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Zhu C, Zhang T, Li Q, Chen X, Wang K. Depression and Anxiety During the COVID-19 Pandemic: Epidemiology, Mechanism, and Treatment. Neurosci Bull 2023; 39:675-684. [PMID: 36411394 PMCID: PMC9685018 DOI: 10.1007/s12264-022-00970-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/12/2022] [Indexed: 11/23/2022] Open
Abstract
The Coronavirus Disease 2019 (COVID-19) pandemic has had an adverse impact on the physical and mental health of the public worldwide. In addition to illness in patients with COVID-19, isolated people and the general population have experienced mental health problems due to social distancing policies, mandatory lockdown, and other psychosocial factors, and the prevalence of depression and anxiety significantly increased during the pandemic. The purpose of this review is to elucidate the epidemiology, contributing factors, and pathogenesis of depression and anxiety. during the pandemic. These findings indicate that physicians and psychiatrists should pay more attention to and identify those with a high risk for mental problems, such as females, younger people, unmarried people, and those with a low educational level. In addition, researchers should focus on identifying the neural and neuroimmune mechanisms involved in depression and anxiety, and assess the intestinal microbiome to identify effective biomarkers. We also provide an overview of various intervention methods, including pharmacological treatment, psychological therapy, and physiotherapy, to provide a reference for different populations to guide the development of optimized intervention methods.
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Affiliation(s)
- Chunyan Zhu
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230032, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230032, China
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, 230032, China
| | - Ting Zhang
- Department of Psychiatry, The First Affiliated Hospital of Anhui Medical University, Hefei, 230032, China
| | - Qianqian Li
- Department of Psychiatry, The First Affiliated Hospital of Anhui Medical University, Hefei, 230032, China
| | - Xingui Chen
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230032, China
| | - Kai Wang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230032, China.
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230032, China.
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, 230032, China.
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230032, China.
- Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, 230032, China.
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Lee JS, Jaini PA, Papa F. An Epigenetic Perspective on Lifestyle Medicine for Depression: Implications for Primary Care Practice. Am J Lifestyle Med 2022; 16:76-88. [PMID: 35185430 PMCID: PMC8848122 DOI: 10.1177/1559827620954779] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/17/2020] [Accepted: 08/13/2020] [Indexed: 06/16/2024] Open
Abstract
Depression is the most common presenting mental health disorder in primary care. It is also a major contributor to somatic complaints, worsening of chronic medical conditions, poor quality of life, and suicide. Current pharmacologic and psychotherapeutic approaches avert less than half of depression's cumulative burden on society. However, there is a growing body of research describing both how maladaptive lifestyle choices contribute to the development and worsening of depression and how lifestyle-oriented medical interventions can reduce the incidence and severity of depression. This research, largely derived from an emerging field called epigenetics, elucidates the interactions between our lifestyle choices and those epigenetic factors which mediate our tendencies toward either health, or the onset, if not worsening of disease. The present review highlights how lifestyle choices involving diet, physical activity, sleep, social relationships, and stress influence epigenetic processes positively or negatively, and thereby play a significant role in determining whether one does or does not suffer from depression. The authors propose that medical training programs consider and adopt lifestyle medicine oriented instructional initiatives that will enable tomorrow's primary care providers to more effectively identify and therapeutically intervene in the maladaptive choices contributing to their patients' depression.
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Affiliation(s)
- Jenny Sunghyun Lee
- Jenny Sunghyun Lee, Department of Preventive Medicine, Loma Linda University Medical School, 24785 Stewart Street, Loma Linda, CA 92350; e-mail:
| | - Paresh Atu Jaini
- Department of Preventive Medicine, Loma Linda University Medical School, Loma Linda, California (JSL)
- Department of Psychiatry, John Peter Smith Hospital, Fort Worth, Texas (PAJ)
- Department of Medical Education, University of North Texas Health Science Center, Fort Worth, Texas (FP)
| | - Frank Papa
- Department of Preventive Medicine, Loma Linda University Medical School, Loma Linda, California (JSL)
- Department of Psychiatry, John Peter Smith Hospital, Fort Worth, Texas (PAJ)
- Department of Medical Education, University of North Texas Health Science Center, Fort Worth, Texas (FP)
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Abstract
Human activity recognition (HAR) is a classification task that involves predicting the movement of a person based on sensor data. As we can see, there has been a huge growth and development of smartphones over the last 10–15 years—they could be used as a medium of mobile sensing to recognize human activity. Nowadays, deep learning methods are in a great demand and we could use those methods to recognize human activity. A great way is to build a convolutional neural network (CNN). HAR using Smartphone dataset has been widely used by researchers to develop machine learning models to recognize human activity. The dataset has two parts: training and testing. In this paper, we propose a hybrid approach to analyze and recognize human activity on the same dataset using deep learning method on cloud-based platform. We have applied principal component analysis on the dataset to get the most important features. Next, we have executed the experiment for all the features as well as the top 48, 92, 138, and 164 features. We have run all the experiments on Google Colab. In the experiment, for the evaluation of our proposed methodology, datasets are split into two different ratios such as 70–10–20% and 80–10–10% for training, validation, and testing, respectively. We have set the performance of CNN (70% training–10% validation–20% testing) with 48 features as a benchmark for our work. In this work, we have achieved maximum accuracy of 98.70% with CNN. On the other hand, we have obtained 96.36% accuracy with the top 92 features of the dataset. We can see from the experimental results that if we could select the features properly then not only could the accuracy be improved but also the training and testing time of the model.
