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Haag FB, Resende E Silva DT, Antunes CS, Waclawovsky G, Lucchese-Lobato F. Effects of circuit training and Yoga on biochemical and psychological responses to stress and cardiovascular markers: A randomized clinical trial with nursing and medical students in Southern Brazil. Psychoneuroendocrinology 2024; 167:107110. [PMID: 38954979 DOI: 10.1016/j.psyneuen.2024.107110] [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: 02/03/2024] [Revised: 06/12/2024] [Accepted: 06/18/2024] [Indexed: 07/04/2024]
Abstract
A Randomized Controlled Trial involving 158 Brazilian medical and nursing students assessed one of three conditions over an 8-week period: 1) a circuit training protocol (CTG); 2) a yoga protocol (YG); or 3) no intervention (CG). The objective was to evaluate the effectiveness of circuit training and yoga protocols in reducing perceived mental stress and examining their effects on serum cortisol levels, as well as on traditional cardiovascular risk factors (CRFs), during an academic semester. Mental stress was measured using self-reported stress questionnaires. For the CTG, comparisons of pre- vs. post-intervention data indicated a reduction in self-reported stress levels on a Brazilian scale (p < 0.001) and an international scale (p < 0.05). Regarding CRFs, there was a reduction in waist circumference (WC) (p < 0.05), systolic blood pressure (SBP) (p < 0.05), and heart rate (HR) (p < 0.001). No changes were observed in diastolic blood pressure (DBP) (p = 0.211) and serum cortisol (SC) (p = 0.423). In the YG, pre- vs. post-intervention data indicated a reduction in self-reported stress levels on the ISSL (p < 0.001), in both resistance and exhaustion stress levels on the PSS scale (p < 0.001), and in SC levels (p < 0.001), WC (p < 0.05), and SBP (p < 0.05); however, HR and DBP did not change (p = 0.168 and p = 0.07, respectively) in this group. No changes were noted in any measures in the CG. The intervention protocols demonstrated that both CTG and YG can positively impact mental or biochemical stress responses, as well as CRFs.
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Affiliation(s)
- Fabiana Brum Haag
- Nursing Department, Federal University of Fronteira Sul (UFFS), Chapecó, Santa Catarina, Brazil
| | - Débora Tavares Resende E Silva
- Department of Graduate Studies in Biomedical Sciences, Federal University of Fronteira Sul (UFFS), Chapecó, Santa Catarina, Brazil
| | | | - Gustavo Waclawovsky
- Institute of Cardiology of Rio Grande do Sul/University Foundation of Cardiology, Porto Alegre, Brazil
| | - Fernanda Lucchese-Lobato
- Institute of Cardiology of Rio Grande do Sul/University Foundation of Cardiology, Porto Alegre, Brazil; Columbia University Irving Medical Center, Division of Child and Adolescent Psychiatry, New York, NY, USA; Santo Antônio Children's Hospital, Sr. Santa Casa de Misericórdia, Porto Alegre, Brazil, New York, NY, USA.
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Kabiri LS, Le J, Diep CS, Chung E, Wong J, Perkins-Ball AM, Perkins HY, Rodriguez AX. Lower perceived stress among physically active elite private university students with higher levels of gratitude. Front Sports Act Living 2024; 6:1369205. [PMID: 39045567 PMCID: PMC11263090 DOI: 10.3389/fspor.2024.1369205] [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: 01/11/2024] [Accepted: 06/26/2024] [Indexed: 07/25/2024] Open
Abstract
Elite private universities have high stress levels, particularly for underrepresented populations. While physical activity and gratitude can both reduce stress, independent effects from gratitude and interaction effects between physical activity and gratitude on stress are insufficiently explored. Our study investigated these effects among undergraduates at elite private universities. Undergraduates (n = 145) completed an online survey in Fall 2022. Moderate-high physical activity levels were reported by 96.19% of the sample. No significant interaction effect between physical activity and gratitude was seen nor a significant main effect of physical activity on perceived stress. A significant main effect of gratitude on perceived stress [F (2, 99) = 16.732, p < .001, ω2 = .253] was found with higher perceived stress among participants with low compared to moderate (p = .001) or high gratitude (p < .001). Gratitude exerted an independent, significant effect on perceived stress among elite university undergraduates and could be used as an additional healthy coping mechanism along with physical activity to combat stress.
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Affiliation(s)
- Laura S. Kabiri
- Department of Kinesiology, Wiess School of Natural Sciences, Rice University, Houston, TX, United States
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Hird EJ, Slanina-Davies A, Lewis G, Hamer M, Roiser JP. From movement to motivation: a proposed framework to understand the antidepressant effect of exercise. Transl Psychiatry 2024; 14:273. [PMID: 38961071 PMCID: PMC11222551 DOI: 10.1038/s41398-024-02922-y] [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: 04/05/2023] [Revised: 03/28/2024] [Accepted: 05/10/2024] [Indexed: 07/05/2024] Open
Abstract
Depression is the leading cause of disability worldwide, exerting a profound negative impact on quality of life in those who experience it. Depression is associated with disruptions to several closely related neural and cognitive processes, including dopamine transmission, fronto-striatal brain activity and connectivity, reward processing and motivation. Physical activity, especially aerobic exercise, reduces depressive symptoms, but the mechanisms driving its antidepressant effects are poorly understood. Here we propose a novel hypothesis for understanding the antidepressant effects of exercise, centred on motivation, across different levels of explanation. There is robust evidence that aerobic exercise decreases systemic inflammation. Inflammation is known to reduce dopamine transmission, which in turn is strongly implicated in effort-based decision making for reward. Drawing on a broad range of research in humans and animals, we propose that by reducing inflammation and boosting dopamine transmission, with consequent effects on effort-based decision making for reward, exercise initially specifically improves 'interest-activity' symptoms of depression-namely anhedonia, fatigue and subjective cognitive impairment - by increasing propensity to exert effort. Extending this framework to the topic of cognitive control, we explain how cognitive impairment in depression may also be conceptualised through an effort-based decision-making framework, which may help to explain the impact of exercise on cognitive impairment. Understanding the mechanisms underlying the antidepressant effects of exercise could inform the development of novel intervention strategies, in particular personalised interventions and boost social prescribing.
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Affiliation(s)
- E J Hird
- Institute of Cognitive Neuroscience, University College London, London, UK.
| | - A Slanina-Davies
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - G Lewis
- Division of Psychiatry, University College London, London, UK
| | - M Hamer
- Institute of Sport, Exercise and Health, University College London, London, UK
| | - J P Roiser
- Institute of Cognitive Neuroscience, University College London, London, UK
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Xu Y, Wu Z, Xin S, Gao Y, Han Y, Zhao J, Guo Y, Dong Y, Liu Y, Wang F, Li B. Temporal trends and age-period-cohort analysis of depression in U.S. adults from 2013 to 2022. J Affect Disord 2024; 362:237-243. [PMID: 38944291 DOI: 10.1016/j.jad.2024.06.090] [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: 04/14/2024] [Revised: 06/03/2024] [Accepted: 06/22/2024] [Indexed: 07/01/2024]
Abstract
BACKGROUND In the United States, the lifetime prevalence of depression in the US population is 20.6 %. We aimed to understand the temporal trends in the prevalence of depression among adults in the United States during the period 2013-2022 as well as the effects of age, period, and cohort effects on the prevalence of depression. METHODS Data from 3,139,488 participants in the U.S. Behavioral Risk Factor Surveillance System (BRFSS) from 2013 to 2022 were used in this study. The joinpoint regression model was used to calculate annual percentage change (APC) and average annual percentage change (AAPC) to learn about the time trends in the prevalence of depression. Age-period-cohort models were used to estimate the effects of age, period, and birth cohort effects on the prevalence of depression. RESULTS The prevalence of depression among adults in the United States showed an overall increasing trend from 2013 to 2022. The rate of increase was greater in males than females, with AAPC values of 1.44 % (95 % CI: 0.32-2.18), and 1.23 % (95 % CI: 0.32-2.25), respectively. Regarding the age effect, the risk of depression among adults in the United States generally showed an increasing and then decreasing trend with age. The risk of developing the condition reached its maximum at 50-54 years (RR = 1.28, 95 % CI = 1.26-1.30). Regarding the period effect, the risk of depression among US adults was higher during 2018-2022 than during 2013-2017. The overall cohort effect for depression prevalence was a higher risk for those born later, with a maximum RR of 1.51 (95 % CI: 1.47-1.54). CONCLUSION The prevalence of adult depression in the United States is showing an increasing trend. Middle-aged people and those born later in life deserve more attention as high-risk groups. It is recommended that the condition burden of depression be reduced with the promotion of healthy lifestyles, the promotion of interpersonal communication, as well as enhanced mental health education and mental health literacy.
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Affiliation(s)
- Yang Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun 130021, PR China
| | - Zibo Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun 130021, PR China
| | - Sitong Xin
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun 130021, PR China
| | - Yuqi Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun 130021, PR China
| | - Yu Han
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun 130021, PR China
| | - Jing Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun 130021, PR China
| | - Yuangang Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun 130021, PR China
| | - Yibo Dong
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun 130021, PR China
| | - Yan Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun 130021, PR China
| | - Fengdan Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun 130021, PR China
| | - Bo Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun 130021, PR China.
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Danka MN, Steptoe A, Iob E. Physical activity, low-grade inflammation, and psychological responses to the COVID-19 pandemic among older adults in England. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.14.24305797. [PMID: 38699297 PMCID: PMC11065037 DOI: 10.1101/2024.04.14.24305797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
Mental health responses to the COVID-19 pandemic have been widely studied, but less is known about the potentially protective role of physical activity (PA) and the impact of low-grade inflammation. Using a sample of older adults from England, this study tested (1) if pre-pandemic PA and its changes during the pandemic were associated with mental health responses; (2) if older adults with low-grade inflammation experienced greater increases in depression and anxiety, compared to pre-pandemic levels; (3) if PA attenuated the association between inflammation and depression/anxiety. The study used data from the English Longitudinal Study of Ageing, a cohort study following a national sample aged 50+. Information on mental health and PA were collected before the pandemic (2016/17 and 2018/19) and during November and December 2020. Inflammation was ascertained using pre-pandemic C-reactive protein (CRP). Analyses were adjusted for sociodemographic and health-related factors and pre-pandemic mental health. Increasing PA from before to during the pandemic was linked to reduced odds of depression (OR = 0.955, 95%CI [0.937, 0.974]) and anxiety (OR = 0.954, 95%CI [0.927; 0.982]). Higher pre-pandemic PA was associated with reduced odds of depression (OR = 0.964, 95%CI [0.948, 0.981]) and anxiety (OR = 0.976, 95%CI [0.953, 1.000]), whereas elevated CRP was associated with 1.343 times higher odds of depression (95%CI [1.100, 1.641]). PA did not attenuate the inflammation-depression association. The findings suggest that PA may contribute to psychological resilience among older adults, independently of inflammation. Further research is needed to explore the psychobiological pathways underlying this protective mechanism.
