1: Evaluation. Pediatr Rev 2024; 45:483-493. [PMID: 39217122 DOI: 10.1542/pir.2022-005688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/06/2024] [Accepted: 03/09/2024] [Indexed: 09/04/2024]
Abstract
By young adulthood, 1 in 5 teens will experience an episode of major depression. The second leading cause of death among youths aged 15 to 24 years is suicide, most of which will have been caused by untreated or undiagnosed depression. Depression is a highly heritable condition: depressed children often have depressed parents. Support to caregivers is important because depressed parents can have negative effects on children's development and future mental health. Groups more vulnerable to mental health disorders such as depression include Black, Indigenous, and persons of color and lesbian, gay, bisexual, transgender, or queer/questioning, who in recent years have the highest rate of suicide attempts (Black teens, sexual minority youth), the highest increases in suicide rates (Black children and youths), and the highest suicide rates (American Indian/Alaskan native). They frequently experience more adverse childhood events, which increases the risk of depression and suicide attempts. Pediatricians are most likely to care for these vulnerable youths, who often are less engaged in specialty mental health care for a variety of reasons, including stigma and barriers to access. By offering behavioral and mental health care to vulnerable populations in primary care, mental health equity may be achieved. Screening for depression and assessment for suicide are within the scope of pediatric practice and among the competencies recommended by the American Academy of Pediatrics and The American Board of Pediatrics.
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Affiliation(s)
- Linda Chokroverty
- Departments of Psychiatry and Behavioral Sciences and Pediatrics, Montefiore Health Systems/Albert Einstein College of Medicine, Bronx, NY
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Klaufus LH, Verlinden E, van der Wal MF, Cuijpers P, Chinapaw MJM, Boschloo L. Exploring the Association of Age with Depressive Symptomatology in Childhood and Adolescence: A Network Study. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024; 53:669-679. [PMID: 35939779 DOI: 10.1080/15374416.2022.2096044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE This study aimed to explore the association of age with individual depression and anxiety symptoms and their connectivity (i.e., number/strength of connections with other symptoms) in girls and boys. METHOD Our study comprised cross-sectional data from 31,960 Dutch girls and 32,162 Dutch boys aged 8 to 18 and considered 11 depression symptoms and 14 anxiety symptoms measured by the Revised Child Anxiety and Depression Scale. Network estimations were used to examine whether age was associated with individual symptoms and, in a separate step, with the connectivity of depression symptoms with other depression symptoms and with the connectivity of depression symptoms with anxiety symptoms. RESULTS Age was, in general, positively associated with depression symptoms in girls, but not in boys, and with the connectivity of depression symptoms with other depression symptoms in both sexes. These findings were the most profound for energy-related symptoms in girls. Age was, in general, negatively associated with anxiety symptoms and not or negatively associated with the connectivity of depression symptoms with anxiety symptoms in girls and boys, respectively. Substantial differences across symptoms were found. CONCLUSIONS This study shows that it is important to focus on individual symptoms, for age is mainly associated with energy-related depression symptoms and their connectivity in girls. Future etiologic studies may examine the role of energy-related depression symptoms in the development of depressive symptomatology in girls as these symptoms seem potential targets for the prevention of depression in the female population.
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Affiliation(s)
- Leonie H Klaufus
- Department of Epidemiology, Health Promotion, and Health Care Innovation, Public Health Service Amsterdam
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit
| | - Eva Verlinden
- Department of Epidemiology, Health Promotion, and Health Care Innovation, Public Health Service Amsterdam
| | - Marcel F van der Wal
- Department of Epidemiology, Health Promotion, and Health Care Innovation, Public Health Service Amsterdam
| | - Pim Cuijpers
- Department of Clinical, Neuro, and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit
| | - Mai J M Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit
| | - Lynn Boschloo
- Department of Clinical, Neuro, and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit
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Anker EA, Bøe Sture SE, Hystad SW, Kodal A. The effect of physical activity on anxiety symptoms among children and adolescents with mental health disorders: a research brief. Front Psychiatry 2024; 15:1254050. [PMID: 38818022 PMCID: PMC11138150 DOI: 10.3389/fpsyt.2024.1254050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 04/29/2024] [Indexed: 06/01/2024] Open
Abstract
Background Anxiety is prevalent among children and adolescents (termed youths), and leads to reduced quality of life, disability, loss of education and reduced life-span. Physical activity has shown promising effects on symptoms of anxiety in adult populations, and an increasing amount of research has also demonstrated some effect in youth. However, physical activity is not widely used in youth mental health care, and research is very limited. Methods/design This single arm, pre-post study explores the effect of a manualized physical activity-based 14-session intervention termed Confident, Active and Happy Youth. Participants are youth attending specialized mental health care (N=51, M age = 13.4, SD = 2.2). Changes in anxiety symptoms are examined using mixed models with residual maximum likelihood (REML). The potential effect of anxiety subtype differences, participant age, comorbidity, and time spent in out-patient care are explored. Results Youths did not report any effect on anxiety symptoms after participation in CAHY, however, their parents report a significant reduction in youth's anxiety symptoms in general (b = -0.11, 95%, CI: -0.21 to -0.01) and specifically for social phobia (b = -0.19, 95% CI: -0.35 to -0.03). Age and comorbidity showed no significant effect on anxiety symptoms post treatment. Prior treatment time in youth mental health care demonstrated inconclusive results. Conclusion The study finds initial evidence of symptomatic change in a clinical population of youth's receiving a physical activity-based intervention. Our research provides preliminary support for physical activity as a supplementary treatment method for mental health disorders among youths. Clinical Trial Registration clinicaltrials.gov, NCT05049759.
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Affiliation(s)
- Ella Aase Anker
- Department of Child and Adolescent Psychiatry, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Svanhild E. Bøe Sture
- Department of Child and Adolescent Psychiatry, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Sigurd William Hystad
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Arne Kodal
- Department of Child and Adolescent Psychiatry, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
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Kodal A, Muirhead F, Reilly JJ, Wergeland GJ, Thorsen PJB, Bovim LP, Elgen IB. Feasibility of a physical activity intervention for children and adolescents with anxiety and depression. Pilot Feasibility Stud 2024; 10:49. [PMID: 38443992 PMCID: PMC10913538 DOI: 10.1186/s40814-024-01466-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 02/14/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Physical activity is identified as a key modifiable factor towards good short- and long-term mental health and has shown positive effects on anxiety and depression in children and adolescents. However, physical activity-based interventions are not a part of standard mental health care and evidence on the effect of such interventions is still lacking. A transdiagnostic, physical activity-based intervention was developed as a supplement to routine clinical care for youth in specialized child and adolescent mental health services. METHODS /design. The feasibility of the physical activity intervention (Confident, Active, and Happy Youth) was evaluated in an open-label study by assessing the recruitment process, acceptability, intervention suitability, contentment, and preliminary intervention effects in the form of youth and parent-rated anxiety and depressive symptoms. Physical activity levels were objectively measured using Actigraph™ physical activity sensors, and progression to a definitive study was evaluated in accordance with a priori criteria. RESULTS In total 21 of 25 eligible youth consented to participate, two dropped out of the intervention and 19 completed (76% of eligible participants). The retention rate among consenting participants was 89% and mean attendance to sessions was 83%. The suitability of the intervention was rated as good by the youth and their parents, and intervention contentment was rated high. Changes in youth and parent-rated symptom measures following the intervention were negligible, except for parent-rated anxiety symptoms assessed at 10-month follow-up. Accelerometer data indicated lower levels of moderate to vigorous activity during sessions than intended. No adverse effects were noted. CONCLUSION This feasibility study met the pre-determined progression criteria to a definitive study. Thus, a larger trial with longer follow-up should be conducted to explore the effect of the intervention. TRIAL REGISTRATION ClnicalTrials.gov, NCT05049759. Retrospectively registered, 20.09.2021.