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Hu S, Tucker L, Wu C, Yang L. Beneficial Effects of Exercise on Depression and Anxiety During the Covid-19 Pandemic: A Narrative Review. Front Psychiatry 2020; 11:587557. [PMID: 33329133 PMCID: PMC7671962 DOI: 10.3389/fpsyt.2020.587557] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 10/14/2020] [Indexed: 01/08/2023] Open
Abstract
First reported in Dec 2019, the on-going COVID-19 pandemic has become a public health emergency of international concern (PHEIC). The isolation and quarantine during the COVID-19 pandemic limited the physical and social activities of the population, which contributed to the increased prevalence of mental disorder. Depression and anxiety are the most common mental illnesses conferring a serious impact on individuals' life quality. This review summarizes the mental health consequences of COVID-19, especially for depression and anxiety. Exercise as an intervention for anxiety and depression has been demonstrated in both of the animal studies and human clinical trials. The underlying mechanism including the regulation on the production of brain-derived neurotrophic factor (BDNF), D-β-hydroxybutyrate, synaptic transmission, hypothalamic pituitary adrenal (HPA) axis, tryptophan hydroxylase, GSK3β/β-catenin pathway, neuroinflammation, oxidative stress and PGC-1α1-PPAR axis. In addition, we summarized the exercise strategies to fight against anxiety and depression according to the information from American College of Sports Medicine (ACSM), World Health Organization and recent literatures about physical exercise during COVID-19.
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Affiliation(s)
- Shaojuan Hu
- College of Physical Education and Sports Science, HengYang Normal University, Hengyang, China
| | - Lorelei Tucker
- Department of Neuroscience and Regenerative Medicine, Augusta University, Augusta, GA, United States
| | - Chongyun Wu
- Laboratory of Laser Sports Medicine, College of Physical Education and Sports Science, South China Normal University, Guangzhou, China
| | - Luodan Yang
- Department of Neuroscience and Regenerative Medicine, Augusta University, Augusta, GA, United States
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Cope K, Vandelanotte C, Short CE, Conroy DE, Rhodes RE, Jackson B, Dimmock JA, Rebar AL. Reflective and Non-conscious Responses to Exercise Images. Front Psychol 2018; 8:2272. [PMID: 29375419 PMCID: PMC5768653 DOI: 10.3389/fpsyg.2017.02272] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 12/14/2017] [Indexed: 11/13/2022] Open
Abstract
Images portraying exercise are commonly used to promote exercise behavior and to measure automatic associations of exercise (e.g., via implicit association tests). The effectiveness of these promotion efforts and the validity of measurement techniques partially rely on the untested assumption that the images being used are perceived by the general public as portrayals of exercise that is pleasant and motivating. The aim of this study was to investigate how content of images impacted people's automatic and reflective evaluations of exercise images. Participants (N = 90) completed a response time categorization task (similar to the implicit association test) to capture how automatically people perceived each image as relevant to Exercise or Not exercise. Participants also self-reported their evaluations of the images using visual analog scales with the anchors: Exercise/Not exercise, Does not motivate me to exercise/Motivates me to exercise, Pleasant/Unpleasant, and Energizing/Deactivating. People tended to more strongly automatically associate images with exercise if the images were of an outdoor setting, presented sport (as opposed to active labor or gym-based) activities, and included young (as opposed to middle-aged) adults. People tended to reflectively find images of young adults more motivating and relevant to exercise than images of older adults. The content of exercise images is an often overlooked source of systematic variability that may impact measurement validity and intervention effectiveness.