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Affiliation(s)
- Martin N. Danka
- Centre for Longitudinal Studies, University College London, UK
- Department of Behavioural Science and Health, University College London, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, UK
| | - Eleonora Iob
- Department of Behavioural Science and Health, University College London, UK
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Chen R, Guo Y, Kuang Y, Zhang Q. Effects of home-based exercise interventions on post-stroke depression: A systematic review and network meta-analysis. Int J Nurs Stud 2024; 152:104698. [PMID: 38290424 DOI: 10.1016/j.ijnurstu.2024.104698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 01/11/2024] [Accepted: 01/12/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Post-stroke depression (PSD) is a common and persistent mental disorder that negatively impacts stroke outcomes. Exercise-based interventions have been shown to be an effective non-pharmacological treatment for improving depression in patients with mild stroke, but no reviews have yet synthesized the effects of home-based exercise on PSD. OBJECTIVE The purpose of this systematic review and network meta-analysis was to synthesize the available evidence to compare the effectiveness of different types of home-based exercise programs on PSD and identify the optimal home-based exercise modality to inform clinical decision-making for the treatment of PSD. METHODS PubMed, Embase, the Cochrane Library, CINAHL, and PsycINFO were systematically searched from their inception dates to March 7, 2023. We searched for randomized controlled trials (RCTs) of home-based exercise for PSD in adults aged 18 years and older. Only scores of depression retrieved directly post-treatment were included as the primary endpoint for the analysis. Version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB-2) was used to assess the quality of included studies. We conducted traditional pairwise meta-analysis for direct comparisons using Review Manager 5.4.1, followed by network meta-analysis using Stata 15.1 for both the network evidence plot and analysis. The surface under the cumulative ranking curve (SUCRA) was used to estimate the intervention hierarchy. The protocol was registered with PROSPERO under registration number CRD42022363784. RESULTS A total of 517 participants from nine RCTs were included. Based on the ranking probabilities, mind-body exercise was the most effective way in improving PSD (SUCRA: 90.4 %, Hedges' g: -0.59, 95 % confidence interval [CI]: -1.16 to -0.02), followed by flexibility/neuro-motor skills training (SUCRA: 42.9 %, Hedges' g: -0.10, 95 % CI: -0.70 to 0.49), and aerobic exercise (SUCRA: 39.3 %, Hedges' g: -0.07, 95 % CI: -0.81 to 0.67). We performed a subgroup analysis of mind-body exercise. In mind-body exercise interventions, Tai Chi was the most effective way to improve PSD (SUCRA: 99.4 %, Hedges' g: -0.94, 95 % CI: -1.28 to -0.61). CONCLUSIONS Our network meta-analysis that provides evidence with very low certainty indicates potential benefits of home-based exercise for alleviating PSD, with mind-body exercises, notably Tai Chi, showing promise as an effective treatment. However, further rigorous studies are needed to solidify these findings. Specifically, multicenter RCTs comparing specific exercises to no intervention are crucial, assessing not only efficacy but also dose, reach, fidelity, and long-term effects for real-world optimization.
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Affiliation(s)
- Rong Chen
- Sun Yat Sen University, School of Nursing, 74 Zhongshan 2nd Rd, Guangzhou 510080, Guangdong, China
| | - Yijia Guo
- Sun Yat Sen University, School of Nursing, 74 Zhongshan 2nd Rd, Guangzhou 510080, Guangdong, China
| | - Yashi Kuang
- Sun Yat Sen University, School of Nursing, 74 Zhongshan 2nd Rd, Guangzhou 510080, Guangdong, China
| | - Qi Zhang
- Sun Yat Sen University, School of Nursing, 74 Zhongshan 2nd Rd, Guangzhou 510080, Guangdong, China.
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Yu L, Zhang X, Li W. Causal effects of various types of physical activities on psychiatric disorders: a Mendelian randomization study. Front Sports Act Living 2024; 6:1331586. [PMID: 38500549 PMCID: PMC10944951 DOI: 10.3389/fspor.2024.1331586] [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: 11/03/2023] [Accepted: 02/21/2024] [Indexed: 03/20/2024] Open
Abstract
Background Psychiatric disorders (PD) pose a significant burden, with vast prevalence and mortality, inflicting substantial costs on individuals and society. Despite its widespread prevalence, the complex pathogenesis of PD remains elusive, leading to limited and challenging therapeutic development. An emerging risk factor for chronic diseases, prolonged sedentary behavior, contrasts with the therapeutic potential of exercise, regardless of its intensity, for various ailments, including PD. Yet, the diversity in exercise modalities and intensities may offer varied impacts on health. This study, leveraging Mendelian Randomization (MR), seeks to investigate the causal relationship between exercise and PD, aiming to elucidate the optimal exercise modality and intensity for PD mitigation while addressing potential confounders. Methods This study employed a Mendelian randomization analysis using the genome-wide association study (GWAS) database to investigate the causal relationship between types of physical activity and psychiatric disorders. Sensitivity analysis was conducted to demonstrate the reliability and robustness of the results. Results In the past 4 weeks, engaging in a substantial amount of DIY physical activity was found to have a causal relationship with psychiatric disorders (IVW: OR = 0.228, 95% CI: 0.113-0.461, P = 0.000038). As for the types of exercises, there may be a potential causal association between aerobic training (including swimming, cycling, fitness, and bowling) and psychiatric disorders (IVW: OR = 0.322, 95% CI = 0.148-0.704, P = 0.004). However, there was no causal relationship found between mild DIY physical activity and psychiatric disorders (IVW: OR = 0.918, 95% CI = 0.417-2.021, P = 0.831). Furthermore, it seems that there is no causal relationship between vigorous exercise and psychiatric disorders (IVW: OR = 2.705, 95% CI = 0.081-3.419, P = 0.578). Conclusion Our study confirms that only a certain level of training activity can have a protective effect on psychiatric disorders, while mild physical activity or vigorous training does not have an impact on psychiatric disorders.
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Affiliation(s)
- Lan Yu
- Department of Gynaecology, Dalian Women and Children’s Medical Center (Group), Dalian, Liaoning, China
| | - Xu Zhang
- Department of Clinical Medicine, Harbin Medical University, Harbin, Heilongjiang, China
- Department of Clinical Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Wangshu Li
- Department of Gynaecology, Dalian Women and Children’s Medical Center (Group), Dalian, Liaoning, China
- Department of Key Laboratory for Early Diagnosis and Biotherapy of Malignant Tumors in Children and Women in Liaoning Province, Dalian, Liaoning, China
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Yamada A, Akahane D, Takeuchi S, Miyata K, Sato T, Gotoh A. Robot therapy aids mental health in patients with hematological malignancy during hematopoietic stem cell transplantation in a protective isolation unit. Sci Rep 2024; 14:4737. [PMID: 38413634 PMCID: PMC10899246 DOI: 10.1038/s41598-024-54286-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 02/10/2024] [Indexed: 02/29/2024] Open
Abstract
Patients with hematological malignancy experience physical and psychological pain, such as a sense of isolation and confinement due to intensive chemotherapy in a protective isolation unit (PIU). We examined whether the intervention of a robotic puppy, aibo (manufactured by Sony), could improve patients' mental health as an alternative therapy for pet therapy, which is not feasible in PIU. This study included 21 patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT) (n = 16) or autologous HSCT (n = 5). The patients were randomly divided into the aibo and control groups. Psychological effects were regularly assessed by measuring the levels of salivary stress hormone chromogranin A (CgA), serum oxytocin, and serum cortisol and the quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR) scores. The aibo group demonstrated a significant decrease in CgA level, while the control group showed the opposite trend. In addition, changes in serum oxytocin and cortisol levels indicated that aibo helped reduce stress. There was no significant difference in the QIDS-SR scores between the two groups; however, the psychomotor activity in the aibo group improved significantly. These findings suggest that aibo intervention during a stay in a PIU can improve the mental health of patients with hematological malignancies who have undergone HSCT.
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Affiliation(s)
- Akiko Yamada
- Department of Hematology, Tokyo Medical University, 6-7-1, Nishi-Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
| | - Daigo Akahane
- Department of Hematology, Tokyo Medical University, 6-7-1, Nishi-Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Shiho Takeuchi
- Center for Diversity, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Kaori Miyata
- Department of Nursing, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Takako Sato
- Department of Nursing, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Akihiko Gotoh
- Department of Hematology, Tokyo Medical University, 6-7-1, Nishi-Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
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Bendau A, Petzold MB, Kaminski J, Plag J, Ströhle A. Exercise as Treatment for "Stress-Related" Mental Disorders. Curr Neuropharmacol 2024; 22:420-436. [PMID: 37779399 PMCID: PMC10845075 DOI: 10.2174/1570159x22666230927103308] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 03/29/2023] [Accepted: 04/02/2023] [Indexed: 10/03/2023] Open
Abstract
The beneficial impact of physical activity on preventing and treating mental disorders has captured growing (research) interest. This article aims to provide a concise overview of essential evidence regarding the effectiveness and underlying mechanisms of physical activity for individuals with mental disorders clustered as "stress-related" conditions. Empirical findings (e.g., longitudinalprospective studies, interventional randomized-controlled-trials, reviews, meta-analyses) regarding the effects of physical activity in the prevention and treatment of stress-related mental disorders are summarized. Furthermore, potential mechanisms underlying these effects are discussed, and recommendations regarding the use of physical activity are outlined. The majority of studies indicate good efficacy of physical activity in prospectively lowering the risk for the incidence of subsequent stress-related mental disorders as well as in the treatment of manifest disorders. Most evidence targets unipolar depressive disorder and, secondly, anxiety disorders. Research regarding posttraumatic stress disorder, obsessive-compulsive disorders, and somatoform disorders is promising but scarce. Physical activity seems to be useful as a stand-alone-treatment as well as in combination with other psychotherapeutic or pharmacological treatments. Multiple intertwined physiological, psychological, and social mechanisms are assumed to mediate the beneficial effects. Recommendations regarding physical activity can orientate on official guidelines but should consider the individual needs and circumstances of each subject. In summary, physical activity seems to be effective in the prevention and treatment of stressrelated mental disorders and, therefore, should be fostered in healthcare-settings. Future studies are needed to clarify partly inconsistent patterns of results and to close research gaps, e.g., concerning somatoform disorders.
