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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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Dell'Acqua C, Messerotti Benvenuti S, Cellini N, Brush CJ, Ruggerone A, Palomba D. Familial risk for depression is associated with reduced physical activity in young adults: evidence from a wrist-worn actigraphy study. Transl Psychiatry 2024; 14:219. [PMID: 38806490 PMCID: PMC11133440 DOI: 10.1038/s41398-024-02925-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 05/08/2024] [Accepted: 05/10/2024] [Indexed: 05/30/2024] Open
Abstract
Depression is characterized by reduced physical activity and sleep-wake cycle disturbances, often considered important features of the disease. While a few studies have suggested that self-reported reduced physical activity and sleep-wake cycle disturbances might both be linked to depression vulnerability, actigraphy-based measures in vulnerable samples remain largely unexplored. This study relied on actigraphy-based parameters to test whether these disturbances characterize depression vulnerability. Seven-day actigraphy data were collected from 20 (13 female) university students with a high vulnerability to depression, which was determined by the presence of a family history of the condition but no current symptoms, and 32 (21 female) controls with neither a family history of depression nor current depressive symptoms. Daily physical activity, namely gross motor activity, was quantified as average daily acceleration and time spent engaging in moderate-vigorous physical activity (MVPA). The sleep-wake cycle and circadian rhythms were assessed as total sleep duration per night (in hours), sleep within sleep period time (in hours), sleep efficiency (%), and relative amplitude (i.e., the difference between the activity during the day and the night, which reflects circadian rhythms amplitude). Results showed that individuals with a familial risk for depression exhibited reduced daily acceleration and time spent in MVPA relative to the control group, particularly on the weekend during their free time away from scheduled activities. On the other hand, the two groups were comparable in terms of sleep estimates. Taken together, reduced physical activity, but not sleep-wake disturbances, seem to be associated with vulnerability to depression and might be a viable target for identification and prevention efforts.
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Affiliation(s)
- Carola Dell'Acqua
- Department of General Psychology, University of Padua, Padua, Italy.
| | - Simone Messerotti Benvenuti
- Department of General Psychology, University of Padua, Padua, Italy
- Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
- Hospital Psychology Unit, Padua University Hospital, Padua, Italy
| | - Nicola Cellini
- Department of General Psychology, University of Padua, Padua, Italy
- Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
| | - C J Brush
- Department of Movement Sciences, University of Idaho, Moscow, ID, USA
| | | | - Daniela Palomba
- Department of General Psychology, University of Padua, Padua, Italy
- Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
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Marinelli R, Parker AG, Levinger I, Bourke M, Patten R, Woessner MN. Resistance training and combined resistance and aerobic training as a treatment of depression and anxiety symptoms in young people: A systematic review and meta-analysis. Early Interv Psychiatry 2024. [PMID: 38710640 DOI: 10.1111/eip.13528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 04/08/2024] [Indexed: 05/08/2024]
Abstract
AIM To determine the treatment effect of resistance training in reducing symptoms of anxiety and depression in young people. METHODS We searched MEDLINE, PsychINFO, and PubMed for articles published in English from January 1980 to September 2023 for randomized controlled trials (RCT) that included at least 4 weeks of resistance training, with participants aged 26 years or younger with clinically elevated anxiety and depression symptoms. A random-effects meta-analysis was used to calculate a pooled effect size of resistance training pre-and post-intervention compared to control groups. The quality of evidence was assessed using the Cochrane risk-of-bias 2 (RoB 2) and Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) criteria. RESULTS Ten RCTs involving 376 participants (209 females and 127 males) across educational, clinical, and community based setting were eligible for inclusion in the analysis. Resistance training was associated with a significant reduction in depressive (Hedge's g = -1.06, 95% CI -1.61 to -0.51, p < .001) and anxiety (Hedge's g = -1.02, 95% CI -1.50 to -0.54, p < .001) symptoms. Substantial heterogeneity was observed in the analysis of depression symptoms (I2 = 79%) and anxiety symptoms (I2 = 66%). Six trials had a low risk of bias, four trials showed some concerns. The GRADE analysis demonstrated a high level of certainty for depressive symptoms and a moderate level for anxiety symptoms. CONCLUSION Resistance training is an effective intervention in reducing depression and anxiety symptoms in young people, delivered across a range of settings. Future trials exploring the effect resistance training interventions with long-term follow up are warranted to understand the outcomes.
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Affiliation(s)
- Ryan Marinelli
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Victoria, Australia
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Alexandra G Parker
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Itamar Levinger
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Victoria, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, Victoria, Australia
| | - Matthew Bourke
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Rhiannon Patten
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Victoria, Australia
| | - Mary N Woessner
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Victoria, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, Victoria, Australia
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Purgato M, Cadorin C, Prina E, Cabral Ferreira M, Del Piccolo L, Gerber M, Jordans MJD, Ostuzzi G, Richards J, Rudi D, Vitali F, Cortese S, Schena F, Barbui C. Umbrella Systematic Review and Meta-Analysis: Physical Activity as an Effective Therapeutic Strategy for Improving Psychosocial Outcomes in Children and Adolescents. J Am Acad Child Adolesc Psychiatry 2024; 63:172-183. [PMID: 37331468 DOI: 10.1016/j.jaac.2023.04.017] [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: 01/12/2023] [Revised: 04/21/2023] [Accepted: 05/31/2023] [Indexed: 06/20/2023]
Abstract
OBJECTIVE Physical activity (PA) interventions are part of many interdisciplinary programs for the management of children and adolescents with or without physical or psychological conditions or disabilities. Aiming to summarize the available evidence, we conducted an umbrella review of meta-analyses of PA interventions that included psychosocial outcomes in populations of children and adolescents. METHOD Literature searches were conducted in PubMed, Cochrane Central, Web of Science, Medline, SPORTDiscus, and PsychInfo from January 1, 2010, to May 6, 2022. Meta-analyses of randomized and quasi-randomized studies investigating the efficacy of PA interventions for psychosocial outcomes in children and adolescents were included. Summary effects were recalculated using common metric and random-effects models. We assessed between-study heterogeneity, predictive intervals, publication bias, small study effects, and whether the results of the observed positive studies were greater than expected due to chance. On the basis of these calculations, strength of associations was assessed using quantitative umbrella review criteria, and credibility of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Quality was assessed using the AMSTAR 2 tool. This study is registered with the Open Science Framework, https://osf.io/ap8qu. RESULTS A total of 112 studies from 18 meta-analyses generating 12 new meta-analyses comprising 21,232 children and adolescents in population groups including attention-deficit/hyperactivity disorder, cancer, cerebral palsy, chronic respiratory diseases, depression, neuromotor impairment, and obesity and in general populations were included. PA interventions were efficacious in reducing psychological symptoms in all meta-analyses across the different population groups using random-effects models. However, umbrella review criteria suggested a weak strength of association for this outcome, and GRADE credibility of evidence ranged from moderate to very low. For psychological well-being, 3 out of 5 meta-analyses identified significant effects, but the strength of these associations was weak, and GRADE credibility of evidence ranged from moderate to very low. Similarly, for social outcomes, meta-analyses reported a significant summary effect, but the strength of association was weak, and GRADE credibility of evidence ranged from moderate to very low. For self-esteem, one meta-analysis in children with obesity failed to show any effect. CONCLUSION Even though existing meta-analyses suggested a beneficial effect of PA interventions on psychosocial outcomes across different population groups, the strength of associations was weak, and the credibility of evidence was variable depending on the target population, outcome, and condition or disability. Randomized studies of PA interventions in children and adolescents with and without different physical and psychological conditions or disabilities should always include psychosocial outcomes as an important dimension of social and mental health. STUDY PREREGISTRATION INFORMATION Prenatal Maternal Infection and Adverse Neurodevelopment: A Structural Equation Modelling Approach to Downstream Environmental Hits; https://osf.io/; ap8qu.
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Affiliation(s)
- Marianna Purgato
- University of Verona, Verona, Italy; Cochrane Global Mental Health, University of Verona, Verona, Italy.
| | | | | | | | | | | | | | - Giovanni Ostuzzi
- University of Verona, Verona, Italy; Cochrane Global Mental Health, University of Verona, Verona, Italy
| | | | | | | | - Samuele Cortese
- University of Southampton, Solent NHS Trust, Southampton, United Kingdom, the University of Nottingham, Nottingham, United Kingdom, and New York University Grossman School of Medicine, New York
| | | | - Corrado Barbui
- University of Verona, Verona, Italy; Cochrane Global Mental Health, University of Verona, Verona, Italy
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Salam RA, Khan MH, Meerza SSA, Das JK, Lewis-Watts L, Bhutta ZA. An evidence gap map of interventions for noncommunicable diseases and risk factors among children and adolescents. Nat Med 2024; 30:290-301. [PMID: 38195753 DOI: 10.1038/s41591-023-02737-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 11/27/2023] [Indexed: 01/11/2024]
Abstract
Substance misuse, obesity, mental health conditions, type 1 diabetes, cancers, and cardiovascular and chronic respiratory diseases together account for 41% of disability-adjusted life years linked to noncommunicable diseases (NCDs) among children and adolescents worldwide. However, the evidence on risk factors and interventions for this age group is scarce. Here we searched four databases to generate an evidence gap map of existing interventions and research gaps for these risk factors and NCDs. We mapped 159 reviews with 2,611 primary studies; most (96.2%) were conducted in high-income countries, and only 100 studies (3.8%) were from low- and middle-income countries (LMICs). The efficacy of therapeutic interventions on biomarkers and adverse events for NCDs appears to be well evidenced. Interventions for mental health conditions appear to be moderately evidenced, while interventions for obesity and substance misuse appear to be moderate to very low evidenced. Priority areas for future research include evaluating digital health platforms to support primary NCD prevention and management, and evaluating the impact of policy changes on the prevalence of obesity and substance misuse. Our findings highlight the wide disparity of evidence between high-income countries and LMICs. There is an urgent need for increased, targeted financing to address the research gaps in LMICs.
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Affiliation(s)
- Rehana A Salam
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Maryam Hameed Khan
- Institute for Global Health and Development, Aga Khan University Hospital, Karachi, Pakistan
| | - Syed Saqlain Ali Meerza
- Institute for Global Health and Development, Aga Khan University Hospital, Karachi, Pakistan
| | - Jai K Das
- Institute for Global Health and Development, Aga Khan University Hospital, Karachi, Pakistan
| | - Laura Lewis-Watts
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada.