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Affiliation(s)
- Arne Kodal
- Department of Child and Adolescent Psychiatry, Division of Psychiatry, Haukeland University Hospital, N-5021, Bergen, Norway.
- Norce Research, RKBU Vest-Regional Centre for Child and Youth Mental Health and Child Welfare, Postboks 22, Nygårdstangen, Bergen, 5838, Norway.
| | - Fiona Muirhead
- School of Psychological Science and Health, University of Strathclyde, Glasgow, Scotland
| | - John J Reilly
- School of Psychological Science and Health, University of Strathclyde, Glasgow, Scotland
| | - Gro Janne Wergeland
- Department of Child and Adolescent Psychiatry, Division of Psychiatry, Haukeland University Hospital, N-5021, Bergen, Norway
- Department of Clinical Medicine, Faculty of Medicine, University of Bergen, N-5020, Bergen, Norway
| | - Paul Joachim Bloch Thorsen
- Department of Child and Adolescent Psychiatry, Division of Psychiatry, Haukeland University Hospital, N-5021, Bergen, Norway
| | - Lars Peder Bovim
- Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
| | - Irene Bircow Elgen
- Department of Child and Adolescent Psychiatry, Division of Psychiatry, Haukeland University Hospital, N-5021, Bergen, Norway
- Department of Clinical Medicine, Faculty of Medicine, University of Bergen, N-5020, Bergen, Norway
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Liu WY, Li HM, Jiang H, Zhang WK. Effect of exercise training on heath, quality of life, exercise capacity in juvenile idiopathic arthritis: a meta-analysis of randomized controlled trials. Pediatr Rheumatol Online J 2024; 22:33. [PMID: 38438855 PMCID: PMC10910763 DOI: 10.1186/s12969-024-00967-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/21/2024] [Indexed: 03/06/2024] Open
Abstract
OBJECTIVE Little is known about the efficacy and safety of exercise training on juvenile idiopathic arthritis (JIA). This study aims to investigate the effect of exercise on health, quality of life, and different exercise capacities in individuals with JIA. METHOD A comprehensive search of Medline, Embase, Web of Science, and the Cochrane Library was conducted from database inception to October, 2023. Included studies were randomized controlled trials (RCTs) reporting the effects of exercise on JIA patients. Two independent reviewers assessed the literature quality using the Cochrane Collaboration's risk of bias tool. Standardized mean differences (SMD) were combined using random or fixed effects models. The level of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. RESULT Five RCTs met the inclusion criteria, containing 216 female participants and 90 males. The meta-analysis results showed that exercise had no significant effect on JIA patients based on the Child Health Assessment Questionnaire (CHAQ) (SMD=-0.32, 95%CI: -0.83, 0.19; I2 = 73.2%, P = 0.011) and Quality of Life (QoL) (SMD = 0.27, 95%CI: -0.04, 0.58; I2 = 29.4%, P = 0.243) and no significant effect on peak oxygen uptake (VO2peak). However, exercise significantly reduced visual analog scale (VAS) pain scores in JIA patients (SMD = 0.50, 95%CI: -0.90, -0.10; I2 = 50.2%, P = 0.134). The quality of evidence assessed by GRADE was moderate to very low. CONCLUSION Exercise does not significantly affect the quality of life and exercise capacity in JIA patients but may relieve pain. More RCTs are needed in the future to explore the effects of exercise on JIA.
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Affiliation(s)
- Wen-Yu Liu
- Weifang Institute of Technology, Weifang, Shandong, China
- Dongshin University, Rojo, South Jeolla, South Korea
| | - Hui-Min Li
- Yantai Gold College, Yantai, Shandong, China
| | - Hao Jiang
- Weifang Institute of Technology, Weifang, Shandong, China
| | - Wen-Kui Zhang
- Dongshin University, Rojo, South Jeolla, South Korea.
- Universiti Malaysia Sarawak, East Malaysian Borneo, Sarawak, Malaysia.
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Mortazavi R, Grudin R, Jarbin H, Larsson I. Empowered and engaged: Group exercise for adolescent depression - perspectives from adolescents, parents and healthcare professionals. SAGE Open Med 2024; 12:20503121231225340. [PMID: 38313468 PMCID: PMC10838026 DOI: 10.1177/20503121231225340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 12/19/2023] [Indexed: 02/06/2024] Open
Abstract
Objectives Depression is increasing and is a leading cause of disease burden among adolescents. Available evidence-based treatments with medication or psychotherapy have modest effects. Aerobic exercise is a hopeful alternative as an augmenter or a stand-alone treatment. Qualitative studies have shown that participants in group exercise for adolescent depression experienced improved mood and a sense of achievement, commitment and empowerment. This study aimed to explore not only adolescents' but also parents' and healthcare professionals' experiences of a group exercise intervention for adolescents with depression. Methods Nine adolescents who had participated in a group aerobic exercise intervention for 12 weeks, eight parents and two healthcare professionals were interviewed. We used a latent qualitative content analysis with an inductive approach that resulted in nine sub-categories, three categories and an overarching theme. Results The experiences of a group exercise intervention for adolescents with depression were expressed in the overarching theme 'Group exercise for adolescent depression promotes empowerment and engagement in everyday life', based on three categories: exercise alleviates depressive symptoms, exercise contributes to balance in life and exercise promotes self-esteem. However, there was variation in our results, in that not all participants experienced improvements from exercising. Adolescents described more varied experiences, while parents and healthcare professionals mainly expressed positive views. Conclusions Our findings suggest that group exercise for adolescent depression promotes empowerment and engagement in everyday life, according to adolescents, and more clearly so according to parents and healthcare professionals.