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Affiliation(s)
- Antonia Bendau
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, CCM, Charitéplatz 1, 10117, Berlin, Germany
- HMU Health and Medical University Potsdam, Potsdam, Germany
| | - Moritz Bruno Petzold
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, CCM, Charitéplatz 1, 10117, Berlin, Germany
- Department of Psychology, MSB Medical School Berlin, Berlin, Germany
| | - Jan Kaminski
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, CCM, Charitéplatz 1, 10117, Berlin, Germany
| | - Jens Plag
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, CCM, Charitéplatz 1, 10117, Berlin, Germany
- HMU Health and Medical University Potsdam, Potsdam, Germany
- Oberberg Fachklinik Potsdam, Potsdam, Germany
| | - Andreas Ströhle
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, CCM, Charitéplatz 1, 10117, Berlin, Germany
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Liu H, Ma Y, Lin L, Sun Z, Li Z, Jiang X. Association between activities of daily living and depressive symptoms among older adults in China: evidence from the CHARLS. Front Public Health 2023; 11:1249208. [PMID: 38035294 PMCID: PMC10687586 DOI: 10.3389/fpubh.2023.1249208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/23/2023] [Indexed: 12/02/2023] Open
Abstract
Objective The limitation of activities of daily living (ADL) affects the mental health of older adults. We distinguished activities of daily living into basic activities of daily living (BADL) and instrumental activities of daily living (IADL) and aimed to explore the relationship between the two limitations and depressive symptoms among Chinese older adults by using nationally representative cross-sectional data. Methods Data from the China Health and Retirement Longitudinal Study (CHARLS, wave 4) were used, and 9,789 older adults aged 60 years and above were screened. The 10-item Center for Epidemiologic Studies Depression (CES-D-10) scale was used to measure the depressive symptoms of older adults, and a 12-item scale for ADL was used to estimate functional limitations. Generalized linear mixed-effect models were employed to examine the relationship between BADL/IADL and depressive symptoms among older adults. Results The prevalence of high-risk depression among older adults was 43.5%, and the rates of limitation in BADL and IADL were 19.02 and 25.29%, respectively. The prevalence of high-risk depression significantly differed among subgroups of smoking, drinking, chronic diseases, duration of sleep, having social activities or not, and the type of medical insurance. Older adults with limited BADL or IADL were at a higher risk of depression than those without limitations of BADL or IADL; BADL (OR-adjusted = 2.71; 95% CI: 2.40-3.06) and IADL (OR-adjusted = 2.68; 95% CI: 2.41-2.98) had various influences on the risk of depression in older adults. Conclusion ADL was a related factor in the risk of depression among older adults in China. BADL and IADL had different effects on the risk of depression, suggesting that older adults with physical function limitations might be more likely to suffer from depression.
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Affiliation(s)
- Haixia Liu
- School of Public Health and Management, Binzhou Medical University, Yantai, China
| | - Yang Ma
- School of Public Health and Management, Binzhou Medical University, Yantai, China
| | - Lin Lin
- Periodicals Department, Binzhou Medical University, Yantai, China
| | - Zekun Sun
- School of Public Health and Management, Binzhou Medical University, Yantai, China
| | - Zeyu Li
- School of Public Health and Management, Binzhou Medical University, Yantai, China
| | - Xinxin Jiang
- School of Public Health and Management, Binzhou Medical University, Yantai, China
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Molina-Hidalgo C, Stillman CM, Collins AM, Velazquez-Diaz D, Ripperger HS, Drake JA, Gianaros PJ, Marsland AL, Erickson KI. Changes in stress pathways as a possible mechanism of aerobic exercise training on brain health: a scoping review of existing studies. Front Physiol 2023; 14:1273981. [PMID: 37885801 PMCID: PMC10598664 DOI: 10.3389/fphys.2023.1273981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 09/25/2023] [Indexed: 10/28/2023] Open
Abstract
Physical activity (PA) in the form of aerobic exercise (AE) preserves and improves neurocognitive function across the lifespan. However, a mechanistic understanding of the pathways by which aerobic exercise impacts brain health is still lacking, particularly with respect to stress-related pathways. One mechanistic hypothesis is that AE improves neurocognitive health in part by modifying circulating levels of stress-related hormones and signaling factors associated with the hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system (ANS), as commonly measured by the biomarkers cortisol (CORT) and salivary α-amylase (sAA). Thus, this hypothesis predicts that changes in stress biomarkers, such as CORT and sAA, are possible explanatory pathways mediating the positive effects of AE on neurocognitive health. In the present review article, we provide a summary of available studies examining the possibility that exercise-induced changes to stress biomarkers could partly account for exercise-related improvements in neurocognitive health. Our review indicates that despite the intuitive appeal of this hypothesis, there is insufficient evidence available to conclude that chronic and habitual AE affects neurocognitive health by altering stress biomarker pathways. The cross-sectional nature of the majority of reviewed studies highlights the need for well-controlled studies to adequately test this hypothesis.
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Affiliation(s)
| | - Chelsea M. Stillman
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Audrey M. Collins
- AdventHealth Research Institute, Neuroscience Institute, Orlando, FL, United States
| | - Daniel Velazquez-Diaz
- AdventHealth Research Institute, Neuroscience Institute, Orlando, FL, United States
- ExPhy Research Group, Department of Physical Education, University of Cadiz, Cadiz, Spain
| | - Hayley S. Ripperger
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jermon A. Drake
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Peter J. Gianaros
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Anna L. Marsland
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Kirk I. Erickson
- AdventHealth Research Institute, Neuroscience Institute, Orlando, FL, United States
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
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12
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Luthra NS, Christou DD, Clow A, Corcos DM. Targeting neuroendocrine abnormalities in Parkinson's disease with exercise. Front Neurosci 2023; 17:1228444. [PMID: 37746149 PMCID: PMC10514367 DOI: 10.3389/fnins.2023.1228444] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/22/2023] [Indexed: 09/26/2023] Open
Abstract
Parkinson's Disease (PD) is a prevalent and complex age-related neurodegenerative condition for which there are no disease-modifying treatments currently available. The pathophysiological process underlying PD remains incompletely understood but increasing evidence points to multiple system dysfunction. Interestingly, the past decade has produced evidence that exercise not only reduces signs and symptoms of PD but is also potentially neuroprotective. Characterizing the mechanistic pathways that are triggered by exercise and lead to positive outcomes will improve understanding of how to counter disease progression and symptomatology. In this review, we highlight how exercise regulates the neuroendocrine system, whose primary role is to respond to stress, maintain homeostasis and improve resilience to aging. We focus on a group of hormones - cortisol, melatonin, insulin, klotho, and vitamin D - that have been shown to associate with various non-motor symptoms of PD, such as mood, cognition, and sleep/circadian rhythm disorder. These hormones may represent important biomarkers to track in clinical trials evaluating effects of exercise in PD with the aim of providing evidence that patients can exert some behavioral-induced control over their disease.
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Affiliation(s)
- Nijee S. Luthra
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Demetra D. Christou
- Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, FL, United States
| | - Angela Clow
- Department of Psychology, School of Social Sciences, University of Westminster, London, United Kingdom
| | - Daniel M. Corcos
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, McCormick School of Engineering, Northwestern University, Chicago, IL, United States
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13
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Leão LL, Valadares WGDA, Silva NSSE, Duarte SFP, de Paula AMB, Haikal DSA, Santos SHS, Soares J, Cruz J, Santos J, Teixeira GL, Monteiro-Junior RS. Increased Depression and the Worsening of Depressive Symptoms Associated with Physical Inactivity during the COVID-19 Pandemic: A Two-Phase Cross-Sectional Study. Behav Sci (Basel) 2023; 13:bs13040340. [PMID: 37102854 PMCID: PMC10135763 DOI: 10.3390/bs13040340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 04/07/2023] [Accepted: 04/13/2023] [Indexed: 04/28/2023] Open
Abstract
The COVID-19 pandemic has increased the incidence of depression and other mental disorders in the general population, influenced by various individual and contextual factors. Physical activity (PA) interventions offer a promising approach to mitigating the negative mental health effects of the pandemic. This study aims to analyze the association between PA and depressive symptoms. A total of 785 individuals aged 37.4 ± 13.2 years (72.5% female) were evaluated at two different time points: the first between 2018 and 2019, and the second during the COVID-19 pandemic in 2020. Depressive symptoms, demographic, and socioeconomic data were assessed using the Beck Depression Inventory to estimate depressive symptoms. Frequency analysis and binary and multinomial regression were employed for data analysis. The prevalence of mild depressive symptoms increased from 23.1% before the pandemic to 35.1% during the pandemic. Our findings reveal that practicing PA before the pandemic was a protective factor (OR: 0.19; 95% CI: 0.13, 0.30; p < 0.001) against mild depressive symptoms. Additionally, individuals who continued to practice PA during the pandemic had a lower chance of presenting mild (OR: 0.21; 95% CI: 0.15, 0.30) and moderate/severe (OR: 0.15; 95% CI: 0.08, 0.27) symptoms. Furthermore, our study shows that PA, which was already a protective factor before the pandemic, remained protective during the pandemic, even for those with the highest levels of depression.
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Affiliation(s)
- Luana Lemos Leão
- Graduate Program in Health Sciences, Centre of Biological Sciences and Health, State University of Montes Claros, Montes Claros 39401-089, MG, Brazil
| | - Weslley Gomes de Araújo Valadares
- Graduate Program in Health Sciences, Centre of Biological Sciences and Health, State University of Montes Claros, Montes Claros 39401-089, MG, Brazil
- Instituto de Pesquisa e Extensão em Saúde-INPES, Vitória da Conquista 45020-750, BA, Brazil
| | - Nayra Suze Souza E Silva
- Graduate Program in Health Sciences, Centre of Biological Sciences and Health, State University of Montes Claros, Montes Claros 39401-089, MG, Brazil
| | | | - Alfredo Maurício Batista de Paula
- Graduate Program in Health Sciences, Centre of Biological Sciences and Health, State University of Montes Claros, Montes Claros 39401-089, MG, Brazil
| | - Desirée Sant Ana Haikal
- Graduate Program in Health Sciences, Centre of Biological Sciences and Health, State University of Montes Claros, Montes Claros 39401-089, MG, Brazil
| | - Sérgio Henrique Sousa Santos
- Graduate Program in Health Sciences, Centre of Biological Sciences and Health, State University of Montes Claros, Montes Claros 39401-089, MG, Brazil
- Food Engineering Department, Instituto de Ciências Agrárias, Universidade Federal de Minas Gerais, Montes Claros 39404-547, MG, Brazil
| | - Jeane Soares
- Department of Psychology, UniFG University Center, Guanambi 46430-000, BA, Brazil
| | - Joelton Cruz
- Department of Psychology, UniFG University Center, Guanambi 46430-000, BA, Brazil
| | - Jordana Santos
- Department of Psychology, UniFG University Center, Guanambi 46430-000, BA, Brazil
| | - Gustavo Leal Teixeira
- Language Department, Instituto de Ciências Agrárias, Universidade Federal de Minas Gerais, Montes Claros 39404-547, MG, Brazil
| | - Renato Sobral Monteiro-Junior
- Graduate Program in Health Sciences, Centre of Biological Sciences and Health, State University of Montes Claros, Montes Claros 39401-089, MG, Brazil
- Department of Neurology, School of Medicine, Universidade Federal Fluminense, Niterói 24220-000, RJ, Brazil
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14
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da Cunha LL, Feter N, Alt R, Rombaldi AJ. Effects of exercise training on inflammatory, neurotrophic and immunological markers and neurotransmitters in people with depression: A systematic review and meta-analysis. J Affect Disord 2023; 326:73-82. [PMID: 36709828 DOI: 10.1016/j.jad.2023.01.086] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 01/18/2023] [Accepted: 01/23/2023] [Indexed: 01/28/2023]
Abstract
BACKGROUND Major depressive disorder is the most common type of mental disorder. The biological pathway by which exercise promotes its antidepressant effects remains uncleared. This study aimed to systematically review the chronic effect of exercise on blood biomarkers and its association with changes in depressive symptoms in adults with major depressive disorder. METHODS Randomized controlled trials (RCT) published until February 2020 were screened in seven databases. Studies were systematically reviewed by two independent reviewers. Random effect meta-analysis was performed and reported as standardized mean differences (SMD) and 95 % confidence interval (CI). The meta- analysis protocol was registered with PROSPERO (CRD42021221177). RESULTS From 3865 records, 12 studies (N = 757 participants, mean age [SD]: 43.0 [11.0], 66.2 % women) were included in this review. Exercise training resulted in superior increase in circulating BDNF (SMD: 0.44, 95%CI: 0.15, 0.73) and kynurenine (SMD: 0.29, 95%CI: 0.04, 0.54), and decrease depressive symptoms (SMD: -0.72, 95%CI: -1.08, -0.37) in adults with major depression disorder compared to control groups. Multivariate meta-regression analysis showed that improvements in circulating levels of BDNF, kynurenine and interleukyn-6 were associated with decreases in depressive symptoms. LIMITATIONS Results were not stratified by the type of medication used by participants due to the lack of reporting of the included studies. Few studies provided data on other biomarkers (e.g., TNF-α and IL-10) besides BNDF and kynurenine. CONCLUSIONS Antidepressant effect of exercise may be triggered by improved circulating levels of BNDF, kynurenine, and interleukine-6 in adults with major depressive disorder.