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Yang Y, Zhang Z, Liu J, Cao H. Interactive effects of sleep and physical activity on depression among rural university students in China. Front Psychol 2023; 14:1240856. [PMID: 37842696 PMCID: PMC10569218 DOI: 10.3389/fpsyg.2023.1240856] [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: 06/15/2023] [Accepted: 09/11/2023] [Indexed: 10/17/2023] Open
Abstract
Background Decreased sleep quality and physical activity among university students have become important concerns, while depressive symptoms are on the rise, especially in rural areas. Previous studies have confirmed the association between sleep quality and physical activity and depressive symptoms, but the effect of their interaction on depressive symptoms has been less studied. For this reason, the present study analyzed the interaction between sleep quality and physical activity on depressive symptoms to provide reference and assistance for mental health promotion and intervention for university students in rural areas of China. Methods In this study, we investigated sleep quality, physical activity, and depressive symptoms in 11,423 university students in rural areas of China. The association of sleep quality and physical activity with depressive symptoms was analyzed by using univariate analysis and logistic regression analysis. And further analyzed the association between the interaction effect of sleep quality and physical activity and depressive symptoms. Results The proportion of university students with depressive symptoms in rural China was 33.3%, with a higher proportion of girls students (36.7%) having depressive symptoms than boys students (28.8%). Logistic regression analysis of the interaction between sleep quality and physical activity and depressive symptoms in university students showed that university students with poor sleep quality and MVPA>60 min/d (OR = 4.40,95% CI: 3.75-5.05) had the highest risk of depressive symptoms (p < 0.001). University students with moderate sleep quality and MVPA of 30-60 min/d (OR = 1.18, 95% CI: 0.75-1.61) had the lowest risk of depressive symptoms (p < 0.001). Moreover, there was no gender difference in this result. Conclusion The prevalence of depressive symptoms was higher among university students in rural areas of China. There was an interaction between sleep quality and MVPA on depressive symptoms, maintaining a good quality of sleep and an appropriate length of MVPA has a contributory effect on mental health, and the same trend was found for both boys and girls students. It is recommended that university students in rural areas of China should first maintain proper sleep quality while maintaining 30-60 min of MVPA per day, which may reduce the risk of depressive symptoms.
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Affiliation(s)
- Yang Yang
- Physical Education Institute, Huanghuai University, Zhumadian, China
| | - Zhen Zhang
- Physical Education Institute, Huanghuai University, Zhumadian, China
| | - Jia Liu
- Physical Education Institute, Huanghuai University, Zhumadian, China
| | - Hongmin Cao
- School of Physical Education, Chizhou University, Chizhou, 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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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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Treadmill exercise training improves the high-fat diet-induced behavioral changes in the male rats. Biol Futur 2022; 73:483-493. [PMID: 36495402 DOI: 10.1007/s42977-022-00144-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 12/02/2022] [Indexed: 12/14/2022]
Abstract
The purpose of this study was to investigate the effects of treadmill exercise training on obesity-induced behavioral changes in high-fat diet (HFD)-induced male rats. In this study, 40 male Sprague-Dawley rats were divided into 4 groups after they were weaned: Control (C), Exercise (E), Obese (O) and Obese + Exercise (O + E). For the obesity model % 60 high-fat diet were applied. After obesity was induced, rats were either moderate aerobic exercise (treadmill running) trained or left untrained. Different tasks to assess spatial learning and memory (Morris water maze test (MWMT)), depressive-like behavior (forced swimming test(FST), tail suspension test (TST) and anxiety-like behavior (light-dark test (LDT) and open field test (OFT)) were conducted. Exercise caused a significant reduction in duration of immobility in the O group in FST and the decrease in immobility in the O + E rats in TST. The O + E rats demonstrated a significant increase in the time spent in the light box as compared to the O group in the LDT. The O + E rats did not show any behavioral alterations as compared to all the other groups in the OFT. In the O + E group, there was a significant increase in the time spent in the target quadrant compared to the O group in the MWMT. Our results support that treadmill exercise could improve cognitive, depressive-like, anxiety-like behavioral changes in the HFD-induced obese rats.
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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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11
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Philippot A, Dubois V, Lambrechts K, Grogna D, Robert A, Jonckheer U, Chakib W, Beine A, Bleyenheuft Y, De Volder AG. Impact of physical exercise on depression and anxiety in adolescent inpatients: A randomized controlled trial. J Affect Disord 2022; 301:145-153. [PMID: 35007642 DOI: 10.1016/j.jad.2022.01.011] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 07/30/2021] [Accepted: 01/02/2022] [Indexed: 12/22/2022]
Abstract
BACKGROUND Physical exercise therapy is of proven efficacy in the treatment of adults with depression, but corresponding evidence is lacking in depressed adolescent inpatients. The aim of this study was to document the effect of add-on treatment with structured physical exercise in a clinical population of adolescents hospitalized for depression and anxiety in a psychiatric hospital. METHODS A group of 52 adolescent inpatients was randomly assigned to a physical exercise or control program three to four times per week over a six-week period (20 hours in total). The primary outcome was the Hospital Anxiety Depression Scale (HADS) for evaluation of depression and anxiety symptoms. Secondary outcomes were psychological self-assessments, diagnostic interviews, and physical examinations. RESULTS Six participants were lost in each group, leaving 20 inpatients each in the intervention and control groups. A linear mixed model with F-test revealed a significant interaction in favor of physical exercise in reducing the mean depression score (HADS-D) by 3.8 points [95% (CI), range 1.8 to 5.7], compared to a mean reduction score of 0.7 [95% (CI), range -0,7 to 2.0] in the control group. No significant interaction was found for anxiety symptoms (HADS-A). LIMITATIONS The investigation was limited to the six-week hospital window and the small sample size prevented exploring differences in social characteristics. CONCLUSION Structured physical exercise add-on therapy integrated into the psychiatric hospitalization of adolescents has led to a reduction in their depressive symptoms, demonstrating its effectiveness in the care of adolescent inpatients with depression.
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Affiliation(s)
- Arnaud Philippot
- MSL-In Laboratory, Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium; Psychiatric Hospital Area+/Epsylon, ASBL, Brussels, Belgium
| | - Vincent Dubois
- Psychiatric Hospital Area+/Epsylon, ASBL, Brussels, Belgium
| | - Kate Lambrechts
- Psychiatric Hospital Area+/Epsylon, ASBL, Brussels, Belgium; Environmental, Aging (Integrative) Physiology Laboratory, Haute Ecole Bruxelles-Brabant (HE2B), Brussels, Belgium
| | - Denis Grogna
- Psychiatric Hospital Area+/Epsylon, ASBL, Brussels, Belgium
| | - Annie Robert
- EPID Epidemiology and Biostatistics Research Pole Environmental, Institut de recherche expérimentale et clinique, Université catholique de Louvain
| | - Ugo Jonckheer
- Psychiatric Hospital Area+/Epsylon, ASBL, Brussels, Belgium
| | - Wagdan Chakib
- Psychiatric Hospital Area+/Epsylon, ASBL, Brussels, Belgium
| | | | - Yannick Bleyenheuft
- MSL-In Laboratory, Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium.
| | - Anne G De Volder
- MSL-In Laboratory, Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium; Pediatric Neurology Service, Cliniques Universitaires Saint-Luc, Brussels, Belgium
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12
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Adolescents' Long-Term Experiences of Manageability, Comprehensibility, and Meaningfulness of a Group-Based Exercise Intervention for Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052894. [PMID: 35270586 PMCID: PMC8910745 DOI: 10.3390/ijerph19052894] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 02/23/2022] [Accepted: 02/25/2022] [Indexed: 01/08/2023]
Abstract
Physical exercise is a potentially effective treatment for adolescents with mild to moderate depression. However, there is a lack of long-term follow-ups to reveal adolescents’ experiences of exercise as a treatment for depression. The salutogenic concept of sense of coherence (SOC), comprising the domains manageability, comprehensibility, and meaningfulness is important to understand behaviour change. This study aimed to describe adolescents’ long-term experiences of manageability, comprehensibility, and meaningfulness of a group-based exercise intervention for depression. Fourteen adolescents with persistent depression were recruited from a psychiatric outpatient clinic and interviewed one year after participating in a 14-week moderate to vigorous exercise intervention for depression. An abductive qualitative content analysis was conducted, based on the three SOC domains manageability, comprehensibility, and meaningfulness. The results revealed that participation in the intervention was made manageable by a supportive environment, including: the intervention design, togetherness with peer group, and encouragement from adults. The comprehensibility of the intervention emerged through the insights regarding health benefits of exercise and the aim of the intervention. Meaningfulness was achieved through improved health behaviour, well-being and self-esteem, along with strengthened belief in the future and increased commitment to everyday life. The group-based exercise intervention was experienced as manageable, comprehensible, and meaningful.
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13
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Min S, Masanovic B, Bu T, Matic RM, Vasiljevic I, Vukotic M, Li J, Vukovic J, Fu T, Jabucanin B, Bujkovic R, Popovic S. The Association Between Regular Physical Exercise, Sleep Patterns, Fasting, and Autophagy for Healthy Longevity and Well-Being: A Narrative Review. Front Psychol 2021; 12:803421. [PMID: 34925198 PMCID: PMC8674197 DOI: 10.3389/fpsyg.2021.803421] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 11/12/2021] [Indexed: 11/22/2022] Open
Abstract
This narrative review of the literature assessed whether regular physical exercise and sleep patterns, fasting and autophagy, altogether can be an adequate strategy for achieving healthy longevity and well-being within different stage of life. There are a large number of studies dealing with well-being and healthy longevity; however, few of them have given us a specific formula for how to live long and healthy. Despite all the advances that have been made to create adequate physical exercise programs, sleep patterns or nutritional protocols, the relation between different types of fasting, nutritional supplementation as well as regular physical exercise and sleep patterns have not yet been satisfactorily resolved to cause the best effects of autophagy and, therefore, well-being and healthy longevity. In this way, future studies should clarify more efficiently the relationship between these variables to understand the association between regular physical exercise, sleep patterns, fasting and autophagy for healthy longevity and well-being.