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Affiliation(s)
- Rebecca Mortazavi
- Faculty of Medicine, Department of Clinical Sciences, Child and Adolescent Psychiatry, Lund University, Lund, Sweden
- Child and Adolescent Psychiatric Clinic, Region Halland, Halmstad, Sweden
| | - Rebecca Grudin
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Håkan Jarbin
- Faculty of Medicine, Department of Clinical Sciences, Child and Adolescent Psychiatry, Lund University, Lund, Sweden
- Child and Adolescent Psychiatric Clinic, Region Halland, Halmstad, Sweden
| | - Ingrid Larsson
- Department of Health and Nursing, School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Spenshult Research and Development Centre, Halmstad, Sweden
- Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden
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Kauczor-Rieck K, Allroggen M, Gradl-Dietsch G. [Sports and Physical Exercise Therapy in the Treatment of Mental Health Issues in Children and Adolescents]. ZEITSCHRIFT FUR KINDER- UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2024; 52:110-123. [PMID: 38224568 DOI: 10.1024/1422-4917/a000961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
Sports and Physical Exercise Therapy in the Treatment of Mental Health Issues in Children and Adolescents Abstract: Mental disorders are among the most common chronic diseases in childhood and adolescence in Germany and worldwide. The health benefits of a physically active lifestyle during adolescence are well documented. Furthermore, a growing body of evidence suggests a positive impact of physical activity on mental health and emotional well-being. Longitudinal studies also show an association between physical activity and reduced risk of developing a mental disorder. Therefore, therapeutic exercise plays an important role in child and adolescent psychiatry. High-quality randomized-controlled trials are needed to substantiate the described effects.
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Affiliation(s)
- Katja Kauczor-Rieck
- Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Homburg, Deutschland
| | - Marc Allroggen
- Universitätsklinik Ulm, Kinder- und Jugendpsychiatrie/Psychotherapie, Ulm, Deutschland
| | - Gertraud Gradl-Dietsch
- LVR-Klinikum Essen, Kliniken und Institut der Universität Duisburg-Essen, Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Essen, Deutschland
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Pettrey C, Kerr PL, Dickey TO. Physical Exercise as an Intervention for Depression: Evidence for Efficacy and Mu-Opioid Receptors as a Mechanism of Action. ADVANCES IN NEUROBIOLOGY 2024; 35:221-239. [PMID: 38874725 DOI: 10.1007/978-3-031-45493-6_11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
Physical exercise is often cited as an important part of an intervention for depression, and there is empirical evidence to support this. However, the mechanism of action through which any potential antidepressant effects are produced is not widely understood. Recent evidence points toward the involvement of endogenous opioids, and especially the mu-opioid system, as a partial mediator of these effects. In this chapter, we discuss the current level of empirical support for physical exercise as either an adjunctive or standalone intervention for depression. We then review the extant evidence for involvement of endogenous opioids in the proposed antidepressant effects of exercise, with a focus specifically on evidence for mu-opioid system involvement.
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Affiliation(s)
| | - Patrick L Kerr
- Behavioral Medicine & Psychiatry, WVU School of Medicine, Charleston, WV, USA
| | - T O Dickey
- West Virginia University School of Medicine-Charleston, Charleston, WV, USA
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Whitney AJ, Lindeque Z, Kruger R, Steyn SF. Running from depression: the antidepressant-like potential of prenatal and pre-pubertal exercise in adolescent FSL rats exposed to an early-life stressor. Acta Neuropsychiatr 2023:1-15. [PMID: 37969008 DOI: 10.1017/neu.2023.52] [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: 11/17/2023]
Abstract
OBJECTIVE We aimed to answer the questions of whether early-life (perinatal and/or juvenile) exercise can induce antidepressant-like effects in a validated rodent model of depression, and whether such early-life intervention could prevent or reverse the adverse effects of early-life stress in their offspring. METHODS Male and female Flinders sensitive line rats born to a dam that exercised during gestation, or not, were either maternally separated between PND02 and 16 and weaned on PND17 or not. Half of these animals then underwent a fourteen-day low-intensity exercise regimen from PND22. Baseline depressive-like behaviour was assessed on PND21 and then reassessed on PND36, whereafter hippocampal monoamine levels, redox state markers and metabolic markers relevant to mitochondrial function were measured. RESULTS Pre-pubertal exercise was identified as the largest contributing factor to the observed effects, where it decreased immobility time in the FST by 6%, increased time spent in the open arms of the EPM by 9%. Hippocampal serotonin and norepinephrine levels were also increased by 35% and 26%, respectively, whilst nicotinic acid was significantly decreased. CONCLUSION These findings suggest that pre-pubertal low-intensity exercise induces beneficial biological alterations that could translate into antidepressant behaviour in genetically susceptible individuals.
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Affiliation(s)
- Ashleigh J Whitney
- Centre of Excellence for Pharmaceutical Sciences, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Zander Lindeque
- Human Metabolomics, Faculty of Natural and Agricultural Sciences, North-West University, Potchefstroom, South Africa
| | - Ruan Kruger
- Hypertension in African Research Team (HART), North-West University, Potchefstroom, South Africa
- MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Stephan F Steyn
- Centre of Excellence for Pharmaceutical Sciences, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
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Hu S, Li X, Yang L. Effects of physical activity in child and adolescent depression and anxiety: role of inflammatory cytokines and stress-related peptide hormones. Front Neurosci 2023; 17:1234409. [PMID: 37700748 PMCID: PMC10493323 DOI: 10.3389/fnins.2023.1234409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 08/08/2023] [Indexed: 09/14/2023] Open
Abstract
Depression and anxiety are the most common mental illnesses affecting children and adolescents, significantly harming their well-being. Research has shown that regular physical activity can promote cognitive, emotional, fundamental movement skills, and motor coordination, as a preventative measure for depression while reducing the suicide rate. However, little is known about the potential role of physical activity in adolescent depression and anxiety. The studies reviewed in this paper suggest that exercise can be an effective adjunctive treatment to improve depressive and anxiety symptoms in adolescents, although research on its neurobiological effects remains limited.