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Affiliation(s)
- Larissa L da Cunha
- Postgraduate Program of Physical Education, Universidade Federal de Pelotas, Pelotas, Brazil; Study Group of Neuroscience, Physical Activity and Exercise, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Natan Feter
- Study Group of Neuroscience, Physical Activity and Exercise, Universidade Federal de Pelotas, Pelotas, Brazil; Postgraduate Program of Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
| | - Ricardo Alt
- Study Group of Neuroscience, Physical Activity and Exercise, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Airton J Rombaldi
- Postgraduate Program of Physical Education, Universidade Federal de Pelotas, Pelotas, Brazil; Study Group of Neuroscience, Physical Activity and Exercise, Universidade Federal de Pelotas, Pelotas, Brazil
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15
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da Silva Rodrigues G, Noronha NY, Almeida ML, Sobrinho ACDS, Watanabe LM, Pinhel MADS, de Lima JGR, Zhang R, Nonino CB, Alves CRR, Bueno Júnior CR. Exercise training modifies the whole blood DNA methylation profile in middle-aged and older women. J Appl Physiol (1985) 2023; 134:610-621. [PMID: 36701486 DOI: 10.1152/japplphysiol.00237.2022] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
This is a longitudinal single-arm clinical trial aimed to investigate whether exercise training would modify the whole blood methylation profile in healthy women. A total of 45 subjects were engaged in an exercise training protocol during a 14-wk follow up, consisting of aerobic cardiorespiratory and muscle strength exercises. Subjects were evaluated at baseline (PRE), after 7 wk of exercise training (POST 7), and after 14 wk of exercise training (POST 14). Functional primary outcomes included anthropometric, blood pressure, biochemical measurements, physical tests, and global health assessments. Blood samples were collected at each time point to determine the methylation profile using a DNA methylation array technique screening up to 850k different sites. Exercise training decreased blood pressure and triglyceride levels and enhanced physical performance, including upper- and lower-body maximum strength. Moreover, exercise training improved markers of quality of life. In the array analysis, 14 wk of exercise training changed the methylation of more than 800 sites. Across these differentially methylated sites, we found that differentially methylated sites in the promoter region were more hypermethylated after exercise training, suggesting that this hypermethylation process may affect the transcription process. When inputting the differentially methylated sites in pathway analysis, we found several metabolic pathways, including AMPK signaling, TGF-β signaling, and insulin signaling. This study demonstrates that exercise training promotes a robust change in the whole blood methylation profile and provides new insights into the key regulators of exercise-induced benefits.NEW & NOTEWORTHY We have shown that exercise training lowers blood pressure and triglyceride levels, improves physical performance, and improves quality of life in middle-aged and elderly women. Regarding epigenetic data, we noticed that more than 800 sites are differentially methylated in whole blood after physical training. We emphasize that the differentially methylated sites in the promoter region are more hypermethylated after physical training. In addition, this study shows that key members of metabolic pathways, including AMPK signaling, TGF-β signaling, and insulin signaling, are among the genes hypermethylated after physical exercise in older women.
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Affiliation(s)
| | - Natália Y Noronha
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Mariana L Almeida
- College of Nursing of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Andressa C da S Sobrinho
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Lígia M Watanabe
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Marcela A de S Pinhel
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - João G R de Lima
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Ren Zhang
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States
| | - Carla B Nonino
- Health Sciences Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Christiano R R Alves
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States
| | - Carlos R Bueno Júnior
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.,College of Nursing of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.,School of Physical Education and Sport of Ribeirão Preto, University of Sao Paulo, Sao Paulo, Brazil
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16
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da Costa ME, Cândido LM, de Avelar NCP, Danielewicz AL. How much time of sedentary behavior is associated with depressive symptoms in community-dwelling older adults in southern Brazil? Geriatr Nurs 2023; 50:25-30. [PMID: 36640515 DOI: 10.1016/j.gerinurse.2022.12.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 01/15/2023]
Abstract
AIMS Identify sedentary behavior (SB) cut-off points to screen for depressive symptoms in older adults and verify the association between these conditions. METHODS A cross-sectional survey of 308 community-dwelling older adults was conducted. The outcome was the presence of depressive symptoms (≥6 points on the Geriatric Depression Scale-15). The exposure was SB using the self-reported time on a weekday and weekend (International Physical Activity Questionnaire). The cut-off points for SB categorization were determined by the receiver operating characteristic curve and multivariate logistic regression to verify the association. RESULTS Older adults who spent ≥4.5 hours/day in SB (sensitivity = 48.8%; specificity = 67.8%) were 1.81 times more likely (95%CI: 1.03;3.15) to have depressive symptoms compared to those who stayed for shorter periods. CONCLUSIONS There was an association between SB and depressive symptoms; therefore, older adults must have SB <4.5 hours/day to reduce the chances of developing depressive symptoms.
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Affiliation(s)
- Maria Eduarda da Costa
- Department of Health Sciences, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
| | - Letícia Martins Cândido
- Postgraduate Program in Rehabilitation Sciences, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
| | | | - Ana Lúcia Danielewicz
- Department of Health Sciences, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil; Postgraduate Program in Rehabilitation Sciences, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil.
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17
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Luthra NS, Clow A, Corcos DM. The Interrelated Multifactorial Actions of Cortisol and Klotho: Potential Implications in the Pathogenesis of Parkinson's Disease. Brain Sci 2022; 12:1695. [PMID: 36552155 PMCID: PMC9775285 DOI: 10.3390/brainsci12121695] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
The pathogenesis of Parkinson's disease (PD) is complex, multilayered, and not fully understood, resulting in a lack of effective disease-modifying treatments for this prevalent neurodegenerative condition. Symptoms of PD are heterogenous, including motor impairment as well as non-motor symptoms such as depression, cognitive impairment, and circadian disruption. Aging and stress are important risk factors for PD, leading us to explore pathways that may either accelerate or protect against cellular aging and the detrimental effects of stress. Cortisol is a much-studied hormone that can disrupt mitochondrial function and increase oxidative stress and neuroinflammation, which are recognized as key underlying disease mechanisms in PD. The more recently discovered klotho protein, considered a general aging-suppressor, has a similarly wide range of actions but in the opposite direction to cortisol: promoting mitochondrial function while reducing oxidative stress and inflammation. Both hormones also converge on pathways of vitamin D metabolism and insulin resistance, also implicated to play a role in PD. Interestingly, aging, stress and PD associate with an increase in cortisol and decrease in klotho, while physical exercise and certain genetic variations lead to a decrease in cortisol response and increased klotho. Here, we review the interrelated opposite actions of cortisol and klotho in the pathogenesis of PD. Together they impact powerful and divergent mechanisms that may go on to influence PD-related symptoms. Better understanding of these hormones in PD would facilitate the design of effective interventions that can simultaneously impact the multiple systems involved in the pathogenesis of PD.
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Affiliation(s)
- Nijee S. Luthra
- Department of Neurology, University of California San Francisco, San Francisco, CA 94127, USA
| | - Angela Clow
- Department of Psychology, School of Social Sciences, University of Westminster, London W1B 2HW, UK
| | - Daniel M. Corcos
- Department of Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL 60208, USA
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18
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Bani-Issa W, Radwan H, Al Shujairi A, Hijazi H, Al Abdi RM, Al Awar S, Saqan R, Alameddine M, Ibrahim A, Rahman HA, Naing L. Salivary cortisol, perceived stress and coping strategies: A comparative study of working and nonworking women. J Nurs Manag 2022; 30:3553-3567. [PMID: 35666587 DOI: 10.1111/jonm.13697] [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: 03/03/2022] [Revised: 05/14/2022] [Accepted: 06/01/2022] [Indexed: 12/13/2022]
Abstract
AIMS This study investigated stress levels and coping strategies among working and nonworking women in the United Arab Emirates. BACKGROUND Stress levels in working and nonworking women have previously been studied, but few studies used cortisol to measure stress or examined how coping strategies affect stress levels. METHODS We employed a cross-sectional design with a convenience sample of women aged 20-65 years. Information on women's sociodemographic characteristics, perceived stress (using the Perceived Stress Scale) and coping strategies (using the Brief-COPE) was collected. Participants' morning (07:00-08:00) and evening (19:00-20:00) cortisol levels were measured using unstimulated saliva samples. RESULTS In total, 417 working and 403 nonworking women participated in this study. More nonworking women reported high stress levels than working women (14.1% vs. 4.1%, p = .001). Working women reported more use of informational support and venting to cope with stress compared with nonworking women (94.0% vs. 88.1%, p = .001). More nonworking women had impaired morning (<0.094 mg/dl) and evening (>0.359 mg/dl) cortisol compared with working women (58.1% vs. 28.5% and 41.7% vs. 18.0%, respectively). Compared with working women, nonworking women had 3.25 (95%CI: 2.38, 4.47) and 3.78 (95%CI: 2.65, 5.43) times the odds of impaired morning and evening cortisol, respectively. CONCLUSION Nonworking women exhibited higher levels of stress than working women. There is an urgent need to support nonworking women to manage stress through appropriate awareness campaigns and public health policies. IMPLICATIONS FOR MANAGEMENT Policymakers and community leaders should consider the mental health of nonworking women as a priority in planning public health policies and programmes. Nurse managers must have a voice in reforming public health policy to support early assessment and management of stress among nonworking women.