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Affiliation(s)
- Sicheng Min
- College of Physical Education, Hunan Normal University, Changsha, China
| | - Bojan Masanovic
- Faculty for Sport and Physical Education, University of Montenegro, Niksic, Montenegro.,Montenegrosport, Podgorica, Montenegro
| | - Te Bu
- College of Physical Education, Hunan Normal University, Changsha, China
| | - Radenko M Matic
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia.,Western Balkan Sport Innovation Lab, Podgorica, Montenegro
| | - Ivan Vasiljevic
- Faculty for Sport and Physical Education, University of Montenegro, Niksic, Montenegro
| | - Marina Vukotic
- Faculty for Sport and Physical Education, University of Montenegro, Niksic, Montenegro
| | - Jiaomu Li
- College of Physical Education, Hunan Normal University, Changsha, China
| | - Jovan Vukovic
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Tao Fu
- College of Exercise and Health Sciences, Tianjin University of Sport, Tianjin, China
| | - Blazo Jabucanin
- Faculty for Sport and Physical Education, University of Montenegro, Niksic, Montenegro
| | - Rajko Bujkovic
- Faculty of Business Studies, Mediterranean University, Podgorica, Montenegro
| | - Stevo Popovic
- Faculty for Sport and Physical Education, University of Montenegro, Niksic, Montenegro.,Western Balkan Sport Innovation Lab, Podgorica, Montenegro.,Montenegrin Sports Academy, Podgorica, Montenegro
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14
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Axelsdóttir B, Biedilae S, Sagatun Å, Nordheim LV, Larun L. Review: Exercise for depression in children and adolescents - a systematic review and meta-analysis. Child Adolesc Ment Health 2021; 26:347-356. [PMID: 33277972 DOI: 10.1111/camh.12438] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/30/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND The objective of this systematic review was to examine the treatment effects of exercise on children and adolescents with depression compared to either other nonexercise treatments or no treatment. A study protocol was registered in PROSPERO (CRD42018101982). METHOD Cochrane Central Register of Controlled Trials (CENTRAL), Medline (Ovid), Embase (Ovid), PsycINFO (Ovid), AMED (Ovid), SPORTDiscus, PEDro, CINAHL (EBSCO), ERIC (EBSCO), Web of Science, and databases for grey literature and dissertations were searched from their inception through 30 August 2020 for randomized controlled trials. Varieties of search terms for depression, children and adolescents, exercise, and study design were applied. No limits were placed on publication year, language or publication type. Registers for ongoing trials were also searched. Two authors independently screened references, extracted data and assessed risk of bias in the included trials. The effect sizes for depression postintervention were pooled in a meta-analysis, and the certainty of the evidence was assessed using GRADE (Grading of Recommendations Assessments, Development, and Evaluation). RESULTS 13,307 references were screened. Four trials were included (n = 159). Participants were between 12 and 18 years old, and predominantly female. A meta-analysis with a random-effects model was performed, and a moderate effect in favour of exercise on postintervention depression severity was identified (SMD = -0.59, 95% CI = -1.08 to -0.10, p = .02). However, the overall certainty of the evidence for this outcome was low. One trial found a nonsignificant decrease in depression severity at six-month follow-up (n = 42, SMD = -0.59, 95% CI = -1.22 to 0.04, p = 0.07), and the overall certainty of the evidence for this outcome was very low. One trial found no statistically significant differences between the exercise and control groups on quality of life. Other outcomes, including adverse events, psychological well-being and social functioning, were not evaluated. CONCLUSION Low certainty evidence suggests that exercise interventions may be associated with a decrease in adolescent depression severity. However, our confidence in the effect estimate is limited, and the true effect may be substantially different. Thus, large, high-quality trials including follow-up periods are needed.
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Affiliation(s)
- Brynhildur Axelsdóttir
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway.,Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
| | - Sølvi Biedilae
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway.,Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
| | - Åse Sagatun
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Lena V Nordheim
- Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
| | - Lillebeth Larun
- Division of Health Services, Norwegian Institute of Public Health, Oslo, Norway
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15
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Serrander M, Bremander A, Jarbin H, Larsson I. Joy of living through exercise - a qualitative study of clinically referred adolescents' experiences of moderate to vigorous exercise as treatment for depression. Nord J Psychiatry 2021; 75:574-581. [PMID: 33884944 DOI: 10.1080/08039488.2021.1909128] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
AIM Depression is common and rising in adolescents. Recent meta-analyses indicate a moderate effect of exercise on depression symptoms. Clinically referred adolescents and their experiences of an exercise intervention have rarely been studied. The aim of this study was to describe clinically referred adolescents' experience of moderate to vigorous exercise as a treatment for depression. METHODS A total of 16 clinically referred adolescents with persistent major depression, who had taken part in a 14-week aerobic exercise intervention of moderate to vigorous intensity, were interviewed. Data was analysed by latent qualitative content analysis. RESULTS After taking part in the exercise intervention the adolescents expressed enhanced participation in daily life and joy of living by demonstrating commitment and a sense of empowerment. The categories contained both improved vitality and structure of everyday life as well as improved self-esteem and self-control. Participation in the exercise intervention changed their self-image, relationships, school performance, and family life. The adolescents highlighted that exercising in a group was beneficial, giving security and structure. CONCLUSIONS Adolescents with persistent depression experienced several beneficial aspects of participating in an aerobic group exercise of moderate to vigorous intensity.
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Affiliation(s)
- Maria Serrander
- Child and Adolescent Habilitation, Skåne University Hospital, Malmö, Sweden
| | - Ann Bremander
- Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sonderborg, Denmark.,The Rydberg Laboratory for Applied Sciences, Halmstad University, Halmstad, Sweden.,Spenshult Research and Development Centre, Halmstad, Sweden
| | - Håkan Jarbin
- Faculty of Medicine, Department of Clinical Sciences Lund, Lund University, Sweden.,Child and Adolescent Psychiatry, Region Halland, Sweden
| | - Ingrid Larsson
- Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden.,Spenshult Research and Development Centre, Halmstad, Sweden.,Center of Research on Welfare, Health and Sport, School of Health and Welfare, Halmstad University, Halmstad, Sweden
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16
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Jarbin H, Höglund K, Skarphedinsson G, Bremander A. Aerobic exercise for adolescent outpatients with persistent major depression: Feasibility and acceptability of moderate to vigorous group exercise in a clinically referred sample. Clin Child Psychol Psychiatry 2021; 26:954-967. [PMID: 33858215 DOI: 10.1177/13591045211000782] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
AIMS To assess feasibility and acceptability of exercise in clinically referred adolescents with major depression. METHODS Outpatients12 to 17 years with mild to moderate persistent depression participated in a supervised, pulse monitored, 14-week aerobic exercise but without control group. Primary outcome was adherence and secondary was clinician-rated Quick Inventory of Depressive Symptomatology - Adolescent (QIDS-A17-C), aerobic capacity, functioning, and well-being. RESULTS Twenty-one (66%) of 32 eligible adolescents with major depression with disease duration 2.4 (1.1-5.3) years and comorbid ADHD (71%) and anxiety disorders (62%) consented. Estimated maximum heart rate above 70% was achieved for mean 31.6 minutes, indicating that the intensity and duration of the exercise intervention was well received. Fourteen patients (67%) participated throughout the program and attended a median of 29 (81%, range 20-35) supporting satisfaction with the intervention by most patients. QIDS-A17-C score decreased compared to baseline at 15 weeks (p < .001) and further at 1 year (p < .001). Aerobic capacity improved during the intervention but was not maintained, while functioning improved and after 1 year also well-being. CONCLUSION This 14 week moderate to vigorous aerobic exercise intervention was feasible and well accepted by most adolescents with persistent depression and extensive comorbidities.
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Affiliation(s)
- Håkan Jarbin
- Child and Adolescent Psychiatry, Region Halland, Sweden.,Department of Clinical Sciences Lund, Lund University, Faculty of Medicine, Child and Adolescent Psychiatry, Lund, Sweden
| | | | | | - Ann Bremander
- Section of Rheumatology, Department of Clinical Sciences, Lund University, Sweden.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sonderborg, Denmark.,The Rydberg Laboratory for Applied Sciences, Halmstad University, Sweden
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17
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Marchi J, Johansson N, Sarkadi A, Warner G. The Impact of the COVID-19 Pandemic and Societal Infection Control Measures on Children and Adolescents' Mental Health: A Scoping Review. Front Psychiatry 2021; 12:711791. [PMID: 34552516 PMCID: PMC8451953 DOI: 10.3389/fpsyt.2021.711791] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 08/13/2021] [Indexed: 12/23/2022] Open
Abstract
Background: The COVID-19 pandemic is primarily a crisis that affects people's physical health. However, it is well-known from previous epidemics and pandemics that there are other indirect negative impacts on mental health, among others. The purpose of this scoping review was to explore and summarise primary empirical research evidence on how the COVID-19 pandemic and societal infection control measures have impacted children and adolescents' mental health. Methods: A literature search was conducted in five scientific databases: PubMed, APA PsycINFO, Web of Science, CINHAL, and Social Science Premium Collection. The search string was designed using the Population (0-18 years), Exposure (COVID-19), Outcomes (mental health) framework. Mental health was defined broadly, covering mental well-being to mental disorders and psychiatric conditions. Results: Fifty-nine studies were included in the scoping review. Of these, 44 were cross-sectional and 15 were longitudinal studies. Most studies reported negative impact of the COVID-19 pandemic on child and adolescent mental health outcomes, yet the evidence was mixed. This was also the case for studies investigating societal control measures. Strong resilience, positive emotion regulation, physical activity, parental self-efficacy, family functioning and emotional regulation, and social support were reported as protective factors. On the contrary, emotional reactivity and experiential avoidance, exposure to excessive information, COVID-19 school concerns, presence of COVID-19 cases in the community, parental mental health problems, and high internet, social media and video game use were all identified as potentially harmful factors. Conclusions: Due to the methodological heterogeneity of the studies and geographical variation, it is challenging to draw definitive conclusions about the real impact of the COVID-19 pandemic on the mental health of children and adolescents. However, the existing body of research gives some insight to how parents, clinicians and policy makers can take action to mitigate the effects of COVID-19 and control measures. Interventions to promote physical activity and reduce screen time among children and adolescents are recommended, as well as parenting support programs.