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Affiliation(s)
- Shaojuan Hu
- College of Physical Education and Sports Science, Hengyang Normal University, Hengyang, China
| | - Xinyuan Li
- College of Physical Education and Sports Science, Hengyang Normal University, Hengyang, China
| | - Luodan Yang
- College of Physical Education and Sport Science, South China Normal University, Guangzhou, China
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Zhang Y, Li G, Liu C, Guan J, Zhang Y, Shi Z. Comparing the efficacy of different types of exercise for the treatment and prevention of depression in youths: a systematic review and network meta-analysis. Front Psychiatry 2023; 14:1199510. [PMID: 37333923 PMCID: PMC10272399 DOI: 10.3389/fpsyt.2023.1199510] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 05/03/2023] [Indexed: 06/20/2023] Open
Abstract
Purpose Depression disorder is the most commonly diagnosed type of mental illness among youths. Although a plethora of evidence suggests a positive relationship between exercise and lower levels of depression in youths, the findings regarding the variation in magnitude of this relationship are inconclusive with respect to the preventive and therapeutic effects of different types of exercise. This network meta-analysis aimed to determine the best type of exercise for the treatment and prevention of depression in youths. Methods A comprehensive search of databases, including PubMed, EMBASE, The Cochrane Library, Web of Science, PsychINFO, ProQuest, Wanfang, and CNKI, was conducted to identify relevant research on exercise interventions for depression in youth populations. The risk of bias in the included studies was evaluated using Cochrane Review Manager 5.4 according to the Cochrane Handbook 5.1.0 Methodological Quality Evaluation Criteria. The network meta-analysis was performed using STATA 15.1 to calculate the standardized mean difference (SMD) of all concerned outcomes. The node-splitting method was used to test the local inconsistency of the network meta-analysis. Funnel plots were used to evaluate the potential impact of bias in this study. Result Utilizing data extracted from 58 studies (10 countries, 4,887 participants), we found that for depressed youths, exercise is significantly better than usual care in reducing anxiety (SMD = -0.98, 95% CI [-1.50, -0.45]). For non-depressed youths, exercise is significantly better than usual care in reducing anxiety (SMD = -0.47, 95% CI [ -0.66, -0.29]). In the treatment of depression, resistance exercise (SMD = -1.30, 95% CI [ -1.96, -0.64]), aerobic exercise (SMD = -0.83, 95% CI [-1.10 -0.72]), mixed exercise (SMD = -0.67, 95% CI [-0.99, -0.35]), and mind-body exercise (SMD = -0.61, 95% CI [-0.84, -0.38]) all showed significant efficacy over usual care. For the prevention of depression, resistance exercise (SMD = -1.18, 95% CI [-1.65, -0.71]), aerobic exercise (SMD = -0.72, 95% CI [-0.98, -0.47]), mind-body exercise (SMD = -0.59, 95% CI [-0.93, -0.26]), and mixed exercise (SMD = -1.06, 95% CI [-1.37 to -0.75]) were all significantly effective compared to usual care. According to the test of the surface under the cumulative ranking score (SUCRA), the ranking of exercises for the treatment of depression in depressed youths is as follows: resistance exercise (94.9%) > aerobic exercise (75.1%) > mixed exercise (43.8%) > mind-body exercise (36.2%) > usual care (0%). For the prevention of depression in non-depressed youths, resistance exercise (90.3%) > mixed exercise (81.6%) > aerobic exercise (45.5%) > mind-body exercise (32.6%) > usual care (0%). Resistance exercise thus had the best comprehensive effect on both the treatment and prevention of depression in youths (clusterank value = 1914.04). Subgroup analyses show that a frequency of 3-4 times per week, a duration of 30-60 min, and a length of more than 6 weeks were found to be the most effective interventions for depression (P > 0.001). Conclusion This study provides compelling evidence that exercise is a viable intervention for improving depression and anxiety in young individuals. In addition, the study emphasizes the importance of selecting the appropriate type of exercise to optimize treatment and prevention. Specifically, the results suggest that resistance exercise, performed 3-4 times per week, with sessions lasting 30-60 min and a length of more than 6 weeks, yields optimal results for the treatment and prevention of depression in young individuals. These findings have significant implications for clinical practice, particularly given the challenges associated with implementing effective interventions and the economic burden of treating and preventing depression in young people. However, it is worth noting that additional head-to-head studies are necessary to confirm these findings and strengthen the evidence base. Nevertheless, this study provides valuable insights into the role of exercise as a potential treatment and preventative measure for depression in young people. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=374154, identifier: 374154.
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Affiliation(s)
- Yihan Zhang
- School of Educational Science, Hunan Normal University, Changsha, China
- College of Physical Education, Hunan Normal University, Changsha, China
| | - Geng Li
- College of Physical Education, Hunan Normal University, Changsha, China
| | - Chengzhen Liu
- School of Educational Science, Hunan Normal University, Changsha, China
| | - Jinliang Guan
- School of Educational Science, Hunan Normal University, Changsha, China
| | - Yuantong Zhang
- College of Physical Education, Hunan Normal University, Changsha, China
| | - Zifu Shi
- School of Educational Science, Hunan Normal University, Changsha, China
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Bian J, Xiang Z. Do the various leisure forms have equal effects on mental health? A longitudinal analysis of self-selected leisure activities. Front Public Health 2023; 11:1134854. [PMID: 37261235 PMCID: PMC10227434 DOI: 10.3389/fpubh.2023.1134854] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 04/17/2023] [Indexed: 06/02/2023] Open
Abstract
The deteriorating trends of unbalanced income, progressive age-related health problems, and loss of traditional ties necessitate ever-flexible interventions that are helpful to overcome a decline in Chinese adults' mental health. This study aimed to test whether engagement in different domains of leisure is associated with a composite index of mental health, both concurrently and subsequently. Longitudinal data including 10,968 participants (females = 5,804) with a mean age of 46.01 years in the Chinese General Social Survey (CGSS) were analyzed using generalized estimating equations with a logit link. The results showed that face-to-face experiences, such as sports with all ORs of < 1 at the significance level of α = 0.01 and meeting with all ORs of < 1 at the significance level of α = 0.01 except daily in-person meeting frequency, are important for protecting mental health owing to the increasing social support by building close ties. The results also indicate that online leisure with all ORs < 1 at the significance level of α = 0.01 has positive effects on lowering the odds of depression. In addition, receptive cognitive leisure, such as watching television or movies with all ORs < 1 at the significance level of α = 0.05 level, was not consistently associated with depression. However, active cognitive leisure, such as reading with all ORs of < 1 at a significance level of α = 0.01, was associated with lower odds of depression.
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Affiliation(s)
- Junyi Bian
- School of Physical Education, Guangzhou Sport University, Guangzhou, China
- Department of Human Performance and Health Education, Western Michigan University, Kalamazoo, MI, United States
| | - Zubing Xiang
- School of Physical Education, Chongqing University, Chongqing, China
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14
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Rochette E, Saidi O, Merlin É, Duché P. Physical activity as a promising alternative for young people with juvenile idiopathic arthritis: Towards an evidence-based prescription. Front Immunol 2023; 14:1119930. [PMID: 36860845 PMCID: PMC9969142 DOI: 10.3389/fimmu.2023.1119930] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 01/31/2023] [Indexed: 02/17/2023] Open
Abstract
Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in young people. Although biologics now enable most children and adolescents with JIA to enjoy clinical remission, patients present lower physical activity and spend more time in sedentary behavior than their healthy counterparts. This impairment probably results from a physical deconditioning spiral initiated by joint pain, sustained by apprehension on the part of both the child and the child's parents, and entrenched by lowered physical capacities. This in turn may exacerbate disease activity and lead to unfavorable health outcomes including increased risks of metabolic and mental comorbidities. Over the past few decades, there has been growing interest in the health benefits of increased overall physical activity as well as exercise interventions in young people with JIA. However, we are still far from evidence-based physical activity and / or exercise prescription for this population. In this review, we give an overview of the available data supporting physical activity and / or exercise as a behavioral, non-pharmacological alternative to attenuate inflammation while also improving metabolism, disease symptoms, poor sleep, synchronization of circadian rhythms, mental health, and quality of life in JIA. Finally, we discuss clinical implications, identify gaps in knowledge, and outline a future research agenda.