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Affiliation(s)
- Wegdan Bani-Issa
- Department of Nursing, College of Health Sciences, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Hadia Radwan
- College of Health Sciences, Department of Clinical Nutrition and Dietetics, Research Institute of Medical and Health Sciences Research, University of Sharjah, Sharjah, United Arab Emirates
| | - Arwa Al Shujairi
- Medical Affair Department, GSK Gulf, Dubai, United Arab Emirates
| | - Heba Hijazi
- Department of Health Services Administration, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,Department of Health Management and Policy, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Rabah M Al Abdi
- Department of Biomedical Engineering, Faculty of Engineering, Jordan University of Science and Technology, Irbid, Jordan
| | - Shamsa Al Awar
- Department of Obstetrics and Gynaecology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Roba Saqan
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Mohamad Alameddine
- Department of Health Services Administration, University of Sharjah, Sharjah, United Arab Emirates
| | - Ali Ibrahim
- Marketing Department, American University in the Emirates, United Arab Emirates.,Marketing Department, Griffith University, Brisbane, Australia
| | - Hanif Abdul Rahman
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Bandar Seri Begawan, Brunei.,University of Michigan School of Nursing, Ann Arbor, Michigan, USA
| | - Lin Naing
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Bandar Seri Begawan, Brunei
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19
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De Nys L, Anderson K, Ofosu EF, Ryde GC, Connelly J, Whittaker AC. The effects of physical activity on cortisol and sleep: A systematic review and meta-analysis. Psychoneuroendocrinology 2022; 143:105843. [PMID: 35777076 DOI: 10.1016/j.psyneuen.2022.105843] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/16/2022] [Accepted: 06/19/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Managing stress and having good quality sleep are inter-related factors that are essential for health, and both factors seem to be affected by physical activity. Although there is an established bidirectional relationship between stress and sleep, remarkably few studies have been designed to examine the effects of physical activity on cortisol, a key biomarker for stress, and sleep. Research is particularly scarce in older people despite both sleep and cortisol changing with age. This systematic literature review addresses this gap. METHODS A systematic review was conducted following the PRISMA guidelines. Original, peer-reviewed records of intervention studies such as randomized controlled trials (RCTs) and non-RCTs with relevant control groups were eligible for inclusion. The Participant, Intervention, Comparison, Outcome (PICO) characteristics were (1) adults or older adults (2) physical activity programmes of any duration, (3) controls receiving no intervention or controls included in a different programme, (4) cortisol measurement, and subjective or objective measures of sleep. RESULTS Ten original studies with low-to-moderate risk of bias were included. Findings from this review indicated with moderate- and low-certainty evidence, respectively, that physical activity was an effective strategy for lowering cortisol levels (SMD [95% CI] = -0.37 [-0.52, -0.21] p < .001) and improving sleep quality (SMD [95% CI] = -0.30 [-0.56, -0.04], p = .02). Caution is needed to generalize these findings to the general population, as included trials were predominantly participants with breast cancer, included few males and no older adults. CONCLUSION Cortisol regulation and sleep quality are intertwined, and physical activity programmes could improve both in several ways. Further, physical activity may benefit adults with long term conditions or current poor (mental) health states the most, although more research is needed to support this claim fully. Few intervention studies have examined the inter-relationship between cortisol and sleep outcomes in males or older adults, indicating fruitful enquiry for future research.
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Affiliation(s)
- Len De Nys
- Faculty of Health Sciences and Sport, University of Stirling, Scotland, UK.
| | - Kerry Anderson
- Faculty of Health Sciences and Sport, University of Stirling, Scotland, UK
| | - Esther F Ofosu
- Faculty of Health Sciences and Sport, University of Stirling, Scotland, UK
| | - Gemma C Ryde
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland, UK
| | - Jenni Connelly
- Faculty of Health Sciences and Sport, University of Stirling, Scotland, UK
| | - Anna C Whittaker
- Faculty of Health Sciences and Sport, University of Stirling, Scotland, UK
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20
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Wang L, Ma J, Wu W, Fang Y, Liu F, Yang Q, Hu X, Gu X, He Z, Sun D, Jin L, Zhang X. Effect of aerobic exercise as a treatment on type 2 diabetes mellitus with depression-like behavior zebrafish. Life Sci 2022; 300:120578. [PMID: 35489565 DOI: 10.1016/j.lfs.2022.120578] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 04/11/2022] [Accepted: 04/20/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Depression is the most known complication of type 2 diabetes mellitus (T2DM). Aerobic exercise improves glycemic control in T2DM, although the underlying mechanisms of comorbid depression-like behaviors in T2DM have not yet been fully elucidated. METHODS 120 zebrafish were randomly assigned to four groups: Control, T2DM, T2DM + metformin, and T2DM + aerobic exercise. Then, all animals except the control group were fed with high glucose fairy shrimp (~40 g/kg/day) and exposed reserpine (40 μg/ml for 20 min) for 10 days. Here, behavioral tests were used for model verification. Following the verification, all groups were treated as before. Additionally, the T2DM + metformin group received metformin (~10.6 mg/kg/day) at the same time, while the T2DM + aerobic exercise group received aerobic exercise 30 min/day. Finally, blood glucose and behavioral tests, as well as protein and molecular levels were determined at Day 11 and 12. RESULTS Aerobic exercise alleviated depressive-like behavior and enhanced the levels of antidepressant biomarkers (NE, 5-HIAA) in zebrafish after 10 consecutive days of exercise. Additionally, 10 consecutive days of aerobic exercise decreased the levels of inflammatory biomarkers (IFN-γ, IL-1, IL-4) and depressive biomarkers (cortisol). Meanwhile, it also aided in the reduction of CD11b, IL-6, IL-6R, and caspase-3 expression to combat the neuroinflammation induced by T2DM, mediated the BDNF-TrkB pathway, and increased Bcl-2/Bax levels. CONCLUSION Given the remarkable similarity in neurochemistry between humans and zebrafish, this study supports the effectiveness of aerobic exercise as clinical guidance in preventing and treating T2DM complicated with depression.
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Affiliation(s)
- Lei Wang
- Institute of Life Sciences & Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
| | - Jiahui Ma
- Institute of Life Sciences & Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
| | - Wei Wu
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400044, China
| | - Yimeng Fang
- Institute of Life Sciences & Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
| | - Fan Liu
- Institute of Life Sciences & Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
| | - Qinsi Yang
- Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou 325000, China
| | - Xiang Hu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Xuejiang Gu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Zhiying He
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Da Sun
- Institute of Life Sciences & Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China.
| | - Libo Jin
- Institute of Life Sciences & Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China.
| | - Xingxing Zhang
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
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21
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Nardin DMK, Stocco MR, Aguiar AF, Machado FA, de Oliveira RG, Andraus RAC. Effects of photobiomodulation and deep water running in patients with chronic non-specific low back pain: a randomized controlled trial. Lasers Med Sci 2022; 37:2135-2144. [PMID: 35246766 DOI: 10.1007/s10103-021-03443-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 10/13/2021] [Indexed: 12/01/2022]
Abstract
Photobiomodulation therapy (PBM) is often used to treat musculoskeletal disorders such as chronic non-specific low back pain (NSCLBP) as it can have positive effects on biomarkers-creatine kinase (CK) and serum cortisol levels-related to stress caused by physical exercise, such as deep water running (DWR) or by pain. The aim of this study was to evaluate the effects of the combination of PBM and aquatic exercise (DWR) on the intensity of pain, disability, 6-min walk test adapted (6WTA), and on cortisol and creatine kinase (CK) levels in a population with NSCLBP. The participants were allocated into three groups: TGPBM (Photobiomodulation and Training Group), TGPLA (Placebo Photobiomodulation and Training Group), and the GPBM (Photobiomodulation Group). Information regarding anthropometric data, blood pressure, and heart rate were collected, and the questionnaires were applied: IPAQ-Short Form, Oswestry Disability Index, and the Visual Analog Scale for Pain. The submaximal exercise test (6WTA) was performed. Blood was collected for analysis of cortisol and CK levels. The training sessions were performed twice a week, for 4 weeks. In the intragroup comparisons, there were statistically significant changes in the TGPBM and GPBM groups in the outcomes pain intensity, disability (reductions in both groups), and in cortisol (increased in the TGPBM and reduced in the GPBM); in the TGPLA group, there was a statistically significant reduction only in the outcome of pain intensity. In the intergroup comparison, in the comparison between TGPBM and TGPLA, there was a statistically significant difference in the level of cortisol, as well as in the comparison between TGPBM and GPBM, in which there was a statistically significant difference for this same outcome (cortisol) and for the 6WTA outcome. The effects of the combination of PBM and aquatic exercise have positive effects on reducing pain intensity, disability, and cortisol levels, but its effects on other variables (6WTA and CK) are too small to be considered significant. Trial registration number: NCT03465228-April 3, 2019; retrospectively registered (ClinicalTrials.gov).
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Affiliation(s)
- Daniele Mayumi Kurata Nardin
- Program Stricto Sensu in Rehabilitation Sciences, Research and Postgraduate Center, UNOPAR/UEL, Londrina, Brazil
| | - Marieli Ramos Stocco
- Program Stricto Sensu in Rehabilitation Sciences, Research and Postgraduate Center, UNOPAR/UEL, Londrina, Brazil.
| | - Andreo Fernando Aguiar
- Program Stricto Sensu in Rehabilitation Sciences, Research and Postgraduate Center, UNOPAR/UEL, Londrina, Brazil
| | - Fabiana Andrade Machado
- Program Stricto Sensu in Physical Education, Research and Postgraduate Center, UEM/UEL, Maringá, Brazil
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22
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Wang X, Cai ZD, Jiang WT, Fang YY, Sun WX, Wang X. Systematic review and meta-analysis of the effects of exercise on depression in adolescents. Child Adolesc Psychiatry Ment Health 2022; 16:16. [PMID: 35227300 PMCID: PMC8886903 DOI: 10.1186/s13034-022-00453-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 02/18/2022] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Depression is widespread among adolescents and seriously endangers their quality of life and academic performance. Developing strategies for adolescent depression has important public health implications. No systematic review on the effectiveness of physical exercise for adolescents aged 12-18 years with depression or depressive symptoms has previously been conducted. This study aims to systematically evaluate the effect of physical exercise on adolescent depression in the hope of developing optimum physical exercise programs. METHODS Nine major databases at home and abroad were searched to retrieve randomized controlled trials (RCTs) on exercise interventions among adolescents with depression or depressive symptoms. The retrieval period started from the founding date of each database to May 1, 2021. The methodological quality of the included articles was evaluated using the modified PEDro scale. A meta-analysis, subgroup analysis, sensitivity analysis, and publication bias tests were then conducted. RESULTS Fifteen articles, involving 19 comparisons, with a sample size of 1331, were included. Physical exercise significantly reduced adolescent depression (standardized mean difference [SMD] = - 0.64, 95% CI - 0.89, - 0.39, p < 0.01), with a moderate effect size, in both adolescents with depression (SMD = -0.57, 95% CI - 0.90, - 0.23, p < 0.01) and adolescents with depressive symptoms (SMD = - 0.67, 95% CI - 1.00, - 0.33, p < 0.01). In subgroups of different depression categories (depression or depressive symptoms), aerobic exercise was the main form of exercise for the treatment of adolescents with depression. For adolescents with depression, interventions lasting 6 weeks, 30 min/time, and 4 times/week had optimum results. The effects of aerobic exercise and resistance + aerobic exercise in the subgroup of adolescents with depressive symptoms were significant, while the effect of physical and mental exercise (yoga) was not significant. For adolescents with depressive symptoms, aerobic exercise lasting 8 weeks, 75-120 min/time, and 3 times/week had optimum results. Physical exercise with moderate intensity is a better choice for adolescents with depression and depressive symptoms. CONCLUSIONS Physical exercise has a positive effect on the improvement of depression in adolescents. The protocol for this study was registered with INPLASY (202170013). DOI number is 10.37766/inplasy2021.7.0013. Registration Date:2021.7.06.