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Affiliation(s)
| | | | | | - Georgina Warner
- Child Health and Parenting (CHAP), Department of Public Health and Caring Science, Uppsala University, Uppsala, Sweden
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18
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Adolescents' Experiences of Facilitators for and Barriers to Maintaining Exercise 12 Months after a Group-Based Intervention for Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105427. [PMID: 34069571 PMCID: PMC8161306 DOI: 10.3390/ijerph18105427] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/14/2021] [Accepted: 05/16/2021] [Indexed: 01/10/2023]
Abstract
Exercise can improve health among adolescents with depression. Understanding facilitators for and barriers to maintaining exercise among adolescents with depression may increase adherence to exercise and consequently improve health. The aim was to explore adolescents’ experiences of facilitators for and barriers to maintaining exercise after a group-based exercise intervention for depression. Interviews (n = 14) were conducted 12 months after the exercise intervention. A qualitative content analysis was used to extract facilitators and barriers. Facilitators for maintaining exercise among adolescents with depression were (1) greater self-esteem by having companionship while exercising and by achieving exercise results and (2) having a supportive environment in terms of accessibility and coaching. Barriers to maintaining exercise were (1) disease burden due to fatigue, social anxiety, and a lack of drive, and (2) lack of a supportive environment including a lack of social support, as well as structural support. In conclusion, facilitating enhanced self-esteem and continuous support for exercising are important for adolescents with depression to maintain exercise. The disease burden of depression is a substantial barrier that needs to be considered to maintain exercise. The findings can contribute to the development of services that promote and coordinate exercise as a treatment among adolescents with depression.
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19
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Amatriain-Fernández S, Ezquerro García-Noblejas M, Budde H. Effects of chronic exercise on the inhibitory control of children and adolescents: A systematic review and meta-analysis. Scand J Med Sci Sports 2021; 31:1196-1208. [PMID: 33559271 DOI: 10.1111/sms.13934] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/01/2021] [Accepted: 02/03/2021] [Indexed: 12/25/2022]
Abstract
Inhibitory control is a main component of executive functions that relate to the ability to control prepotent responses and to resist interferences. Deficits in inhibitory control have been associated with numerous disorders, but exercise has become a promising approach to benefit this domain. This systematic review and meta-analysis aims to provide synthesized information and effect size calculations of the benefits of chronic exercise interventions on the inhibitory control of healthy children and adolescents. A systematic search of PubMed, PsycINFO, MEDLINE, ERIC, SPORTDiscus, and PsycArticles identified 4166 articles to be screened for eligibility. A total of 10 studies (3138 participants) met the inclusion criteria. A random-effects analysis model was performed in three variables: accuracy, reaction time and combined scores. The results showed a very small but statistically significant effect in accuracy (d = 0.14, 95% CI 0.01 to 0.27, P =.04), and two almost null effects (statistically non-significant), in the reaction time (d = 0.03, 95% CI -0.10 to 0.16, P =.62) and the combined scores (d = 0.06, 95% CI -0.03 to 0.15, P =.17). Despite the high number of studies that reported positive outcomes, this meta-analysis found only modest benefits in the inhibitory control of healthy children and adolescents after they participated in different chronic exercise interventions. The strict inclusion criteria of this study and the high variability in the designs of the exercise interventions included, among other reasons, might explain the obtained results.
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Affiliation(s)
- Sandra Amatriain-Fernández
- Department of Pedagogy, Faculty of Human Sciences, MSH Medical School Hamburg, Hamburg, Germany.,Department of Physical and Sports Education, Faculty of Sport Sciences and Physical Education, University of A Coruña, A Coruña, Spain
| | - Milagros Ezquerro García-Noblejas
- Department of Physical and Sports Education, Faculty of Sport Sciences and Physical Education, University of A Coruña, A Coruña, Spain
| | - Henning Budde
- Department of Pedagogy, Faculty of Human Sciences, MSH Medical School Hamburg, Hamburg, Germany
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20
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Howlett N, Bottoms L, Chater A, Clark AB, Clarke T, David L, Irvine K, Jones A, Jones J, Mengoni SE, Murdoch J, Pond M, Sharma S, Sims EJ, Turner DA, Wellsted D, Wilson J, Wyatt S, Trivedi D. A randomised controlled trial of energetic activity for depression in young people (READY): a multi-site feasibility trial protocol. Pilot Feasibility Stud 2021; 7:6. [PMID: 33390189 PMCID: PMC7779325 DOI: 10.1186/s40814-020-00734-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 11/24/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Prevalence of depression is increasing in young people, and there is a need to develop and evaluate behavioural interventions which may provide benefits equal to or greater than talking therapies or pharmacological alternatives. Exercise could be beneficial for young people living with depression, but robust, large-scale trials of effectiveness and the impact of exercise intensity are lacking. This study aims to test whether a randomised controlled trial (RCT) of an intervention targeting young people living with depression is feasible by determining whether it is possible to recruit and retain young people, develop and deliver the intervention as planned, and evaluate training and delivery. METHODS The design is a three-arm cluster randomised controlled feasibility trial with embedded process evaluation. Participants will be help-seeking young people, aged 13-17 years experiencing mild to moderate low mood or depression, referred from three counties in England. The intervention will be delivered by registered exercise professionals, supported by mental health support workers, twice a week for 12 weeks. The three arms will be high-intensity exercise, low-intensity exercise, and a social activity control. All arms will receive a 'healthy living' behaviour change session prior to each exercise session and the two exercise groups are energy matched. The outcomes are referral, recruitment, and retention rates; attendance at exercise sessions; adherence to and ability to reach intensity during exercise sessions; proportions of missing data; adverse events, all measured at baseline, 3, and 6 months; resource use; and reach and representativeness. DISCUSSION UK National Health Service (NHS) policy is to provide young people with advice about using exercise to help depression but there is no evidence-based exercise intervention to either complement or as an alternative to medication or talking therapies. UK National Institute for Health and Care Excellence (NICE) guidelines suggest that exercise can be an effective treatment, but the evidence base is relatively weak. This feasibility trial will provide evidence about whether it is feasible to recruit and retain young people to a full RCT to assess the effectiveness and cost-effectiveness of an exercise intervention for depression. TRIAL REGISTRATION ISRCTN, ISRCTN66452702 . Registered 9 April 2020.
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Affiliation(s)
- N. Howlett
- Department of Psychology, Sport, and Geography, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB UK
| | - L. Bottoms
- Department of Psychology, Sport, and Geography, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB UK
| | - A. Chater
- Institute for Sport and Physical Activity Research (ISPAR), School of Sport Science and Physical Activity, Faculty of Health, Education, Sport and Social Science, University of Bedfordshire, Polhill Avenue, Bedford, MK41 9EA UK
| | - A. B. Clark
- Norwich Clinical Trials Unit, University of East Anglia, Norwich, Norfolk NR4 7TR UK
| | - T. Clarke
- Norfolk and Suffolk NHS Foundation Trust, Hellesdon Hospital, Drayton High Road, Norwich, NR6 5BE UK
- Norwich Medical School, University of East Anglia, Norwich, Norfolk NR4 7TJ UK
| | - L. David
- Centre for Health Services and Clinical Research, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB UK
| | - K. Irvine
- Department of Psychology, Sport, and Geography, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB UK
| | - A. Jones
- Norwich Medical School, University of East Anglia, Norwich, Norfolk NR4 7TJ UK
| | - J. Jones
- Centre for Research in Public Health and Community Care, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB UK
| | - S. E. Mengoni
- Department of Psychology, Sport, and Geography, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB UK
- Centre for Health Services and Clinical Research, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB UK
| | - J. Murdoch
- Norwich Clinical Trials Unit, University of East Anglia, Norwich, Norfolk NR4 7TR UK
| | - M. Pond
- Norwich Clinical Trials Unit, University of East Anglia, Norwich, Norfolk NR4 7TR UK
| | - S. Sharma
- Department of Psychology, Sport, and Geography, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB UK
| | - E. J. Sims
- Norwich Clinical Trials Unit, University of East Anglia, Norwich, Norfolk NR4 7TR UK
| | - D. A. Turner
- Norwich Medical School, University of East Anglia, Norwich, Norfolk NR4 7TJ UK
| | - D. Wellsted
- Centre for Health Services and Clinical Research, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB UK
| | - J. Wilson
- Norfolk and Suffolk NHS Foundation Trust, Hellesdon Hospital, Drayton High Road, Norwich, NR6 5BE UK
- Norwich Medical School, University of East Anglia, Norwich, Norfolk NR4 7TJ UK
| | - S. Wyatt
- Centre for Health Services and Clinical Research, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB UK
| | - D. Trivedi
- Centre for Research in Public Health and Community Care, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB UK
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Beirão D, Monte H, Amaral M, Longras A, Matos C, Villas-Boas F. Depression in adolescence: a review. MIDDLE EAST CURRENT PSYCHIATRY 2020. [DOI: 10.1186/s43045-020-00050-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Abstract
Background
Depression is a common mental health disease, especially in mid to late adolescence that, due to its particularities, is a challenge and requires an effective diagnosis. Primary care providers are often the first line of contact for adolescents, being crucial in identifying and managing this pathology. Besides, several entities also recommend screening for depression on this period. Thus, the main purpose of this article is to review the scientific data regarding screening, diagnosis and management of depression in adolescence, mainly on primary care settings.
Main body
Comprehension of the pathogenesis of depression in adolescents is a challenging task, with both environmental and genetic factors being associated to its development. Although there are some screening tests and diagnostic criteria, its clinical manifestations are wide, making its diagnosis a huge challenge. Besides, it can be mistakenly diagnosed with other psychiatric disorders, making necessary to roll-out several differential diagnoses. Treatment options can include psychotherapy (cognitive behavioural therapy and interpersonal therapy) and/or pharmacotherapy (mainly fluoxetine), depending on severity, associated risk factors and available resources. In any case, treatment must include psychoeducation, supportive approach and family involvement. Preventive programs play an important role not only in reducing the prevalence of this condition but also in improving the health of populations.
Conclusion
Depression in adolescence is a relevant condition to the medical community, due to its uncertain clinical course and underdiagnosis worldwide. General practitioners can provide early identification, treatment initiation and referral to mental health specialists when necessary.