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Affiliation(s)
- Emmanuelle Rochette
- Department of Pediatrics, Clermont-Ferrand University Hospital, Clermont-Ferrand, France,Clermont Auvergne University, INSERM, CIC 1405, CRECHE unit, Clermont-Ferrand, France,Toulon University, Laboratory “Impact of Physical Activity on Health” (IAPS), Toulon, France,*Correspondence: Emmanuelle Rochette,
| | - Oussama Saidi
- Toulon University, Laboratory “Impact of Physical Activity on Health” (IAPS), Toulon, France
| | - Étienne Merlin
- Department of Pediatrics, Clermont-Ferrand University Hospital, Clermont-Ferrand, France,Clermont Auvergne University, INSERM, CIC 1405, CRECHE unit, Clermont-Ferrand, France
| | - Pascale Duché
- Toulon University, Laboratory “Impact of Physical Activity on Health” (IAPS), Toulon, France
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15
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Lange KW, Nakamura Y, Reissmann A. Sport and physical exercise in sustainable mental health care of common mental disorders: Lessons from the COVID-19 pandemic. SPORTS MEDICINE AND HEALTH SCIENCE 2023:S2666-3376(23)00005-7. [PMID: 36747887 PMCID: PMC9893807 DOI: 10.1016/j.smhs.2023.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 01/25/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023] Open
Abstract
The large-scale disruptions to physical activity during the coronavirus pandemic have been found to be a leading predictor of common mental disorders. In addition, regular physical exercise has been found to alleviate anxiety, sadness and depression during the pandemic. These findings, together with numerous studies published before the pandemic on the effects of physical activity on mental health, should be considered in the provision of mental health care following the pandemic. Cross-sectional research has revealed that all types of exercise and sport are associated with a reduced mental health burden. Therefore, the effectiveness of exercise and sport participation in sustainable mental health care as well as the causal relationship between exercise, psychosocial health and common mental disorders merit further investigation. Physical activity and sport, with their global accessibility, significant and clinically meaningful efficacy as well as virtual absence of adverse effects, offer a promising option for the promotion of mental health, including the prevention and treatment of common mental disorders. Physical exercise and sport are likely to become valuable public mental health resources in the future.
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Affiliation(s)
- Klaus W. Lange
- Corresponding author. University of Regensburg, 93040, Regensburg, Germany
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16
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Zhang CS, Cheng L, Chen X, Wang Y, Wei S, Sun J. The strategies of exercise intervention for adolescent depression: A meta-analysis of randomized controlled trials. Front Psychol 2023; 13:974382. [PMID: 36687827 PMCID: PMC9846179 DOI: 10.3389/fpsyg.2022.974382] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 11/25/2022] [Indexed: 01/06/2023] Open
Abstract
Purpose This study aimed to investigate the effect of exercise intervention, and analyze exercise intervention strategies for adolescent depression through a meta-analysis of RCTs. Methods Accordance to PRISMA guidelines, PubMed, Medline, EBSCO, Web of Science, SPORTDiscus, PsycINFO, ProQuest, and CNKI were searched for eligible records. Peer-reviewed studies were included if they met the following criteria: population (mean age of 10-18 years), intervention (physical activity, sport, or exercise), and outcomes (depression, adherence, ITT, dropout, adverse events, follow-up report). The protocol of this systematic review was registered in PROSPERO (CRD42022321683). Effect sizes calculations and methodological quality of exercise intervention (TESTEX scale) were carried out. The certainty of evidence was assessed by GRADE framework. Results Thirteen randomized controlled trials were eligible for this review, which comprised a total of 433 adolescents. Compared with the control treatment, the effect of exercise on adolescent depression was moderate (SMD = -0.65, 95%CI: -1.03 to -0.27, p < 0.01). Heterogeneity was substantial (T 2 = 0.30, I 2 = 67%, p < 0.01). The moderating effect analysis showed that exercise intervention characteristics (organization form, exercise frequency, exercise intensity, exercise type, and single exercise session duration) of included studies varied greatly revealing multiple factors that may impact the antidepressant effect of exercise on adolescent depression (I 2 > 50%, p < 0.05). Three studies show that the positive effect of exercise on reducing depression in adolescents remained 40 weeks after the intervention. Moreover, owing to the included studies contained methodological limitations, the certainty of evidence was reduced to moderate level. Conclusion This study shows that exercise intervention has a moderate and sustained positive effect on adolescent depression. Our results recommended that adolescents with depression undertake moderate to high intensity group mixed exercise for more than 12 weeks, 20 to 60 min/time, more than 3 times/week. Additionally, our study also shows that the antidepressant effects remained for a long time after the end of exercise interventions. However, following the GRADE framework, we rated the certainty of evidence the primary meta-analysis as moderate evidence due to some limitations of included studies. Therefore, rigorous studies are still needed to verify the results. Systematic review registration [https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=321683], identifier [CRD42022321683].
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Affiliation(s)
- Chang Sheng Zhang
- School of Physical Education, Chengdu Sport University, Chengdu, China
| | - Liang Cheng
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu, China
| | - Xiaoan Chen
- School of Sports Science, Jishou University, Jishou, Hunan, China
| | - Yi Wang
- School of Sports Science, Jishou University, Jishou, Hunan, China
| | - Shuguang Wei
- Department of Psychology, College of Education, Hebei Normal University, Hebei, China
| | - Jinxiu Sun
- School of Sports Science, Jishou University, Jishou, Hunan, China
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17
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Wang R, Cai Y, Lu W, Zhang R, Shao R, Yau SY, Stubbs B, McIntyre RS, Su KP, Xu G, Qi L, So KF, Lin K. Exercise effect on the gut microbiota in young adolescents with subthreshold depression: A randomized psychoeducation-controlled Trial. Psychiatry Res 2023; 319:115005. [PMID: 36565548 DOI: 10.1016/j.psychres.2022.115005] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 11/28/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022]
Abstract
This 3-month randomized psychoeducation-controlled trial (RCT) of exercise was undertaken in young adolescents with subthreshold depression to examine the impact on gut microbiota. Participants (aged 12-14 years) were randomly assigned to an exercise or a psychoeducation-controlled group. The exercise intervention arm took moderate-intensity exercise, comprised of 30 min of running per day, 4 days a week for 3 months. Psychoeducation intervention consisted of 6 sessions of group activity including gaming, reading, and singing. The gut microbiota was assessed by metagenomic sequencing. After 3-month moderate-intensity exercise, the intervention group increased the relative abundance of Coprococcus, Blautia, Dorea, Tyzzerella at the genus level, as well as Tyzzerella nexilis, Ruminococcus obeum at species level when compared to the psychoeducation-controlled group. Moreover, EggNOG analyses showed that the defense and signal transduction mechanism were highly enriched after the active intervention, and changes were correlated with improvements in depressive symptoms measured by Chinese Patient Depression Questionnaire 9. The KEGG pathway of neurodegenerative diseases was depleted in the microbiome in young adolescents with subthreshold depression after exercise intervention. This 3-month RCT suggests that at both the genus and species levels, aerobic group exercise intervention improved in depressive symptoms and revealed changes in gut microbiota suggesting beneficial effects.