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Affiliation(s)
- Xiang Wang
- grid.412543.50000 0001 0033 4148School of Physical Education and Training, Shanghai University of Sport, 650 Qingyuan Ring Road, Yangpu District, Shanghai, 200438 China
| | - Zhi-dong Cai
- grid.412543.50000 0001 0033 4148School of Physical Education and Training, Shanghai University of Sport, 650 Qingyuan Ring Road, Yangpu District, Shanghai, 200438 China
| | - Wan-ting Jiang
- grid.412543.50000 0001 0033 4148School of Physical Education and Training, Shanghai University of Sport, 650 Qingyuan Ring Road, Yangpu District, Shanghai, 200438 China
| | - Yan-yan Fang
- grid.412543.50000 0001 0033 4148School of Physical Education and Training, Shanghai University of Sport, 650 Qingyuan Ring Road, Yangpu District, Shanghai, 200438 China
| | - Wen-xin Sun
- grid.412543.50000 0001 0033 4148School of Physical Education and Training, Shanghai University of Sport, 650 Qingyuan Ring Road, Yangpu District, Shanghai, 200438 China
| | - Xing Wang
- School of Physical Education and Training, Shanghai University of Sport, 650 Qingyuan Ring Road, Yangpu District, Shanghai, 200438, China.
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23
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Bendau A, Petzold M, Ströhle A. Bewegung, körperliche Aktivität und Sport bei depressiven Erkrankungen. NEUROTRANSMITTER 2022. [PMCID: PMC8852946 DOI: 10.1007/s15016-021-9343-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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24
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Henry SS, Ross RA, Rasgon N. Relevance of Sex-Specific Metabolic Phenotypes in Diagnosis and Treatment of Mood Disorders and PTSD. Psychiatr Ann 2022. [DOI: 10.3928/00485713-20211221-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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25
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Asch RH, Holmes SE, Jastreboff AM, Potenza MN, Baldassarri SR, Carson RE, Pietrzak RH, Esterlis I. Lower synaptic density is associated with psychiatric and cognitive alterations in obesity. Neuropsychopharmacology 2022; 47:543-552. [PMID: 34294874 PMCID: PMC8674236 DOI: 10.1038/s41386-021-01111-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/12/2021] [Accepted: 07/15/2021] [Indexed: 01/03/2023]
Abstract
Obesity is a serious medical condition that often co-occurs with stress-related psychiatric disorders. It is recognized that the brain plays a key role in the (patho)physiology of obesity and that there is a bidirectional relationship between obesity and psychopathology, yet molecular mechanisms altered in obesity have not been fully elucidated. Thus, we investigated relationships between obesity and synaptic density in vivo using the radioligand [11C]UCB-J (which binds to synaptic glycoprotein SV2A) and positron emission tomography in individuals with obesity, and with or without stress-related psychiatric disorders. Regions of interest were the dorsolateral prefrontal cortex, orbitofrontal cortex, ventromedial, amygdala, hippocampus, and cerebellum. Forty individuals with a body mass index (BMI) ≥ 25 kg/m2 (overweight/obese), with (n = 28) or without (n = 12) psychiatric diagnosis, were compared to 30 age- and sex-matched normal weight individuals (BMI < 25), with (n = 14) or without (n = 16) psychiatric diagnosis. Overall, significantly lower synaptic density was observed in overweight/obese relative to normal weight participants (ηp2 = 0.193, F = 2.35, p = 0.042). Importantly, in participants with stress-related psychiatric diagnoses, we found BMI to be negatively correlated with synaptic density in all regions of interest (p ≤ 0.03), but no such relationship observed for mentally healthy controls (p ≥ 0.68). In the stress-related psychiatric groups, dorsolateral prefrontal cortex synaptic density was negatively associated with measures of worry (r = -0.46, p = 0.01), tension/anxiety (r = -0.38, p = 0.04), fatigue (r = -0.44, p = 0.02), and attentional difficulties (r = -0.44, p = 0.02). In summary, the findings of this novel in vivo experiment suggest compounding effects of obesity and stress-related psychopathology on the brain and the associated symptomatology that may impact functioning. This offers a novel biological mechanism for the relationship between overweight/obesity and stress-related psychiatric disorders that may guide future intervention development efforts.
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Affiliation(s)
- Ruth H Asch
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Sophie E Holmes
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Ania M Jastreboff
- Department of Internal Medicine (Endocrinology & Metabolism) and Department of Pediatrics (Pediatric Endocrinology), Yale School of Medicine, New Haven, CT, USA
| | - Marc N Potenza
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | | | - Richard E Carson
- Departments of Radiology and Biomedical Imaging and Biomedical Engineering, Yale School of Medicine, New Haven, CT, USA
| | - Robert H Pietrzak
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- U.S. Department of Veteran Affairs National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Irina Esterlis
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
- U.S. Department of Veteran Affairs National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, USA.
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26
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Aas M, Ueland T, Mørch RH, Laskemoen JF, Lunding SH, Reponen EJ, Cattaneo A, Agartz I, Melle I, Steen NE, Andreassen OA. Physical activity and childhood trauma experiences in patients with schizophrenia or bipolar disorders. World J Biol Psychiatry 2021; 22:637-645. [PMID: 33779484 DOI: 10.1080/15622975.2021.1907707] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Physical activity promotes resilience and reduces stress. Here we aimed to clarify the impact of physical activity and childhood trauma experiences on current mood and cognitive function in patients with schizophrenia (SZ) or bipolar disorders (BD). METHODS Three-hundred-and-six patients with DSM-IV schizophrenia (SZ) or bipolar disorder (BD) were included in the study. Diagnoses were assessed using the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I). Physical activity was measured as hours spent on any regular physical activity per week. All patients underwent a neuropsychological test battery. History of Childhood trauma was assessed using the Childhood Trauma Questionnaire and mood symptoms were assessed with the Inventory of Depressive Symptoms. RESULTS Patients with childhood trauma who were physically inactive (˂90 min per week) had the most severe clinical profile, characterised by the highest depressive symptoms (p ˂ 0.001) and lowest performance on working memory tasks (p ˂ 0.001). Among patients with childhood trauma, those who were physically active (≥90 min per week) had better working memory performance than physically inactive patients (p = 0.02). DISCUSSION A history of childhood trauma was associated with poorer working memory and more depressive symptoms only in patients who were physically inactive, suggesting a possible protective factor of physical activity in severe mental disorder.
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Affiliation(s)
- Monica Aas
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Torill Ueland
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Ragni H Mørch
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | | | - Elina J Reponen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Annamaria Cattaneo
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Ingrid Agartz
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway.,Department of Clinical Neuroscience, Centre of Psychiatric Research, Karolinska Institutet, Stockholm, Sweden
| | - Ingrid Melle
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Nils E Steen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ole A Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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27
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Feng Z, Li Q, Zhou L, Chen Z, Yin W. The relationship between depressive symptoms and activity of daily living disability among the elderly: results from the China Health and Retirement Longitudinal Study (CHARLS). Public Health 2021; 198:75-81. [PMID: 34365109 DOI: 10.1016/j.puhe.2021.06.023] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 02/25/2021] [Accepted: 06/22/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The acceleration of population aging has brought an unprecedented impact on China's health system. This study is designed to examine the association between depressive symptoms and activity of daily living disability among the elderly in China. STUDY DESIGN This is a cross-sectional study. METHODS Data were drawn from the China Health and Retirement Longitudinal Study (CHARLS). The 10-item Center for Epidemiologic Studies-Depression (CES-D) scale was used to access depressive symptoms, and physical function was assessed by the Activity of Daily Living (ADL) scale. Multivariate logistic regression was used to assess the association between depressive symptoms and ADL among the elderly. RESULTS Based on a sample of 5863 elderly people over 60 years old, our results showed that 1999 elderly people are with depressive symptoms, accounting for 34.1%. The mean score of ADL among the elderly with depressive symptoms (20.65 ± 7.14) was much higher than that in those without depressive symptoms (17.40 ± 4.87). After controlling potential confounders, multivariate logistic regression showed that ADL and its specific domains including personal care, transfer, medical care, household, and managing money were associated with depressive symptoms. CONCLUSION This cross-sectional study provides evidence of the association between depressive symptoms and ADL disability among the Chinese elderly. As a result, prevention or reduction of ADL disability may have a positive effect on the medical care of the elderly with depressive symptoms.
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Affiliation(s)
- Z Feng
- School of Public Health, Weifang Medical University, Shandong, China; "Health Shandong" Severe Social Risk Prevention and Management Synergy Innovation Center, China
| | - Q Li
- "Health Shandong" Severe Social Risk Prevention and Management Synergy Innovation Center, China; School of Management, Weifang Medical University, Shandong, China
| | - L Zhou
- "Health Shandong" Severe Social Risk Prevention and Management Synergy Innovation Center, China; School of Management, Weifang Medical University, Shandong, China
| | - Z Chen
- "Health Shandong" Severe Social Risk Prevention and Management Synergy Innovation Center, China; School of Management, Weifang Medical University, Shandong, China
| | - W Yin
- "Health Shandong" Severe Social Risk Prevention and Management Synergy Innovation Center, China; School of Management, Weifang Medical University, Shandong, China.