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Alghadir AH, Gabr SA. Hormonal Function Responses to Moderate Aerobic Exercise in Older Adults with Depression. Clin Interv Aging 2020; 15:1271-1283. [PMID: 32821089 PMCID: PMC7423410 DOI: 10.2147/cia.s259422] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 07/14/2020] [Indexed: 12/02/2022] Open
Abstract
Background Poor daily life physical activities among older people were related to depressive mood especially memory loss. In addition to that, the change in physical ability is significantly associated with the score of depression among older age. Objective The present study aimed to evaluate the effects of a supervised aerobic training program with moderate intensity for 12 weeks on mood profiles and hormonal levels of the hypothalamus-pituitary-adrenal axis (HPA axis) of older adults. Methods A total of 80 individuals of both gender (90 males, 110 females) of ages ranged between 65 and 95 years were recruited for this study. Based upon the profile of mood states (POMS) analysis, the participants were classified into two groups: control group (n=30) and depressive group (n=50). Leisure-time physical activity (LTPA), adrenal hormones such as ACTH, corticosterone (CORT), cortisol, DHEA/S, and cortisol:DHEA/S ratio were measured at baseline and post-intervention of moderate aerobic exercise for 12 weeks. Results Older adults with higher depressive scores showed a remarkable change in the level of adrenal hormones compared to control. There was a significant increase in the level of ACTH, CORT, cortisol, and cortisol:DHEA/S ratio, and decrease in DHEA/S. Compared to females, males showed an improvement in depressive mood score along with an increase in LPTA, DHEA/S and decrease in ACTH, CORT, cortisol, cortisol:DHEA/S ratio following 12 weeks of supervised aerobic training, respectively. Conclusion The findings of this study showed that 12 weeks of supervised exercise interventions are promising non-drug therapeutic strategies in improving depression among older adults. The potential performance in a psychological state occurs physiologically via optimizing the levels of the hormones of the HPA axis.
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Affiliation(s)
- Ahmad H Alghadir
- Rehabilitation Research Chair (RRC), College of Applied Medical Sciences (CAMS), King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Sami A Gabr
- Rehabilitation Research Chair (RRC), College of Applied Medical Sciences (CAMS), King Saud University, Riyadh, Kingdom of Saudi Arabia
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Andreotti DZ, Silva JDN, Matumoto AM, Orellana AM, de Mello PS, Kawamoto EM. Effects of Physical Exercise on Autophagy and Apoptosis in Aged Brain: Human and Animal Studies. Front Nutr 2020; 7:94. [PMID: 32850930 PMCID: PMC7399146 DOI: 10.3389/fnut.2020.00094] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 05/22/2020] [Indexed: 12/13/2022] Open
Abstract
The aging process is characterized by a series of molecular and cellular changes over the years that could culminate in the deterioration of physiological parameters important to keeping an organism alive and healthy. Physical exercise, defined as planned, structured and repetitive physical activity, has been an important force to alter physiology and brain development during the process of human beings' evolution. Among several aspects of aging, the aim of this review is to discuss the balance between two vital cellular processes such as autophagy and apoptosis, based on the fact that physical exercise as a non-pharmacological strategy seems to rescue the imbalance between autophagy and apoptosis during aging. Therefore, the effects of different types or modalities of physical exercise in humans and animals, and the benefits of each of them on aging, will be discussed as a possible preventive strategy against neuronal death.
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Affiliation(s)
- Diana Zukas Andreotti
- Laboratory of Molecular and Functional Neurobiology, Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Josiane do Nascimento Silva
- Laboratory of Molecular and Functional Neurobiology, Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Amanda Midori Matumoto
- Laboratory of Molecular and Functional Neurobiology, Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Ana Maria Orellana
- Laboratory of Molecular Neuropharmacology, Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Paloma Segura de Mello
- Laboratory of Molecular Neuropharmacology, Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Elisa Mitiko Kawamoto
- Laboratory of Molecular and Functional Neurobiology, Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
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Holbrook HM, Voller F, Castellini G, Silvestri C, Ricca V, Cassioli E, Ivanova MY, Hudziak JJ. Sport participation moderates association between bullying and depressive symptoms in Italian adolescents. J Affect Disord 2020; 271:33-38. [PMID: 32312695 DOI: 10.1016/j.jad.2020.03.142] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 02/13/2020] [Accepted: 03/29/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND A high rate of bullying episodes has been reported in Italian schools, as well as its association with psychopathology in adolescents. However, information regarding moderators of this interaction are still lacking. This study explored whether gender, exercise frequency, and sport participation exerted a protective effect on the association between bullying and depressive symptoms in Italian students. METHODS Researchers obtained data from 4,829 Italian youth ages 13 to 21 using the self-report Epidemiologia dell'Infortunistica Stradale survey (EDIT) developed by the Regional Health Agency of Tuscany, Italy. Three structural equation models were run to assess moderators of the association between bullying and depressive symptoms. Moderators examined in the models included gender, exercise frequency, and sport participation. RESULTS The association between bullying and depressive symptoms was stronger for females (B=0.95, SE=0.04, p< .001) than for males (B=0.45, SE=0.00, p< .001) and for students who did not play sports (B=0.74, SE=0.09, p< .001) than for those who played sports (B=0.61, SE=0.06, p< .001). Females may be more affected by the depressive effects of bullying than males. CONCLUSIONS Participation in sports buffers against the effects of bullying and may prove a helpful strategy for increasing exercise, positive peer interactions, and mood in adolescents. LIMITATIONS The cross-sectional nature of the study, the possible role of BMI as a confounding factor and the use of a not widely used measure of depression.
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Affiliation(s)
- Hannah M Holbrook
- Vermont Psychological Services, University of Vermont, Burlington, Vermont, United States
| | - Fabio Voller
- Italy Epidemiology Unit Health Agency of Tuscany, Villa La Quiete alle Montalve, Florence, Italy
| | - Giovanni Castellini
- Psychiatric Unit, Department of Health Sciences , University of Florence, Florence, Italy.
| | - Caterina Silvestri
- Italy Epidemiology Unit Health Agency of Tuscany, Villa La Quiete alle Montalve, Florence, Italy
| | - Valdo Ricca
- Psychiatric Unit, Department of Health Sciences , University of Florence, Florence, Italy
| | - Emanuele Cassioli
- Psychiatric Unit, Department of Health Sciences , University of Florence, Florence, Italy
| | - Masha Y Ivanova
- Vermont Center for Children, Youth and Families, University of Vermont, Burlington, Vermont, United States
| | - James J Hudziak
- Vermont Center for Children, Youth and Families, University of Vermont, Burlington, Vermont, United States
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Steyn SF, Harvey BH, Brink CB. Pre-pubertal, low-intensity exercise does not require concomitant venlafaxine to induce robust, late-life antidepressant effects in Flinders sensitive line rats. Eur J Neurosci 2020; 52:3979-3994. [PMID: 32320518 DOI: 10.1111/ejn.14757] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 03/26/2020] [Accepted: 04/16/2020] [Indexed: 12/14/2022]
Abstract
A significant number of adolescents are considered insufficiently active. This is of concern considering the negative association between physical activity and major depressive disorder (MDD). There is a lack of approved pharmacological treatment options in this population partly due to limited information on the risks associated with lasting effects during early life. Therefore, interest in non-pharmacological strategies is gaining popularity with low- to moderate-intensity exercise being especially attractive for its antidepressant-like effects and augmentation properties in combination with antidepressants. Early-life development might present a unique "window of opportunity" to induce long-term beneficial effects in individuals treated with central acting drugs, such as antidepressants. Therefore, we investigated the bio-behavioural effects of pre-pubertal, low-intensity exercise (EXE) and/or venlafaxine (VEN) on depressive-like behaviour in juvenile (postnatal day 35 (PND35)) and young adult (PND60) stress-sensitive Flinders sensitive line (FSL) rats. Interventions were introduced during pre-pubertal development, that is PND21-34, followed by a 26-day washout/sedentary period, when bio-behavioural analyses were performed in the early adulthood group. VEN, alone or in combination with EXE, proved ineffective in inducing any bio-behavioural changes in either age group. EXE did not induce early-life antidepressant-like effects, despite increasing frontal serotonin (5-HT) and noradrenaline (NA) levels. Later in life (PND60), pre-pubertal exercise reduced immobility and increased coping behaviours, together with increased cortical 5-HT levels, despite a significant reduction in locomotor activity. These findings emphasize a strong serotonergic basis to the observed delayed antidepressant effects of EXE later in life.
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Affiliation(s)
- Stephan F Steyn
- Centre of Excellence for Pharmaceutical Sciences, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Brian H Harvey
- Centre of Excellence for Pharmaceutical Sciences, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Christiaan B Brink
- Centre of Excellence for Pharmaceutical Sciences, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
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Wegner M, Amatriain-Fernández S, Kaulitzky A, Murillo-Rodriguez E, Machado S, Budde H. Systematic Review of Meta-Analyses: Exercise Effects on Depression in Children and Adolescents. Front Psychiatry 2020; 11:81. [PMID: 32210847 PMCID: PMC7068196 DOI: 10.3389/fpsyt.2020.00081] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 01/31/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Depression is a common threat to children and adolescents in terms of affecting psychosocial development and increasing their risk of suicide. Apart from conventional treatments for depression, physical exercise has become a promising alternative. This paper aims to systematically review the existing meta-analyses that focus on the impact of physical exercise on clinical and nonclinical depression in children and adolescents. METHODS A systematic literature search was conducted using PsycINFO, PsycARTICLES, MedLine, PubMed, and hand searching. Risk of bias analysis, effect sizes calculations, and evaluation of the methodological characteristics (AMSTAR 2) were carried out. RESULTS Four meta-analyses met the inclusion criteria. After analysing the overlap, the total sample contained 30 single studies (mostly including gender mixed samples) and 2,110 participants (age range 5-20 years). The medium duration of the interventions was 11.5 weeks. The sessions had a medium length of 41 min, and the frequency of implementation was three sessions per week. The most implemented intervention type was aerobic exercise, while control groups mainly continued with their regular routine, among other related options. The overall mean effect of physical exercise on depression was medium (d = -0.50). The additional analysis in clinically depressed samples documented a small to medium mean effect (d = -0.48) in favor of the intervention. CONCLUSION The small to medium but consistently positive effects that were found in the present study place physical exercise as a promising and helpful alternative for children and adolescents with clinical and nonclinical depression. The limited literature focused on children and adolescents in comparison with adult samples points to the need for further research.