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Affiliation(s)
- Runhua Wang
- Department of Affective Disorders, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yuanyuan Cai
- School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Weicong Lu
- Department of Affective Disorders, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ruoxi Zhang
- Department of Affective Disorders, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Robin Shao
- Department of Affective Disorders, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Suk-Yu Yau
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Canada
| | - Kuan-Pin Su
- Department of Psychiatry and MBI-Lab, China Medical University Hospital, Taichung, China
| | - Guiyun Xu
- Department of Affective Disorders, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Liangwen Qi
- School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Kwok-Fai So
- Department of Affective Disorders, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Neuroscience and Neurorehabilitation Institute, University of Health and Rehabilitation Sciences, Qingdao, China; Ministry of Education Joint International Research Laboratory of CNS Regeneration, Jinan University, Guangzhou, China
| | - Kangguang Lin
- Department of Affective Disorders, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Neuroscience and Neurorehabilitation Institute, University of Health and Rehabilitation Sciences, Qingdao, China.
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18
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Rikard-Bell C, Hunt C, McAulay C, Hay P, Morad A, Cunich M, Touyz S. Adolescent Depression from a Developmental Perspective: The Importance of Recognizing Developmental Distress in Depressed Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16029. [PMID: 36498102 PMCID: PMC9736143 DOI: 10.3390/ijerph192316029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/25/2022] [Accepted: 11/25/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE To make the case that developmental distress needs to be assessed when evaluating adolescent depression. METHODS Reviews of relevant papers relating to adolescent depression. RESULTS Adolescent depression is a common and costly health condition, confounded by a lack of consensus among health professionals regarding evidence-based approaches regarding treatments. Little attention has been paid to the contribution of developmental distress. CONCLUSION The current adult-like model of adolescent depression fails to advance the understanding of adolescent depression. A systematic evidence-based approach to identifying developmental self-perception distress in depressed adolescents could provide important advances in treatment to improve short-term and longer-term mental health outcomes. This paper proposes the creation of a psychometric tool to systematically measure developmental self-perception distress in adolescents with depression.
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Affiliation(s)
| | - Caroline Hunt
- School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW 2006, Australia
| | - Claire McAulay
- School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW 2006, Australia
| | - Phillipa Hay
- Faculty of Medicine, University of Western Sydney, Penrith, NSW 2751, Australia
| | - Arshia Morad
- School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW 2006, Australia
| | - Michelle Cunich
- School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW 2006, Australia
| | - Stephen Touyz
- School of Psychology and Inside Out Institute, University of Sydney, Sydney, NSW 2006, Australia
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19
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Mortazavi R, Lalouni M, Grudin R, Serlachius E, Sundberg CJ, Norrbom J, Larsson I, Haglund E, Ivarsson A, Lenhard F, Cronqvist T, Ingemarsson K, Mårsell Å, Rask O, Jarbin H. Moderate-to-vigorous group aerobic exercise versus group leisure activities for mild-to-moderate depression in adolescents: study protocol for a multicentre randomised controlled trial. BMJ Open 2022; 12:e060159. [PMID: 35820753 PMCID: PMC9274524 DOI: 10.1136/bmjopen-2021-060159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 06/21/2022] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Depression is common, increasing among adolescents and carries risk of disability, lower educational achievements, cardiovascular disease, substance abuse, self-harm and suicide. The effects of evidence-based treatments with medication or psychotherapy are modest. Aerobic exercise is a promising intervention for adolescents with depression, but available studies are hampered by methodological shortcomings. This study aims to evaluate aerobic group exercise versus an active comparator of leisure group activities in adolescents from clinical services with mild-to-moderate depression. METHODS AND ANALYSIS This study is a multicentre randomised controlled trial at four psychiatric clinics in Sweden. Participants (n=122) will be randomised 1:1 to group exercise delivered by exercise professionals and supported by mental health (MH) workers or leisure activities lead by the same MH workers for 1 hour three times a week for 12 weeks. Participants will be assessed at baseline, single blind after 13 weeks and 26 weeks and openly after 1 year. Participants randomised to the leisure group will be offered exercise in the open phase. The primary outcome is clinician-rated Children's Depression Rating Scale-Revised. Secondary outcomes are self-rated Quick Inventory of Depressive Symptomatology, self-rated functioning; clinician-rated improvement and functioning; objectively measured aerobic capacity, muscular strength, muscular endurance, body composition and presence or activity of selected biological markers of neuroprotection and neuroinflammation in blood samples. Further outcomes are cost-effectiveness and adolescents', parents' and coaches' experiences of the interventions and an exploration of how the adolescents' health and lifestyle are influenced by the interventions through qualitative interviews. ETHICS AND DISSEMINATION The study is approved by the Swedish Ethical Review Authority (Ref. 2021-05307-01). Informed consent in writing will be provided from patients and parents of participants below 15 years of age. The results of this study will be communicated to the included participants and healthcare providers and also submitted for publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT05076214.
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Affiliation(s)
- Rebecca Mortazavi
- Department of Clinical Sciences, Child and Adolescent Psychiatry, Lund University, Lund, Sweden
- Child and Adolescent Psychiatry, Region Halland, Halmstad, Sweden
| | - Maria Lalouni
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Region Stockholm, Sweden
| | - Rebecca Grudin
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Region Stockholm, Sweden
| | - Eva Serlachius
- Department of Clinical Sciences, Child and Adolescent Psychiatry, Lund University, Lund, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Region Stockholm, Sweden
| | - Carl Johan Sundberg
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
- Department of Learning, Informatics, Karolinska Institutet, Stockholm, Sweden
| | - Jessica Norrbom
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Ingrid Larsson
- Department of Health and Nursing, School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Spenshult Research and Development Centre, Halmstad, Halland, Sweden
| | - Emma Haglund
- The Rydberg Laboratory for Applied Sciences, Halmstad, Sweden
- Department of Health and Sport, School of Health and Sport, Halmstad University, Halmstad, Sweden
| | - Andreas Ivarsson
- Department of Health and Nursing, School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| | - Fabian Lenhard
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Åsa Mårsell
- PRIMA Barn- och Vuxenpsykiatri AB, Stockholm, Sweden
| | - Olof Rask
- Department of Clinical Sciences, Child and Adolescent Psychiatry, Lund University, Lund, Sweden
| | - Håkan Jarbin
- Department of Clinical Sciences, Child and Adolescent Psychiatry, Lund University, Lund, Sweden
- Child and Adolescent Psychiatry, Region Halland, Halmstad, Sweden
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20
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Ji C, Yang J, Lin L, Chen S. Anxiety and Sleep Quality Amelioration in College Students: A Comparative Study between Team Sports and Individual Sports. Behav Sci (Basel) 2022; 12:bs12050149. [PMID: 35621446 PMCID: PMC9138125 DOI: 10.3390/bs12050149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/08/2022] [Accepted: 05/12/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Anxiety is one of the most common mental disorders and is often accompanied by sleep disturbances. Studies have focused on the ameliorative effect of sports games on anxiety and its subsidiary issues. However, the effect on the improvement of such mental and physical disorders between individual sports and team group sports is not yet clear, especially regarding their effects on anxiety and sleep quality improvement. Therefore, this paper explores the improvement effects of individual sports and team sports participation on anxiety symptoms and sleep quality amelioration. Objective: To explore the effects of individual and team group sports participation on ameliorating college students’ anxiety symptoms and sleep quality. Methods: A total of 197 college students were sampled in the study. The self-rating anxiety scale (SAS) and Pittsburgh sleep quality index (PSQI) were used to assess the severity of anxiety symptoms and level of sleep quality. Participants were randomly divided into three groups: team sports, individual sports, and control groups. The distribution ratio of these groups was 1:1:1. Results: Generally, compared with the control group, the subjects in the team sports group and individual sports group had greater improvements in anxiety amelioration and sleep quality improvements. Specifically, the improvement effect between individual and team sports groups was different. To assess the resulting differences, improvements in anxiety symptoms and sleep quality were compared between the team sports group and the individual sports group with reference to the mean change in the control group. In the corrected model, the odds advantage ratio (OR) of anxiety symptom improvement after individual sports was 3.18 (CI 2.87–11.21), and the advantage OR of anxiety symptom improvement after team sports was 4.99 (CI 4.06–14.87). The advantage OR of sleep quality improvement after individual sports was 7.32 (CI 5.53–18.22), and the advantage OR of anxiety symptom improvement after team sports was 7.98 (CI 6.69–19.98). Conclusion: After 6 weeks of intervention, it was found that both team sports and individual sports improved anxiety symptoms and sleep quality with different effects. Team sports were better at improving anxiety, while individual sports and team sports shared the same improvement effect with no significant difference in sleep quality improvement.