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Affiliation(s)
- Kathryn Cope
- Physical Activity Research Group, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - Corneel Vandelanotte
- Physical Activity Research Group, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - Camille E. Short
- Freemasons Foundation Centre for Men's Health, School of Medicine, The University of Adelaide, Adelaide, SA, Australia
| | - David E. Conroy
- Kinesiology and Human Development and Family Studies, The Pennsylvania State University, State College, PA, United States
- Department of Preventive Medicine, Northwestern University, Chicago, IL, United States
| | - Ryan E. Rhodes
- Department of Kinesiology and Science, University of Victoria, Victoria, BC, Canada
| | - Ben Jackson
- School of Human Sciences, The University of Western Australia, Perth, WA, Australia
| | - James A. Dimmock
- School of Human Sciences, The University of Western Australia, Perth, WA, Australia
| | - Amanda L. Rebar
- Physical Activity Research Group, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
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Chung N, Park HY, Park MY, Hwang YY, Lee CH, Han JS, So J, Kim J, Park J, Lim K. Association of daily physical activity level with health-related factors by gender and age-specific differences among Korean adults based on the sixth (2014-2015) Korea national health and nutrition examination survey. J Exerc Nutrition Biochem 2017; 21:30-38. [PMID: 28715884 PMCID: PMC5545202 DOI: 10.20463/jenb.2017.0026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 06/23/2017] [Indexed: 01/19/2023] Open
Abstract
[Purpose] This study examined the effects of daily physical activity level on health-related factors according to gender and identified age-specific differences among Korean adults. [Methods] Using data from the Korea National Health and Nutrition Examination Survey VI (2014-2015), we selected adults aged 19-64 years who participated in both a health examination and health interview survey. The study included 6,457 participants 19-64 years of age (2,611 men, 3,846 women). [Results] Assessment of the differences in health-related factors according to age and physical activity in men and women by repeated two-way analysis of variance (ANOVA) revealed significant interaction effects on total cholesterol (TC) and triglyceride (TG) levels and diastolic blood pressure (DBP) in male participants, but there were no significant interaction effects for any health-related factors in female participants. The group of female participants aged 40-64 years with daily physical activity levels over 200 kcal showed a significantly increased prevalence of 46% for dyslipidemia compared to that in female participants with daily physical activity levels below 200 kcal. Physical activity was positively correlated with weight and high-density lipoprotein cholesterol (HDL-C) levels in men 19-39 years of age, compared to weight, waist circumference (WC), body mass index (BMI), and DBP in men 40-64 years of age, and weight, WC, BMI, glycated hemoglobin (HbA1c) and triglyceride (TG) levels in women 19-39 years of age. In women 40- 64 years of age, physical activity was especially significantly positively correlated with weight, BMI, HDL-C and negatively correlated with fasting glucose and TG levels. [Conclusion] In male and female participants, the 40-64-year age group showed negative results for health-related factors compared to those in the 19-39-year age group. The higher the weight, WC, BMI, the higher is the physical activity level. Physical activity levels were significantly positively correlated with health-related variables.
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Affiliation(s)
- Nana Chung
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, Republic of Korea
| | - Hun-Young Park
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, Republic of Korea
| | - Mi-Young Park
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, Republic of Korea
| | - Yoon-Young Hwang
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, Republic of Korea
| | - Chi-Ho Lee
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, Republic of Korea
| | - Jin-Soo Han
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, Republic of Korea
| | - Jaemoo So
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, Republic of Korea
| | - Jisu Kim
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, Republic of Korea
| | - Jonghoon Park
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, Republic of Korea,Department of Physical Education, Korea University, Seoul, Republic of Korea
| | - Kiwon Lim
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, Republic of Korea,Department of Physical Education, Konkuk University, Seoul, Republic of Korea
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Lee JK, Luchian T, Park Y. Effect of Regular Exercise on Inflammation Induced by Drug-resistant Staphylococcus aureus 3089 in ICR mice. Sci Rep 2015; 5:16364. [PMID: 26542343 PMCID: PMC4635399 DOI: 10.1038/srep16364] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 10/06/2015] [Indexed: 12/18/2022] Open
Abstract
Obesity is often associated with irregular dietary habits and reduced physical activity. Regular exercise induces a metabolic response that includes increased expression of various cytokines, signaling proteins and hormones, and reduced adipocyte size. In this study, mice performed a swimming exercise for 10 min/day, 5 days/week for 3 weeks. We then investigated the effect of this exercise regimen on inflammation induced by infection with drug-resistant Staphylococcus aureus strain 3089 (DRSA). In humans, DRSA causes dermatitis and pneumonitis. Similarly, DRSA induced inflammatory pneumonitis in both no-exercise (No-EX) and swim-trained (SW-EX) ICR mice. Regular exercise increased levels of the pro-inflammatory cytokines TNF-α and IL-1β and nitric oxide in both serum and whole lung tissue in SW-EX, as compared to No-EX control mice. Moreover, levels of the antimicrobial peptide cathelicidin were significantly increased in visceral adipose tissue and whole lung tissue in the SW-EX group, and this was accompanied by a reduction in the size of visceral adipocytes. In addition, levels of the inflammation marker peroxisome proliferator-activated receptor gamma coactivator-1 (PGC-1) were not increased in the lung tissue of SW-EX mice. These findings suggest that in these model mice, regular exercise strengthens immune system responses, potentially preventing or mitigating infectious disease.