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Affiliation(s)
- Mirko Wegner
- Institute of Sport Science, Humboldt-Universität zu Berlin, Berlin, Germany
| | | | - Andrea Kaulitzky
- Faculty of Human Sciences, Department of Pedagogy, Medical School Hamburg, Hamburg, Germany
| | | | - Sergio Machado
- Laboratory of Physical Activity Neuroscience, Physical Activity Sciences Postgraduate Program, Salgado de Oliveira University, Niterói, Brazil
| | - Henning Budde
- Faculty of Human Sciences, Department of Pedagogy, Medical School Hamburg, Hamburg, Germany
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Philippot A, Meerschaut A, Danneaux L, Smal G, Bleyenheuft Y, De Volder AG. Impact of Physical Exercise on Symptoms of Depression and Anxiety in Pre-adolescents: A Pilot Randomized Trial. Front Psychol 2019; 10:1820. [PMID: 31440186 PMCID: PMC6694801 DOI: 10.3389/fpsyg.2019.01820] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 07/23/2019] [Indexed: 11/13/2022] Open
Abstract
Aim The intensity of the most appropriate exercise to use in depressed youth is unclear due to differences in methodology and the lack of evidence documenting the effect of physical activity in children. Therefore, the authors of this study attempted to document the effectiveness of different training intensities to reduce symptoms of depression and anxiety in pre-teens. Methods The study included twenty-seven, randomly selected pre-adolescents (aged between 9–11 years of age) all of whom had Primary education. The participants were enrolled and, over a 5-week period, were subject to either intensive or low-to-moderate exercise programs four times a week. Psychological self-reports, as well as physical examinations, were conducted before and after such programs in blinded assessments. Psychological effects were considered the primary outcome, whilst physical condition was secondary. Results Four subjects were lost and twenty-three were analyzed. General linear model with 2 criteria revealed significant changes (p = 0.05) in trait anxiety symptoms over time in the low-to-moderate intensity group (LMIG). Within group changes followed a significant decrease in levels of anxiety (38.82 ± 2.20 to 33.36 ± 2.83, p = 0.004) and depression (10.36 ± 2.83 to 6.73 ± 1.88, p = 0.006) related symptoms amongst those in the LMIG. Interpretation This study indicated that depression and anxiety symptoms were reduced amongst a non-clinical sample of Primary educated pre-adolescents when they were subject to a low-to-moderate exercise program. The program focused on associating movement with pleasure, encouraged positive and non-competitive interactions between participants. Clinical Trial Registration www.ClinicalTrials.gov, identifier NCT02970825, autumn 2016, updated May 7, 2018 (https://clinicaltrials.gov/ct2/show/NCT02970825).
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Affiliation(s)
- Arnaud Philippot
- MSL-In Laboratory, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium.,Psychiatric Hospital, AREA+, Epsylon ASBL, Brussels, Belgium
| | - Alexandre Meerschaut
- MSL-In Laboratory, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Laura Danneaux
- MSL-In Laboratory, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Gauthier Smal
- MSL-In Laboratory, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Yannick Bleyenheuft
- MSL-In Laboratory, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Anne G De Volder
- MSL-In Laboratory, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium.,Pediatric Neurology Service, Cliniques Universitaires Saint-Luc, Brussels, Belgium
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Sebastianski M, Gates M, Gates A, Nuspl M, Bialy LM, Featherstone RM, Breault L, Mason-Lai P, Hartling L. Evidence available for patient-identified priorities in depression research: results of 11 rapid responses. BMJ Open 2019; 9:e026847. [PMID: 31256024 PMCID: PMC6609077 DOI: 10.1136/bmjopen-2018-026847] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 03/07/2019] [Accepted: 06/11/2019] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES Patient priority setting projects (PPSPs) can reduce research agenda bias. A key element of PPSPs is a review of available literature to determine if the proposed research priorities have been addressed, identify research gaps, recognise opportunities for knowledge translation (KT) and avoid duplication of research efforts. We conducted rapid responses for 11 patient-identified priorities in depression to provide a map of the existing evidence. DESIGN Eleven rapid responses. DATA SOURCES Single electronic database (PubMed). ELIGIBILITY CRITERIA Each rapid response had unique eligibility criteria. For study designs, we used a stepwise inclusion process that started with systematic reviews (SRs) if available, then randomised controlled trials and observational studies as necessary. RESULTS For all but one of the rapid responses we identified existing SRs (median 7 SRs per rapid response, range 0-179). There were questions where extensive evidence exists (ie, hundreds of primary studies), yet uncertainties remain. For example, there is evidence supporting the effectiveness of many non-pharmacological interventions (including psychological interventions and exercise) to reduce depressive symptoms. However, targeted research is needed that addresses comparative effectiveness of promising interventions, specific populations of interest (eg, children, minority groups) and adverse effects. CONCLUSIONS We identified an extensive body of evidence addressing patient priorities in depression and mapped the results and limitations of existing evidence, areas of uncertainty and general directions for future research. This work can serve as a solid foundation to guide future research in depression and KT activities. Integrated knowledge syntheses bring value to the PPSP process; however, the role of knowledge synthesis in PPSPs and methodological approaches are not well defined at present.
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Affiliation(s)
- Meghan Sebastianski
- Alberta Strategy for Patient-Oriented Research (SPOR) SUPPORT Unit Knowledge Translation Platform, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Michelle Gates
- Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Allison Gates
- Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Megan Nuspl
- Alberta Strategy for Patient-Oriented Research (SPOR) SUPPORT Unit Knowledge Translation Platform, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Liza M Bialy
- Alberta Strategy for Patient-Oriented Research (SPOR) SUPPORT Unit Knowledge Translation Platform, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Robin M Featherstone
- Alberta Strategy for Patient-Oriented Research (SPOR) SUPPORT Unit Knowledge Translation Platform, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
- Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Lorraine Breault
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Ping Mason-Lai
- Alberta Strategy for Patient-Oriented Research (SPOR) SUPPORT Unit Patient Engagement Platform, University of Alberta, Edmonton, Alberta, Canada
| | - Lisa Hartling
- Alberta Strategy for Patient-Oriented Research (SPOR) SUPPORT Unit Knowledge Translation Platform, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
- Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
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Park H, Lee KS, Park YJ, Lee DJ, Lee HK. The Association between Organizational Justice and Psychological Well-Being by Regular Exercise in Korean Employees. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2223. [PMID: 31238557 PMCID: PMC6616595 DOI: 10.3390/ijerph16122223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 06/21/2019] [Indexed: 11/16/2022]
Abstract
Many studies have shown that organizational justice (OJ) is related to psychological determinants of employees' physical and mental health in the workplace, and these health outcomes also lead to the psychological well-being (PW) of employees. Additionally, physical activity is one of the most important issues related to health in the workplace. This study compared the level of perceived OJ according to sociodemographic and lifestyle factors and examined the association between OJ and PW by regular exercise (hours per week) in Korean employees. This study used cross-sectional data obtained from 494 subjects in South Korea. Self-administered questionnaires comprising OJ, PW, and lifestyle factors (e.g., smoking, drinking, sleeping, and exercise) were completed by employees in April 2017. Multiple logistic regression analyses were conducted to estimate the association of procedural justice (PJ) and interactional justice (IJ) with the prevalence odds ratios and 95% confidence intervals of the high risk to PW. After the adjustment of sociodemographic characteristics and lifestyle factors, the main effects of PJ and IJ on the high risk to PW were significantly observed, and when these values were stratified by a regular exercise category, the lowest odds ratio was observed in a group that exercised for 1-2 h (hours per week). Organizations must encourage trust and consideration between employees and supervisors and carry out efforts to improve their environment, such as making the decision-making process fairer and encouraging employees to exercise regularly. This intervention may help prevent a high risk to PW.
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Affiliation(s)
- Hanul Park
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea.
- Department of Public Health, Graduate School, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea.
| | - Kang-Sook Lee
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea.
- Department of Public Health, Graduate School, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea.
- Graduate School of Public Health, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea.
| | - Yong-Jun Park
- Graduate School of Public Health, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea.
| | - Dong-Joon Lee
- Graduate School of Public Health, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea.
| | - Hyun-Kyung Lee
- Graduate School of Public Health, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea.
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Williams CF, Bustamante EE, Waller JL, Davis CL. Exercise effects on quality of life, mood, and self-worth in overweight children: the SMART randomized controlled trial. Transl Behav Med 2019; 9:451-459. [PMID: 31094443 PMCID: PMC6520810 DOI: 10.1093/tbm/ibz015] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Overweight children are at risk for poor quality of life (QOL), depression, self-worth, and behavior problems. Exercise trials with children have shown improved mood and self-worth. Few studies utilized an attention control condition, QOL outcomes, or a follow-up evaluation after the intervention ends. The purpose is to test effects of an exercise program versus sedentary program on psychological factors in overweight children. One hundred seventy-five overweight children (87% black, 61% female, age 9.7 ± 0.9 years, 73% obese) were randomized to an 8 month aerobic exercise or sedentary after-school program. Depressive symptoms, anger expression, self-worth, and QOL were measured at baseline and post-test. Depressive symptoms and QOL were also measured at follow-up. Intent-to-treat mixed models evaluated intervention effects, including sex differences. At post-test, QOL, depression, and self-worth improved; no group by time or sex by group by time interaction was detected for QOL or self-worth. Boys' depressive symptoms improved more and anger control decreased in the sedentary intervention relative to the exercise intervention at post-test. At follow-up, depressive symptoms in boys in the sedentary group decreased more than other groups. Exercise provided benefits to QOL, depressive symptoms, and self-worth comparable to a sedentary program. Sedentary programs with games and artistic activities, interaction with adults and peers, and behavioral structure may be more beneficial to boys' mood than exercise. Some benefits of exercise in prior studies are probably attributable to program elements such as attention from adults. Trial Registration: Clinicaltrials.gov, NCT02227095.
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Affiliation(s)
- Celestine F Williams
- Department of Population Health Sciences, Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Eduardo E Bustamante
- Department of Kinesiology & Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Jennifer L Waller
- Biostatistics & Data Science, Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Catherine L Davis
- Department of Population Health Sciences, Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA, USA
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31
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Ogawa S, Kitagawa Y, Fukushima M, Yonehara H, Nishida A, Togo F, Sasaki T. Interactive effect of sleep duration and physical activity on anxiety/depression in adolescents. Psychiatry Res 2019; 273:456-460. [PMID: 30684792 DOI: 10.1016/j.psychres.2018.12.085] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 11/27/2018] [Accepted: 12/16/2018] [Indexed: 10/27/2022]
Abstract
Although effects of sleep duration and physical activity (PA) have been demonstrated on mental health in adolescents, their interactive effect has not been studied. This cross-sectional study first examines this interactive effect on anxiety/depression in adolescents. A total of 983 Japanese students aged 12-17 were studied, using a self-report questionnaire. The interaction of sleep duration and amount of PA and their main effects on anxiety/depression, assessed using the 12-item General Health Questionnaire (GHQ-12), were investigated employing multiple regression, adjusting for grade and sex. Sleep duration and amount of PA were classified as being adequate or not, according to the duration and amount recommended by the National Sleep Foundation and World Health Organization, respectively. As a result, the interaction between sleep duration and amount of PA and their main effects were statistically significant. GHQ-12 score was significantly better in adolescents with either adequate sleep or adequate PA, not both, than those with neither adequate sleep nor adequate PA. The score, however, seemed no further improved in those with both adequate sleep and PA. The present study suggests that effects of sleep and PA on mental health need to be studied with consideration to their interaction.