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Affiliation(s)
- Chaoxin Ji
- Physical Education Department, Northeastern University, Shenyang 110819, China
- Correspondence: (C.J.); (S.C.)
| | - Jun Yang
- College of Information Science and Engineering, Northeastern University, Shenyang 110819, China;
| | - Lin Lin
- School of Social and Political Science, University of Glasgow, Glasgow G12 8QQ, UK;
| | - Song Chen
- Physical Education Department, Northeastern University, Shenyang 110819, China
- Correspondence: (C.J.); (S.C.)
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21
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Development and feasibility testing of a physical activity intervention for youth with anxiety and depression: a study protocol. Pilot Feasibility Stud 2022; 8:48. [PMID: 35236419 PMCID: PMC8889653 DOI: 10.1186/s40814-022-01010-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 02/18/2022] [Indexed: 11/10/2022] Open
Abstract
Background Anxiety and depressive disorders in children and adolescents are highly prevalent and account for more than half of all youth psychiatric disorders. Left untreated, anxiety, and depression lead to numerous detrimental outcomes, including reduced quality of life, psychiatric, and somatic comorbidity and even reduced lifespan. This puts a large strain on child and adolescent mental healthcare services (CAMHS) to provide effective treatments. However, even when provided the best evidence-based treatment, between 40–50% of patients continue to report significant symptom burdens. Thus, there is an immediate need for supplemental and/or new treatment approaches. Physical activity as a supplementary treatment may be such an approach. However, research investigating this approach within this population is scant. This protocol paper describes the development and feasibility trial of a physical activity-based intervention targeting anxiety and depressive symptoms in youth treated in CAMHS. Methods/design The study is based on the UK Medical Council Research Framework (MRC) for developing and evaluating complex interventions. Feasibility and acceptability of the physical activity intervention (confident, active, and happy youth) will be evaluated in an uncontrolled open-label trial using qualitative and quantitative data. Twenty youths with anxiety and/or depressive symptoms will be recruited. Acceptability of assessment procedures, the intervention, and perceived benefits and barriers to participation will be assessed, and qualitative interviews with participants, caregivers, and referring specialists will explore contextual and practical factors associated with intervention delivery. Physical activity will be measured using the Actigraph GT3X+ monitor at baseline, and post-intervention and change in anxiety and depression will be assessed. Discussion This study will contribute to the development of supplementary physical treatment interventions for youth with anxiety and depression in contact with CAMHS. The goal is to examine new avenues of treatment that ultimately may improve upon current treatment outcomes of anxiety and depression. This work will be in preparation for a future definitive randomized controlled trial (RCT) of this approach, in line with the MRC Framework. Trial registration ClnicalTrials.gov, NCT05049759. Registered on August 19, 2021. Retrospectively registered. Supplementary Information The online version contains supplementary material available at 10.1186/s40814-022-01010-6.
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22
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Ji C, Yang J, Lin L, Chen S. Physical Exercise Ameliorates Anxiety, Depression and Sleep Quality in College Students: Experimental Evidence from Exercise Intensity and Frequency. Behav Sci (Basel) 2022; 12:bs12030061. [PMID: 35323380 PMCID: PMC8944991 DOI: 10.3390/bs12030061] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 01/12/2023] Open
Abstract
Background: The main purpose of this study was to investigate the effects of exercise intensity and exercise frequency on anxiety, depression and sleep quality in college students. Methods: All participants came from a university in northeastern China. All participants were tested for Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and were diagnosed with anxiety disorders. The research subjects were divided into six groups, namely the low-intensity and low-frequency group (group 1), low-intensity and moderate-frequency group (group 2), low-intensity and high-frequency group (group 3), high-intensity and low-frequency group (group 4), and high-intensity and moderate-frequency group (group 5) and high-intensity and high-frequency group (group 6). The duration of each physical exercise for each group was 1 h. Participants’ exercise intensity was monitored using Polar H10 HR sensors and the Borg RPE scale. The experiment was carried out for a total of 6 weeks. The researchers conducted pre- and post-test scores on the subjects’ anxiety, depression and sleep quality through questionnaires. Results: Exercise intensity improved anxiety and decreased symptoms of depression better than exercise frequency; sleep quality was more closely related to exercise intensity. Conclusion: Exercise intensity and exercise frequency have different effects on anxiety, depression and sleep quality improvement, indicating that exercise intensity and exercise frequency have different effects on anxiety, depression and sleep quality of college students.
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Affiliation(s)
- Chaoxin Ji
- Department of Physical Education, Northeastern University, Shenyang 110819, China;
- Correspondence:
| | - Jun Yang
- College of Information Science and Engineering, Northeastern University, Shenyang 110819, China;
| | - Lin Lin
- School of Social and Political Science, University of Glasgow, Glasgow G12 8QQ, UK;
| | - Song Chen
- Department of Physical Education, Northeastern University, Shenyang 110819, China;
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23
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Abstract
PURPOSE OF REVIEW To examine recent evidence that informs the treatment of depression in children and adolescents. RECENT FINDINGS There are no new leads in the prevention and early intervention of depression in children and adolescents. For acute treatment of major depressive disorder, talking therapies are moving increasingly to internet-based platforms. Family therapy may have a slight edge over individual psychotherapy in the short-term. Patients with severe depression with endogenous features have a more robust response to pharmacotherapy than do patients with mild-to-moderate depression. Findings in relation to reward sensitivity and changes in brain-derived neurotrophic factor levels contradict research conducted in adults, suggesting developmental differences in the mechanisms underlying depression. Ketamine infusion could have a role for adolescents with treatment refractory depression. There was no new evidence concerning relapse prevention. SUMMARY Most new findings have been concerned with moderators and mediators of treatment.