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Affiliation(s)
- Jong-Kook Lee
- Research Center for Proteinaceous Materials (RCPM), Chosun University, Gwangju, Korea
| | - Tudor Luchian
- Department of Physics, Alexandru I. Cuza University, Iasi, Romania
| | - Yoonkyung Park
- Department of Biotechnology &BK21-Plus Research Team for Bioactive Control Technology, Chosun University, Gwangju, Republic of Korea
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Szuhany KL, Bugatti M, Otto MW. A meta-analytic review of the effects of exercise on brain-derived neurotrophic factor. J Psychiatr Res 2015; 60:56-64. [PMID: 25455510 PMCID: PMC4314337 DOI: 10.1016/j.jpsychires.2014.10.003] [Citation(s) in RCA: 482] [Impact Index Per Article: 53.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 09/29/2014] [Accepted: 10/04/2014] [Indexed: 12/11/2022]
Abstract
Consistent evidence indicates that exercise improves cognition and mood, with preliminary evidence suggesting that brain-derived neurotrophic factor (BDNF) may mediate these effects. The aim of the current meta-analysis was to provide an estimate of the strength of the association between exercise and increased BDNF levels in humans across multiple exercise paradigms. We conducted a meta-analysis of 29 studies (N = 1111 participants) examining the effect of exercise on BDNF levels in three exercise paradigms: (1) a single session of exercise, (2) a session of exercise following a program of regular exercise, and (3) resting BDNF levels following a program of regular exercise. Moderators of this effect were also examined. Results demonstrated a moderate effect size for increases in BDNF following a single session of exercise (Hedges' g = 0.46, p < 0.001). Further, regular exercise intensified the effect of a session of exercise on BDNF levels (Hedges' g = 0.59, p = 0.02). Finally, results indicated a small effect of regular exercise on resting BDNF levels (Hedges' g = 0.27, p = 0.005). When analyzing results across paradigms, sex significantly moderated the effect of exercise on BDNF levels, such that studies with more women showed less BDNF change resulting from exercise. Effect size analysis supports the role of exercise as a strategy for enhancing BDNF activity in humans, but indicates that the magnitude of these effects may be lower in females relative to males.
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Affiliation(s)
- Kristin L. Szuhany
- Department of Psychological and Brain Sciences, Boston University 648 Beacon St., 5th Floor, Boston, MA 02215
| | - Matteo Bugatti
- Department of Psychological and Brain Sciences, Boston University 648 Beacon St., 5th Floor, Boston, MA 02215
| | - Michael W. Otto
- Department of Psychological and Brain Sciences, Boston University 648 Beacon St., 5th Floor, Boston, MA 02215
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Haglund E, Bergman S, Petersson IF, Jacobsson LTH, Strömbeck B, Bremander A. Differences in physical activity patterns in patients with spondylarthritis. Arthritis Care Res (Hoboken) 2013; 64:1886-94. [PMID: 22745014 DOI: 10.1002/acr.21780] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2012] [Accepted: 06/15/2012] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To study patient-reported physical activity in patients with spondylarthritis (SpA) and possible differences in physical activity patterns between the SpA subtypes and sexes. METHODS In 2009, a questionnaire including inquiries concerning physical activity was sent to patients with a SpA diagnosis (n = 3,711). The World Health Organization (WHO) global recommendations of physical activity for health requiring 150 minutes of moderate-intensity physical activity (MI-PA) or 75 minutes of vigorous-intensity physical activity (VI-PA) per week were used as recommended levels. Standardized risk ratios (RRs) were calculated by using physical activity data from the Swedish population. The association within the SpA group between sex, age, disease-related variables, anxiety, and depression and meeting recommended levels of MI-PA and VI-PA (dependent variables) was studied with multivariate analysis. RESULTS A total of 2,167 patients with SpA (48% men, mean ± SD age 55 ± 14 years) responded to the questionnaire. Sixty-eight percent of the patients met the WHO recommendations, more frequently in women than in men (70% versus 66%). The recommendations were more often met in the SpA group (RR 1.09, 95% confidence interval [95% CI] 1.04-1.15) compared with the Swedish population. There was a tendency for young women to meet the WHO recommendations less often than the Swedish population (RR 0.94, 95% CI 0.63-1.25). Different factors were found to influence whether the patients were exercising with a moderate or vigorous intensity. CONCLUSION Seven of 10 patients with SpA met the WHO recommendations of physical activity for health, but we found sex and disease subtype differences. This information can be useful in clinical practice when coaching patients to have a healthier lifestyle.
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Affiliation(s)
- Emma Haglund
- Lund University, Lund, and Spenshult Hospital for Rheumatic Diseases, Halmstad, Sweden.
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