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Affiliation(s)
- Sayoko Ogawa
- The University of Tokyo, Graduate School of Education, Department of Physical and Health Education, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan.
| | - Yuko Kitagawa
- The University of Tokyo, Graduate School of Education, Department of Physical and Health Education, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan; Department of Neuropsychiatry, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi, Tokyo 173-0003, Japan; Japan Society for the Promotion of Science, 5-3-1, Koujimachi, Chiyoda-ku, Tokyo 102-0083, Japan.
| | - Masako Fukushima
- The University of Tokyo Secondary School attached to the Faculty of Education, Nakano-ku, 1-15-1 Minamidai, Tokyo 1648654, Japan.
| | - Hiromi Yonehara
- The University of Tokyo Secondary School attached to the Faculty of Education, Nakano-ku, 1-15-1 Minamidai, Tokyo 1648654, Japan.
| | - Atsushi Nishida
- Tokyo Metropolitan Institute of Medical Science, Department of Psychiatry and Behavioral Science, Setagaya-ku, 2-1-6 Kamikitawaza, Tokyo 1568506, Japan.
| | - Fumiharu Togo
- The University of Tokyo, Graduate School of Education, Department of Physical and Health Education, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan.
| | - Tsukasa Sasaki
- The University of Tokyo, Graduate School of Education, Department of Physical and Health Education, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan.
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32
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Jaworska N, Courtright AK, De Somma E, MacQueen GM, MacMaster FP. Aerobic exercise in depressed youth: A feasibility and clinical outcomes pilot. Early Interv Psychiatry 2019; 13:128-132. [PMID: 29372589 DOI: 10.1111/eip.12537] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 11/08/2017] [Accepted: 12/17/2017] [Indexed: 11/27/2022]
Abstract
AIM Major depressive disorder (MDD) onset generally occurs in adolescence/early adulthood. However, pharmacotherapy use in younger populations is restricted due to black box warnings. Aerobic exercise may be a viable treatment option for mild-to-moderate MDD, but little is known about its acceptability/effectiveness in young adults. METHODS Unmedicated and relatively inactive 18-to-24 olds with MDD completed fitness/clinical assessments at baseline and after 12 weeks of supervised aerobic exercise (3×/wk; 30-minute sessions in target heart rate [HR] zone), with the aim of increasing cardiovascular fitness (VO2max -indexed). RESULTS Post-intervention, predicted VO2max increased, whereas depression scores decreased. A correlation existed between time spent in target HR zone and anxiety symptom decreases. Exercise adherence and satisfaction were high, and drop-out was minimal. CONCLUSIONS This pilot is among the first to assess the feasibility of aerobic exercise as an antidepressant treatment strategy in young adults, a group for which options have limited acceptability.
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Affiliation(s)
- Natalia Jaworska
- Department of Psychiatry, Mathison Centre for Mental Health Research & Education, University of Calgary, Alberta, Canada
| | - Allegra K Courtright
- Department of Psychiatry, Mathison Centre for Mental Health Research & Education, University of Calgary, Alberta, Canada
| | - Elisea De Somma
- Department of Psychiatry, Mathison Centre for Mental Health Research & Education, University of Calgary, Alberta, Canada.,Department of Psychology, York University, Toronto, Ontario, Canada
| | - Glenda M MacQueen
- Department of Psychiatry, Mathison Centre for Mental Health Research & Education, University of Calgary, Alberta, Canada
| | - Frank P MacMaster
- Department of Psychiatry, Mathison Centre for Mental Health Research & Education, University of Calgary, Alberta, Canada.,Child and Adolescent Imaging Research (CAIR) Program, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.,Strategic Clinical Network for Addictions and Mental Health, Alberta Health Services, Calgary, Alberta, Canada
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33
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Lightfoot JT, DE Geus EJC, Booth FW, Bray MS, DEN Hoed M, Kaprio J, Kelly SA, Pomp D, Saul MC, Thomis MA, Garland T, Bouchard C. Biological/Genetic Regulation of Physical Activity Level: Consensus from GenBioPAC. Med Sci Sports Exerc 2019; 50:863-873. [PMID: 29166322 DOI: 10.1249/mss.0000000000001499] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
PURPOSE Physical activity unquestionably maintains and improves health; however, physical activity levels globally are low and not rising despite all the resources devoted to this goal. Attention in both the research literature and the public policy domain has focused on social-behavioral factors; however, a growing body of literature suggests that biological determinants play a significant role in regulating physical activity levels. For instance, physical activity level, measured in various manners, has a genetic component in both humans and nonhuman animal models. This consensus article, developed as a result of an American College of Sports Medicine-sponsored round table, provides a brief review of the theoretical concepts and existing literature that supports a significant role of genetic and other biological factors in the regulation of physical activity. CONCLUSIONS Future research on physical activity regulation should incorporate genetics and other biological determinants of physical activity instead of a sole reliance on social and other environmental determinants.
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Affiliation(s)
- J Timothy Lightfoot
- Department of Health and Kinesiology, Texas A&M University, College Station, TX.,Department of Health and Kinesiology, Texas A&M University, College Station, TX
| | - Eco J C DE Geus
- Department of Health and Kinesiology, Texas A&M University, College Station, TX.,Department of Health and Kinesiology, Texas A&M University, College Station, TX
| | - Frank W Booth
- Department of Health and Kinesiology, Texas A&M University, College Station, TX.,Department of Health and Kinesiology, Texas A&M University, College Station, TX
| | - Molly S Bray
- Department of Health and Kinesiology, Texas A&M University, College Station, TX.,Department of Health and Kinesiology, Texas A&M University, College Station, TX
| | - Marcel DEN Hoed
- Department of Health and Kinesiology, Texas A&M University, College Station, TX.,Department of Health and Kinesiology, Texas A&M University, College Station, TX
| | - Jaakko Kaprio
- Department of Health and Kinesiology, Texas A&M University, College Station, TX.,Department of Health and Kinesiology, Texas A&M University, College Station, TX
| | - Scott A Kelly
- Department of Health and Kinesiology, Texas A&M University, College Station, TX.,Department of Health and Kinesiology, Texas A&M University, College Station, TX
| | - Daniel Pomp
- Department of Health and Kinesiology, Texas A&M University, College Station, TX.,Department of Health and Kinesiology, Texas A&M University, College Station, TX
| | - Michael C Saul
- Department of Health and Kinesiology, Texas A&M University, College Station, TX.,Department of Health and Kinesiology, Texas A&M University, College Station, TX
| | - Martine A Thomis
- Department of Health and Kinesiology, Texas A&M University, College Station, TX.,Department of Health and Kinesiology, Texas A&M University, College Station, TX
| | - Theodore Garland
- Department of Health and Kinesiology, Texas A&M University, College Station, TX.,Department of Health and Kinesiology, Texas A&M University, College Station, TX
| | - Claude Bouchard
- Department of Health and Kinesiology, Texas A&M University, College Station, TX.,Department of Health and Kinesiology, Texas A&M University, College Station, TX
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Fochesatto CF, Gaya ACA, Bandeira DR, Mota J, Alemeida RFD, Dias AF, Brand C, Mello JB, Gaya AR. Association of organized physical activity and levels of cardiorespiratory fitness with indicators of mental health in children. MOTRIZ: REVISTA DE EDUCACAO FISICA 2019. [DOI: 10.1590/s1980-6574201900040089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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35
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Lin TW, Tsai SF, Kuo YM. Physical Exercise Enhances Neuroplasticity and Delays Alzheimer's Disease. Brain Plast 2018; 4:95-110. [PMID: 30564549 PMCID: PMC6296269 DOI: 10.3233/bpl-180073] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Accumulating evidence indicates that exercise can improve learning and memory as well as attenuate neurodegeneration, including Alzheimer's disease (AD). In addition to improving neuroplasticity by altering the synaptic structure and function in various brain regions, exercise also modulates systems like angiogenesis and glial activation that are known to support neuroplasticity. Moreover, exercise helps to maintain a cerebral microenvironment that facilitates synaptic plasticity by enhancing the clearance of Aβ, one of the main culprits of AD pathogenesis. The purpose of this review is to highlight the positive impacts of exercise on promoting neuroplasticity. Possible mechanisms involved in exercise-modulated neuroplasticity are also discussed. Undoubtedly, more studies are needed to design an optimal personalized exercise protocol for enhancing brain function.
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Affiliation(s)
- Tzu-Wei Lin
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Neuroscience and Regenerative Medicine, Medical College of Georgia, Augusta, Georgia, USA
| | - Sheng-Feng Tsai
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Min Kuo
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Cell Biology and Anatomy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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36
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He JP, Paksarian D, Merikangas KR. Physical Activity and Mental Disorder Among Adolescents in the United States. J Adolesc Health 2018; 63:628-635. [PMID: 30170937 DOI: 10.1016/j.jadohealth.2018.05.030] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 05/02/2018] [Accepted: 05/24/2018] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To estimate associations between physical activity (PA) and a broad range of lifetime mental disorders among adolescents, and to evaluate whether the context of sports participation impacts these associations. METHODS The sample included 6,483 13-18 year-olds from the National Comorbidity Survey Adolescent Supplement. Adolescents completed face-to-face psychiatric interviews and a parent provided diagnostic and other family-level information on the participating adolescent by completing a self-administered questionnaire. PA was measured by adolescent self-report and dichotomized to indicate vigorous exercise several times a week. Nineteen psychiatric disorders were assessed using the Diagnostic and Statistical Manual of Mental Disorders criteria. Multiple logistic regression analyses were used to estimate associations of PA with mental disorders, suicidality, and psychological distress. RESULTS Two thirds of adolescents reported being physically active. Active adolescents had significantly lower odds of mood disorder (Odds ratio[OR] = .74, 95% confidence interval [CI]=.58-.94), bipolar II disorder (OR = .54, 95% CI=.30-.99), and general psychological distress (OR = .71, 95% CI=.52-.96) than less/inactive adolescents. In contrast, adolescents who engaged in PA were more likely to have lifetime alcohol use disorder (OR = 1.78, 95% CI = 1.11-2.85), bulimia (OR = 5.84, 95% CI = 2.48-13.79), generalized anxiety disorder (OR = 2.04, 95% CI = 1.16-3.58), and posttraumatic stress disorder (OR = 1.65, 95% CI = 1.07-2.55). The direct associations between PA and alcohol use disorder and bulimia appeared to be specific to adolescents who participated in organized sports. DISCUSSION Associations between PA and lifetime mental disorder among adolescents may differ according to both disorder type and the context in which PA occurs. Longitudinal studies that assess the context of PA may be able to explain apparent discrepant associations between PA and mental disorder.