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Affiliation(s)
- Philip Hazell
- University of Sydney School of Medicine, Concord West, Australia
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24
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Campisi SC, Krause KR, Chan BWC, Courtney DB, Bennett K, Korczak DJ, Szatmari P. Eating, sleeping and moving recommendations in clinical practice guidelines for paediatric depression: umbrella review. BJPsych Open 2021; 7:e185. [PMID: 34607616 PMCID: PMC8503910 DOI: 10.1192/bjo.2021.1020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Current first-line treatments for paediatric depression demonstrate mild-to-moderate effectiveness. This has spurred a growing body of literature on lifestyle recommendations pertaining to nutrition, sleep and exercise for treating paediatric depression. AIMS Paediatric depression clinical practice guidelines (CPGs) were reviewed for quality and to catalogue recommendations on nutrition, sleep and exercise made by higher-quality CPGs. METHOD Searches were conducted in Medline, EMBASE, PsycINFO, Web of Science and CINAHL, and grey literature CPGs databases for relevant CPGs. Eligible CPGs with a minimum or high-quality level, as determined by the Appraisal of Guidelines for Research and Evaluation, Second Edition instrument, were included if they were (a) paediatric; (b) CPGs, practice parameter or consensus or expert committee recommendations; (c) for depression; (d) the latest version and (e) lifestyle recommendations for nutrition, sleep or exercise. Key information extracted included author(s), language, year of publication, country, the institutional body issuing the CPG, target disorder, age group, lifestyle recommendation and the methods used to determine CPG lifestyle recommendations. RESULTS Ten paediatric CPGs for depression with a minimum or high-quality level contained recommendations on nutrition, sleep or exercise. Lifestyle recommendations were predominately qualitative, with quantitative details only outlined in two CPGs for exercise. Most recommendations were brief general statements, with 50% lacking supporting evidence from the literature. CONCLUSIONS Interest in lifestyle interventions for treatment in child and youth depression is growing. However, current CPG lifestyle recommendations for nutrition, sleep or exercise are based on expert opinion rather than clinical trials.
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Affiliation(s)
- Susan C Campisi
- Department of Psychiatry, Hospital for Sick Children, Canada
| | - Karolin R Krause
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Canada; Evidence-Based Practice Unit, University College London, UK; and Evidence-Based Practice Unit, Anna Freud National Centre for Children and Families, UK
| | | | - Darren B Courtney
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Canada; and Department of Psychiatry, University of Toronto, Canada
| | - Kathryn Bennett
- Department of Health Research Methods, Evidence and Impact, McMaster University, Canada
| | - Daphne J Korczak
- Department of Psychiatry, Hospital for Sick Children, Canada; and Department of Psychiatry, University of Toronto, Canada
| | - Peter Szatmari
- Department of Psychiatry, Hospital for Sick Children, Canada; Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Canada; and Department of Psychiatry, University of Toronto, Canada
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Rutter LA, Thompson HM, Howard J, Riley TN, De Jesús-Romero R, Lorenzo-Luaces L. Social Media Use, Physical Activity, and Internalizing Symptoms in Adolescence: Cross-sectional Analysis. JMIR Ment Health 2021; 8:e26134. [PMID: 34524096 PMCID: PMC8482183 DOI: 10.2196/26134] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 03/05/2021] [Accepted: 04/06/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Most American adolescents have access to smartphones, and recent estimates suggest that they spend considerable time on social media compared with other physical and leisure activities. A large body of literature has established that social media use is related to poor mental health, but the complicated relationship between social media and symptoms of depression and anxiety in adolescents is yet to be fully understood. OBJECTIVE We aim to investigate the relationship between social media use and depression and anxiety symptoms in adolescents by exploring physical activity as a mediator. METHODS A Qualtrics survey manager recruited adult panel participants between February and March 2019, who indicated that they had adolescent children who spoke English. A total of 4592 adolescent-parent dyads completed the survey that took approximately 39 minutes. The survey entailed completing web-based questionnaires assessing various aspects of social media use, psychological symptoms, and psychosocial factors. The average age of the adolescent participants was 14.62 (SD 1.68; range 12-17) years, and the majority of the adolescent sample was male (2392/4592, 52.09%). RESULTS Total social media use was associated with more depressive symptoms (multiple R2=0.12; F3,4480=207.1; P<.001), anxiety (multiple R2=0.09; F3,4477=145.6; P<.001), and loneliness (multiple R2=0.06; F3,4512=98.06; P<.001), controlling for age and gender. Physical activity was associated with decreased depression and anxiety symptoms after controlling for other extracurricular activities and social media use (multiple R2=0.24; F5,4290=266.0; P<.001). There were significant differences in symptoms based on gender: female adolescents reported higher rates of social media use and males reported higher rates of depression. Nonbinary and transgender adolescents had higher rates of depression, anxiety, and loneliness than the female and male adolescents in the sample. CONCLUSIONS In a nationally representative sample of adolescents, more social media use was associated with more severe symptoms of depression, anxiety, and loneliness. Increased physical activity was associated with decreased depression and anxiety symptoms. Physical activity partially mediated the relationship between social media use and depression and anxiety. As this was a cross-sectional study, we cannot conclude that social media use causes internalizing symptoms or that physical activity leads to decreased internalizing symptoms-there may be additional confounding variables producing the relationships we observed. Physical activity may protect against the potentially harmful effect of social media on some adolescents. The effect sizes were small to medium, and the results should be interpreted with caution. Other limitations of this study include our reliance on self-reporting. Future work should examine social media use beyond how much time adolescents spend using social media and instead focus on the nature of social media activity.
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Affiliation(s)
- Lauren A Rutter
- Department of Psychological and Brain Sciences, Indiana University Bloomington, Bloomington, IN, United States
| | - Holly M Thompson
- Department of Psychological and Brain Sciences, Indiana University Bloomington, Bloomington, IN, United States
| | - Jacqueline Howard
- Department of Psychological and Brain Sciences, Indiana University Bloomington, Bloomington, IN, United States
| | - Tennisha N Riley
- Department of Counseling and Educational Psychology, Indiana University Bloomington, Bloomington, IN, United States
| | - Robinson De Jesús-Romero
- Department of Psychological and Brain Sciences, Indiana University Bloomington, Bloomington, IN, United States
| | - Lorenzo Lorenzo-Luaces
- Department of Psychological and Brain Sciences, Indiana University Bloomington, Bloomington, IN, United States
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