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28
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Mendonça DCB, Fernandes DR, Hernandez SS, Soares FDG, Figueiredo KD, Coelho FGDM. Physical exercise is effective for neuropsychiatric symptoms in Alzheimer's disease: a systematic review. ARQUIVOS DE NEURO-PSIQUIATRIA 2021; 79:447-456. [PMID: 34161531 DOI: 10.1590/0004-282x-anp-2020-0284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 08/03/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Neuropsychiatric symptoms are disorders frequently seen in Alzheimer's disease. These symptoms contribute to reduction of brain reserve capacity and, in addition, they present unfavorable implications, such as: poor prognosis for the disease, increased functional decline, increased burden on the caregiver and institutionalization. This scenario makes neuropsychiatric symptoms one of the biggest problems in Alzheimer's disease, and gives rise to a need for treatments focused on improving these symptoms. Sow progress in drug trials has led to interest in exploring non-pharmacological measures for improving the neuropsychiatric symptoms of Alzheimer's disease, such as physical exercise. OBJECTIVE To ascertain the effect of exercise on the neuropsychiatric symptoms of Alzheimer's disease and its implications. METHODS This was a systematic review of effective longitudinal research, conducted by searching for articles in the PubMed, Web of Science, CINAHL and Scopus electronic databases, from 2009 to 2019. Studies in which the sample consisted of elderly people aged 65 years old or over with a diagnosis of Alzheimer's disease were included. Initially 334 articles were identified. After exclusions, 21 articles remained to be read in full. From these, five articles fitted the eligibility criteria, and a further two articles were added through manual searches in the references of the articles found. RESULTS Out of the seven articles analyzed in this review, five studies revealed that physical exercise had a positive effect on the neuropsychiatric symptoms of Alzheimer's disease. CONCLUSION This systematic review indicated that physical exercise is a favorable non-pharmacological means for attenuating the neuropsychiatric symptoms of elderly people with Alzheimer's disease, with special attention to aerobic exercises.
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Affiliation(s)
| | - Denise Rodrigues Fernandes
- Universidade Federal de Uberlândia, Programa de Pós-Graduação em Ciências da Saúde, Uberlândia MG, Brazil
| | - Salma Soleman Hernandez
- Universidade do Estado de Santa Catarina, Programa de Pós-Graduação em Ciências do Movimento Humano, Florianópolis SC, Brazil
| | | | - Karina de Figueiredo
- Universidade Federal do Triângulo Mineiro, Programa de Pós-Graduação em Educação Física, Uberaba MG, Brazil
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29
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You Y, Wang D, Wang Y, Li Z, Ma X. A Bird's-Eye View of Exercise Intervention in Treating Depression Among Teenagers in the Last 20 Years: A Bibliometric Study and Visualization Analysis. Front Psychiatry 2021; 12:661108. [PMID: 34220574 PMCID: PMC8249759 DOI: 10.3389/fpsyt.2021.661108] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 04/30/2021] [Indexed: 12/28/2022] Open
Abstract
Background: Exercise is medicine. Multiple studies on the effects and mechanisms of exercise in treating depression among teenagers and adolescents have been widely reported. However, literature involving scientometric analysis of this topic is sparse. Here, we endeavored to conduct a bibliometric study and visualization analysis to give a bird's-eye view of publications between 2000 and 2020 on exercise therapy treating depression. Methods: Relevant original publications were obtained from the Science Citation Index Expanded in the Web of Science Core Collection (WoSCC) database between 2000 and 2020. CiteSpace (5.7.R 5) and VOSviewer (1.6.16) software were used to perform bibliometric analysis of countries, institutions, categories, journals, authors, references, and keywords involved in this topic. Results: A total number of 975 articles on this field were retrieved from the WoSCC database and we identified an overall increase in the amount of publications over the past two decades, with the United States and Harvard University leading the field. Most related publications were published in the journals with a focus on sport, medicine, rehabilitation, psychology, and health, as represented by the dual-map overlay. A series of authors and co-cited authors were identified as main contributors in the exercise-depression-teenager domain. Three major clusters were explored based on the reference co-citation analysis: "exercise," "suicide," and "concussion". Conclusions: Current concerns and hotspots of exercise intervention in depression treatments were summarized by "individual level," "social level," "role of exercise," and "research quality." We considered that the following four directions were potential future perspectives: "research on the effect of specific exercise intervention," "research on the essence of exercise and sports," "research on the combination mode of 'exercise + X'," and "research on the micro and molecular level," which should receive more attention.
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Affiliation(s)
| | | | | | | | - Xindong Ma
- Division of Sport Science and Physical Education, Tsinghua University, Beijing, China
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30
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Rivera-Bonet CN, Birn RM, Ladd CO, Meyerand ME, Abercrombie HC. Cortisol effects on brain functional connectivity during emotion processing in women with depression. J Affect Disord 2021; 287:247-254. [PMID: 33799044 PMCID: PMC8128282 DOI: 10.1016/j.jad.2021.03.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/10/2021] [Accepted: 03/15/2021] [Indexed: 01/30/2023]
Abstract
BACKGROUND Depression is associated with altered functional connectivity and altered cortisol sensitivity, but the effects of cortisol on functional connectivity in depression are unknown. Previous research shows that brief cortisol augmentation (CORT) has beneficial neurocognitive effects in depression. METHODS We investigated the effects of CORT (20mg oral cortisol) on functional connectivity during emotion processing in women with depression. Participants included 75 women with no depression or a depressive disorder. In a double-blind, crossover study, we used functional magnetic resonance imaging to measure effects of CORT vs. placebo on task-based functional connectivity during presentation of emotionally-laden images. We performed psychophysiological interaction (PPI) to test interactions among depression severity, cortisol administration, and task-dependent functional connectivity using the hippocampus and amygdala as seeds. RESULTS During the presentation of negative images, CORT (vs. placebo) increased functional connectivity between the hippocampus and putamen in association with depression severity. During the presentation of positive pictures CORT increased functional connectivity between the hippocampus and middle frontal gyrus as well as superior temporal gyrus in association with depression. LIMITATIONS Because cortisol was pharmacologically manipulated, results cannot be extrapolated to endogenous increases in cortisol levels. The sample did not permit investigation of differences due to race, ethnicity, or sex. Co-morbidities such as anxiety or PTSD were not accounted for. CONCLUSIONS The results suggest that CORT has normalizing effects on task-dependent functional connectivity in women with depression during emotion processing. Increasing cortisol availability or signaling may have therapeutic benefits within affective disorders.
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Affiliation(s)
| | - Rasmus M Birn
- Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI, United States; Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, United States; Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, United States
| | - Charlotte O Ladd
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, United States
| | - Mary E Meyerand
- Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI, United States; Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, United States; Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States
| | - Heather C Abercrombie
- Center for Healthy Minds, University of Wisconsin-Madison, Madison, WI, United States
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31
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Nedic Erjavec G, Sagud M, Nikolac Perkovic M, Svob Strac D, Konjevod M, Tudor L, Uzun S, Pivac N. Depression: Biological markers and treatment. Prog Neuropsychopharmacol Biol Psychiatry 2021; 105:110139. [PMID: 33068682 DOI: 10.1016/j.pnpbp.2020.110139] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 10/06/2020] [Accepted: 10/10/2020] [Indexed: 12/14/2022]
Abstract
Nowadays depression is considered as a systemic illness with different biological mechanisms involved in its etiology, including inflammatory response, hypothalamic-pituitary-adrenal (HPA) axis dysregulation and neurotransmitter and neurotrophic systems imbalance. Novel "omics" approaches, such as metabolomics and glycomics provide information about altered metabolic pathways and metabolites, as well as disturbances in glycosylation processes affected by or causing the development of depression. The clinical diagnosis of depression continues to be established based on the presence of the specific symptoms, but due to its heterogeneous underlying biological background, that differs according to the disease stage, there is an unmet need for treatment response biomarkers which would facilitate the process of appropriate treatment selection. This paper provides an overview of the role of major stress response system, the HPA axis, and its dysregulation in depression, possible involvement of neurotrophins, especially brain-derived neurotrophic factor, glial cell line-derived neurotrophic factor and insulin-like growth factor-1, in the development of depression. Article discusses how activated inflammation processes and increased cytokine levels, as well as disturbed neurotransmitter systems can contribute to different stages of depression and could specific metabolomic and glycomic species be considered as potential biomarkers of depression. The second part of the paper includes the most recent findings about available medical treatment of depression. The described biological factors impose an optimistic conclusion that they could represent easy obtainable biomarkers potentially predicting more personalized treatment and diagnostic options.
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Affiliation(s)
- Gordana Nedic Erjavec
- Rudjer Boskovic Institute, Division of Molecular Medicine, Bijenicka cesta 54, 10000 Zagreb, Croatia
| | - Marina Sagud
- The University of Zagreb School of Medicine, Salata 3, 10000 Zagreb, Croatia; University Hospital Center Zagreb, Department of Psychiatry, Kispaticeva 12, 10000 Zagreb, Croatia
| | - Matea Nikolac Perkovic
- Rudjer Boskovic Institute, Division of Molecular Medicine, Bijenicka cesta 54, 10000 Zagreb, Croatia
| | - Dubravka Svob Strac
- Rudjer Boskovic Institute, Division of Molecular Medicine, Bijenicka cesta 54, 10000 Zagreb, Croatia
| | - Marcela Konjevod
- Rudjer Boskovic Institute, Division of Molecular Medicine, Bijenicka cesta 54, 10000 Zagreb, Croatia
| | - Lucija Tudor
- Rudjer Boskovic Institute, Division of Molecular Medicine, Bijenicka cesta 54, 10000 Zagreb, Croatia
| | - Sandra Uzun
- University Hospital Center Zagreb, Department for Anesthesiology, Reanimatology, and Intensive Care, Kispaticeva 12, 10000 Zagreb, Croatia
| | - Nela Pivac
- Rudjer Boskovic Institute, Division of Molecular Medicine, Bijenicka cesta 54, 10000 Zagreb, Croatia.
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Sánchez-Carro Y, Portella MJ, Leal-Leturia I, Salvat-Pujol N, Etxandi M, de Arriba-Arnau A, Urretavizcaya M, Pousa E, Toll A, Álvarez P, Soria V, López-García P. Age at illness onset and physical activity are associated with cognitive impairment in patients with current diagnosis of major depressive disorder. J Affect Disord 2021; 279:343-352. [PMID: 33099048 DOI: 10.1016/j.jad.2020.10.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 09/04/2020] [Accepted: 10/12/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Cognitive impairment has been reported in patients with Major Depressive Disorder (MDD). This study aims to explore the association between lifestyle habits and health-related factors and the presence of cognitive symptoms in MDD patients. METHODS Demographic, clinical, health-related variables and cognitive scores measured with the Cambridge Neuropsychological Test Automated Battery (CANTAB) were compared between 74 patients with current MDD and 68 healthy controls (HC). To test the hypothesis of associated factors to cognitive symptoms, multivariate backward stepwise linear regression models were run. RESULTS Significant neuropsychological deficits were evident in MDD compared with HC in the global cognitive index (F=8.29; df=1, 140; p=0.005). In the regression analysis performed on MDD and HC, years of schooling (β=-0.11; p=<0.001), job status (β=-0.50; p=0.016), physical activity (β=-0.25; p=0.04) and age at illness onset (β=0.17; p=0.017) were statistically significant factors associated to cognitive impairment. The regression model ran in HC showed that only years of schooling were significant (β=-0.07; p=<0.001) in this group. LIMITATIONS Sample size was relatively small. Everyday cognitive skills were not evaluated. CONCLUSIONS MDD patients have cognitive deficits. These deficits are linked with the years of education, job status, age of onset of the disease and the performance of physical activity. These results support the importance of the implementation of interventions targeting the cognitive reserve and lifestyle habits of MDD patients, in addition to the conventional therapeutic approach focused on symptoms control.