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Affiliation(s)
- Jian-Ping He
- Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| | - Diana Paksarian
- Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| | - Kathleen R Merikangas
- Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland.
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37
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Bélair MA, Kohen DE, Kingsbury M, Colman I. Relationship between leisure time physical activity, sedentary behaviour and symptoms of depression and anxiety: evidence from a population-based sample of Canadian adolescents. BMJ Open 2018; 8:e021119. [PMID: 30337306 PMCID: PMC6196847 DOI: 10.1136/bmjopen-2017-021119] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 07/27/2018] [Accepted: 08/22/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Physical and sedentary activities have been identified as potentially modifiable risk factors for many diseases, including mental illness, and may be effective targets for public health policy and intervention. However, the relative contribution of physical activity versus sedentary behaviour to mental health is less clear. This study investigated the cross-sectional association between physical activity, sedentary activity and symptoms of depression and anxiety at age 14-15 in the National Longitudinal Survey of Children and Youth (NLSCY). METHODS Respondents aged 14-15 years between 1996 and 2009 who reported on symptoms of depression in the NLSCY were included (n=9702). Multinomial logistic regression was used to assess the relationship between physical and sedentary activity and symptoms of depression and anxiety. Joint models including both physical and sedentary activity were also explored. Models were adjusted for sex, ethnicity, immigration status, family income, parental education, recent major stressful life events and chronic health conditions. RESULTS The odds of having moderate and severe symptoms of depression and anxiety compared with no symptoms was 1.43 (1.11 to 1.84) and 1.88 (1.45 to 2.45) times higher, respectively, in physically inactive youth relative to physically active youth. The odds of having moderate and severe symptoms of depression and anxiety compared with no symptoms was 1.38 (1.13 to 1.69) and 1.31 (1.02 to 1.69) times higher, respectively, in sedentary youth relative to non-sedentary youth. In joint models including both physical and sedentary activity, sedentary activity was not consistently associated with symptoms of depression and anxiety. CONCLUSIONS Both physical inactivity and sedentary activity appear to be significantly related to symptoms of depression and anxiety. The importance of distinguishing these two behaviours has relevance for research as well as policies targeting physical activity and mental health in youth.
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Affiliation(s)
- Marc-André Bélair
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Dafna E Kohen
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- Health Analysis Division, Statistics Canada, Ottawa, Ontario, Canada
| | - Mila Kingsbury
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Ian Colman
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
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38
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Vancampfort D, Stubbs B, Firth J, Van Damme T, Koyanagi A. Sedentary behavior and depressive symptoms among 67,077 adolescents aged 12-15 years from 30 low- and middle-income countries. Int J Behav Nutr Phys Act 2018; 15:73. [PMID: 30089487 PMCID: PMC6083627 DOI: 10.1186/s12966-018-0708-y] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 07/26/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depression is common and burdensome in adolescents. Understanding modifiable environmental risk factors is essential. There is evidence that physical activity is protective of depression. However, the impact of sedentary behavior (SB) on depression is relatively under-researched especially in low- and middle-income countries (LMICs). In this cross-sectional study, we explored the association between SB and depressive symptoms in adolescents from 30 LMICs, controlling for confounders including physical activity. METHOD Data from the Global school-based Student Health Survey were analyzed in 67,077 adolescents [mean (SD) age 13.8 (0.9) years; 50.6% girls). Self-report measures assessed depressive symptoms during the past 12 months, and SB, which was a composite variable assessing time spent sitting and watching television, playing computer games, talking with friends during a typical day excluding the hours spent sitting at school and doing homework. Multivariable logistic regression analysis was conducted and a countrywide meta-analysis undertaken. RESULTS The prevalence of depressive symptoms and ≥ 3 h/day of SB were 28.7 and 30.6%, respectively. There was a linear increase in the prevalence of depressive symptoms with increasing sedentary time beyond ≥3 h/day (vs. < 1 h/day). Among boys, 1-2 h/day of SB was associated with lower odds for depression (vs. < 1 h/day). Countrywide meta-analysis demonstrated that spending ≥3 h/day versus < 3 h/day was associated with a 20% increased odds for depressive symptoms (OR = 1.20; 95% CI = 1.16-1.24) with low between-country heterogeneity (I2 = 27.6%). CONCLUSION Our data indicate that being sedentary for ≥3 h/day is associated with increased odds for depressive symptoms in adolescence. Future longitudinal data are required to confirm/refute the findings to inform public interventions which aim to limit the time spent being sedentary in adolescents.
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Affiliation(s)
- Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Tervuursevest 101, 3001 Leuven, Belgium
- KU Leuven, University Psychiatric Center KU Leuven, Leuvensesteenweg 517, 3070 Kortenberg, Belgium
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ UK
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London, Box SE5 8AF UK
| | - Joseph Firth
- NICM Health Research Institute, School of Science and Health, University of Western Sydney, Sydney, Australia
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Tine Van Damme
- KU Leuven Department of Rehabilitation Sciences, Tervuursevest 101, 3001 Leuven, Belgium
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 0883 Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, 28029 Madrid, Spain
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Belvederi Murri M, Ekkekakis P, Magagnoli M, Zampogna D, Cattedra S, Capobianco L, Serafini G, Calcagno P, Zanetidou S, Amore M. Physical Exercise in Major Depression: Reducing the Mortality Gap While Improving Clinical Outcomes. Front Psychiatry 2018; 9:762. [PMID: 30687141 PMCID: PMC6335323 DOI: 10.3389/fpsyt.2018.00762] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 12/20/2018] [Indexed: 12/11/2022] Open
Abstract
Major depression shortens life while the effectiveness of frontline treatments remains modest. Exercise has been shown to be effective both in reducing mortality and in treating symptoms of major depression, but it is still underutilized in clinical practice, possibly due to prevalent misperceptions. For instance, a common misperception is that exercise is beneficial for depression mostly because of its positive effects on the body ("from the neck down"), whereas its effectiveness in treating core features of depression ("from the neck up") is underappreciated. Other long-held misperceptions are that patients suffering from depression will not engage in exercise even if physicians prescribe it, and that only vigorous exercise is effective. Lastly, a false assumption is that exercise may be more harmful than beneficial in old age, and therefore should only be recommended to younger patients. This narrative review summarizes relevant literature to address the aforementioned misperceptions and to provide practical recommendations for prescribing exercise to individuals with major depression.
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Affiliation(s)
- Martino Belvederi Murri
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Department of Psychological Medicine, King's College London, London, United Kingdom
| | | | - Marco Magagnoli
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy
| | - Domenico Zampogna
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy
| | - Simone Cattedra
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy
| | - Laura Capobianco
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy
| | - Gianluca Serafini
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Pietro Calcagno
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy
| | - Stamatula Zanetidou
- Department of Mental Health, Consultation Liaison Psychiatry Service, Bologna, Italy
| | - Mario Amore
- Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genova, Italy
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40
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Vancampfort D, Hallgren M, Firth J, Rosenbaum S, Schuch FB, Mugisha J, Probst M, Van Damme T, Carvalho AF, Stubbs B. Physical activity and suicidal ideation: A systematic review and meta-analysis. J Affect Disord 2018; 225:438-448. [PMID: 28858658 DOI: 10.1016/j.jad.2017.08.070] [Citation(s) in RCA: 123] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 08/07/2017] [Accepted: 08/20/2017] [Indexed: 01/11/2023]
Abstract
BACKGROUND A potential approach to suicide prevention that has not been closely examined, but which holds promise in terms of widespread dissemination without major side-effects, is physical activity (PA). This systematic review and meta-analysis set out to: (a) explore associations between PA and suicidal ideation (SI) levels, and (b) investigate the effect of PA interventions on SI. METHODS Major electronic databases were searched from inception up to 05/2017 to identify quantitative studies reporting an association between PA and SI. A quantitative correlates synthesis and random effects meta-analysis were conducted. RESULTS Fourteen of 21 studies in adults (67%) (n = 130,737), 7/14 (50%) in adolescents (n = 539,170) and 2/3 (67%) in older adults (n = 50,745) found a significant negative association between PA- and SI-levels. Pooled adjusted meta-analysis of 14 effect sizes over eight studies and 80,856 people found that those who were "active" versus those who were "inactive" were less likely to have SI (OR = 0.87, 95%CI = 0.76-0.98). Additionally, meeting PA guidelines conferred a significant protective effect against SI (OR = 0.91, 95%CI = 0.51-0.99, P = 0.03; N studies = 3, n people = 122,395), while not meeting guidelines was associated with increased SI (OR = 1.16, 95%CI = 1.09-1.24, P < 0.001; N = 4, n = 78,860). Data from the intervention studies (N = 3, n = 121) was mixed and limited. LIMITATIONS Our findings are based mainly on cross-sectional studies, while the majority of studies did not include a rigorous physical activity assessment. CONCLUSIONS The current study suggests that higher PA levels are associated with lower SI. However, the associations observed need to be confirmed in prospective observational studies and controlled trials.
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Affiliation(s)
- Davy Vancampfort
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven - University of Leuven, University Psychiatric Centre, Leuven-Kortenberg, Belgium.
| | - Mats Hallgren
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
| | - Joseph Firth
- Institute of Brain, Behaviour and Mental Health, University of Manchester, UK; NICM, School of Science and Health, University of Western Sydney, Australia
| | - Simon Rosenbaum
- School of Psychiatry, UNSW Sydney, Australia; Black Dog Institute, Prince of Wales Hospital, Sydney, Australia
| | - Felipe B Schuch
- Unilasalle, Canoas, Brazil; Escola de Educação Física, Fisioterapia e Dança, Porto Alegre, Brazil; Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - James Mugisha
- Kyambogo University, Kampala, Uganda; Butabika National Referral and Mental Health Hospital, Kampala, Uganda
| | - Michel Probst
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| | - Tine Van Damme
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| | - André F Carvalho
- Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, UK; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK
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Shimoda T, Matsuzawa R, Hoshi K, Yoneki K, Harada M, Watanabe T, Matsunaga A. Effects of supervised exercise on depressive symptoms in hemodialysis patients: a systematic review and meta-analysis of randomized controlled trials. RENAL REPLACEMENT THERAPY 2017. [DOI: 10.1186/s41100-017-0136-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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