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Affiliation(s)
- Yolanda Sánchez-Carro
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain.
| | - Maria J Portella
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Biomedical Research Institute Sant Pau (IIB-Sant Pau), Universitat Autonoma de Barcelona (UAB), Catalonia, Spain
| | - Itziar Leal-Leturia
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain
| | - Neus Salvat-Pujol
- Bellvitge University Hospital, Psychiatry Department. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain
| | - Mikel Etxandi
- Bellvitge University Hospital, Psychiatry Department. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain
| | - Aida de Arriba-Arnau
- Bellvitge University Hospital, Psychiatry Department. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain
| | - Mikel Urretavizcaya
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Bellvitge University Hospital, Psychiatry Department. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Esther Pousa
- Servei de Psiquiatria, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Alba Toll
- Institute of Neuropsychiatry and Addictions, Hospital del Mar, IMIM, Barcelona, Spain
| | - Pilar Álvarez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Institute of Neuropsychiatry and Addictions, Hospital del Mar, IMIM, Barcelona, Spain
| | - Virginia Soria
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Bellvitge University Hospital, Psychiatry Department. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Pilar López-García
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain
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Peters EMJ, Schedlowski M, Watzl C, Gimsa U. [Can Stress Interact with SARS-CoV-2? A Narrative Review with a Focus on Stress-Reducing Interventions that may Improve Defence against COVID-19]. Psychother Psychosom Med Psychol 2021; 71:61-71. [PMID: 33440452 DOI: 10.1055/a-1322-3205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The COVID-19 pandemic is on the rise and causes many concerns and fears in the population as well as among medical care givers. This raises the question as to how psychosocial stress associated with the pandemic can be managed, and also if certain forms of stress can contribute to an increase in infections and critical illnesses. METHODS Against the background of the current state of research on stress and the immune response, we provide a narrative review of studies addressing the question as to how stress can influence the immune defence against viral diseases. RESULTS Excessive stress can compromise the barrier function of the airways and alter neuroendocrine control of immune function, which can create a virus-permissive immune response. DISCUSSION Because certain forms of stress can play a role in the successful immune defence against viral respiratory disease, it is important to identify people with high psychosocial stress and to help them manage their stress. Conclusion Psychosocial measures that contribute to improved stress management may have a positive effect on the immune response against viral respiratory infections.
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Affiliation(s)
- Eva Milena Johanne Peters
- Klinik für Psychosomatik und Psychotherapie, Psychoneuroimmunologie Labor, Justus-Liebig Universität Gießen, Deutschland.,Medizinische Klinik mit Schwerpunkt Psychosomatik und Psychotherapie, CharitéCentrum 12 (CC12) für Innere Medizin und Dermatologie, Berlin, Deutschland
| | - Manfred Schedlowski
- Institut für Medizinische Psychologie und Verhaltensimmunbiologie, Universitätsklinik Essen, Deutschland.,Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Carsten Watzl
- Fachbereich Immunologie, Leibniz-Institut für Arbeitsforschung an der TU Dortmund, Deutschland
| | - Ulrike Gimsa
- Institut für Verhaltensphysiologie, Leibniz-Institut für Nutztierbiologie, Dummerstorf, Deutschland
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Budnik-Przybylska D, Laskowski R, Pawlicka P, Anikiej-Wiczenbach P, Łada-Maśko A, Szumilewicz A, Makurat F, Przybylski J, Soya H, Kaźmierczak M. Do Physical Activity and Personality Matter for Hair Cortisol Concentration and Self-Reported Stress in Pregnancy? A Pilot Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218050. [PMID: 33139602 PMCID: PMC7663188 DOI: 10.3390/ijerph17218050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/20/2020] [Accepted: 10/28/2020] [Indexed: 01/01/2023]
Abstract
Background: Physical activity reduces psychosocial stress in pregnant women. Stress levels might be self-reported (psychosocial) or measured with biomarkers, one of which is hair cortisol concentration (HCC). Additionally, personality has been associated with stress and physical activity. Methods: The first aim of our study was to explore the differences in self-reported stress assessed by the Perceived Stress Scale (PSS) and in HCC with regard to physical activity level in pregnant (N = 29) and non-pregnant (N = 21) women. The second aim was to analyze the correlations among perceived stress, HCC, frequency of exercise and personality in the two groups separately. Results: There was a significant difference in frequency of exercise and self-reported stress between the two groups, with a lower level in pregnant women, but no differences in HCC and in personality were found. In the group of pregnant women, there was a significant negative correlation between HCC and frequency of exercise sessions, with the latter correlating positively with openness to experience. In the group of non-pregnant women, perceived stress negatively correlated with extraversion, agreeableness and emotional stability. HCC correlated negatively with conscientiousness. Conclusions: Our findings indicate the importance of physical activity programs dedicated to pregnant women for their life quality.
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Affiliation(s)
- Dagmara Budnik-Przybylska
- Department of Sport Psychology, Institute of Psychology, Faculty of Social Sciences, University of Gdańsk, 80-309 Gdańsk, Poland; (D.B.-P.); (F.M.); (J.P.)
| | - Radosław Laskowski
- Department of Physiology and Biochemistry, Faculty of Physical Culture, Gdansk University of Physical Education and Sport; 80-336 Gdańsk, Poland;
| | - Paulina Pawlicka
- Department of Cross-Cultural Psychology and Psychology of Gender, Institute of Psychology, Faculty of Social Sciences, University of Gdańsk, 80-309 Gdańsk, Poland;
| | - Paulina Anikiej-Wiczenbach
- Psychological Counseling for Rare Genetic Diseases Institute of Psychology, Faculty of Social Sciences, University of Gdańsk, 80-309 Gdańsk, Poland;
| | - Ariadna Łada-Maśko
- Department of Developmental Psychology and Psychopathology, Institute of Psychology, Faculty of Social Sciences, University of Gdańsk, 80-309 Gdańsk, Poland;
| | - Anna Szumilewicz
- Department of Fitness, Faculty of Physical Culture, Gdansk University of Physical Education and Sport, 80-309 Gdańsk, Poland;
| | - Franciszek Makurat
- Department of Sport Psychology, Institute of Psychology, Faculty of Social Sciences, University of Gdańsk, 80-309 Gdańsk, Poland; (D.B.-P.); (F.M.); (J.P.)
| | - Jacek Przybylski
- Department of Sport Psychology, Institute of Psychology, Faculty of Social Sciences, University of Gdańsk, 80-309 Gdańsk, Poland; (D.B.-P.); (F.M.); (J.P.)
| | - Hideaki Soya
- Sports Neuroscience Division, Advanced Research Initiative for Human High Performance, Faculty of Health and Sport Sciences, University of Tsukuba, 305-8574 Tsukuba, Japan;
| | - Maria Kaźmierczak
- Department of Family Studies and Quality of Life, Institute of Psychology, Faculty of Social Sciences, University of Gdańsk, 80-309 Gdańsk, Poland
- Correspondence:
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Boll LM, Khamirchi R, Alonso L, Llurba E, Pozo ÓJ, Miri M, Dadvand P. Prenatal greenspace exposure and cord blood cortisol levels: A cross-sectional study in a middle-income country. ENVIRONMENT INTERNATIONAL 2020; 144:106047. [PMID: 32822928 DOI: 10.1016/j.envint.2020.106047] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 08/05/2020] [Accepted: 08/06/2020] [Indexed: 06/11/2023]
Abstract
Exposure to greenspace has been associated with reduced stress; however, the available evidence on such an association for the fetus is still very scarce. We, for the first time, investigated the association between maternal greenspace exposure and the level of cortisol, a stress hormone, in the cord blood. Our study was based on a cohort of 150 pregnant women in Sabzevar, Iran (2018). We comprehensively assessed greenspace exposure for each participant through (i) residential surrounding greenspace (using two satellite-derived vegetation indices), (ii) residential proximity to green spaces, (iii) maternal visual access to greenspace, (iv) use of public and private green spaces, (v) having a private garden, and (vi) the number of plant pots at home. Linear regression models were developed to assess the association of each indicator of greenspace exposure with cord blood cortisol levels, controlled for the relevant covariates. We observed that a higher residential surrounding greenspace (100 m buffer), having a window with greenspace view, window greenspace coverage of more than 50%, frequently looking at greenspace through window, residential proximity to large green spaces, and more time spent in green spaces were associated with lower cortisol levels in the cord blood. The findings for residential surrounding greenspace at 300 m and 500 m buffers, residential proximity to any green space regardless of its size, having a private garden, and number of plant pots at home were not conclusive. While about one-third of the association between residential surrounding greenspace (100 m buffer) could be mediated through reduction in exposure to air pollution, we did not observe any strong evidence for such a mediatory role for the visual access to greenspace. The findings stratified for parental education and housing type showed mixed patterns. Our findings suggest that more greenspace exposure might reduce cortisol level in the cord blood.
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Affiliation(s)
- Lilian Marie Boll
- ISGlobal, Barcelona, Spain; University of Southern Denmark (SDU), Esbjerg, Denmark
| | - Ramezanali Khamirchi
- Non-communicable Diseases Research Center, Department of Environmental Health, School of Public Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Lucia Alonso
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain Maternal and Child Health Development Network, Madrid, Spain
| | - Elisa Llurba
- Obstetrics and Gynaecology Department, Santa Creu i Sant Pau Hospital, Barcelona, Spain; Universitat Autónoma de Barcelona (UAB), Spain; Maternal and Child Health Development Network II (SAMID II) RD16/0022/0015SEP, Institute of Health Carlos III, 28029 Madrid, Spain
| | - Óscar J Pozo
- Integrative Pharmacology and Systems Neuroscience Group, IMIM, Hospital del Mar, Barcelona, Spain
| | - Mohammad Miri
- Non-communicable Diseases Research Center, Department of Environmental Health, School of Public Health, Sabzevar University of Medical Sciences, Sabzevar, Iran.
| | - Payam Dadvand
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain Maternal and Child Health Development Network, Madrid, Spain.
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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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37
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Belvederi Murri M, Folesani F, Zerbinati L, Nanni MG, Ounalli H, Caruso R, Grassi L. Physical Activity Promotes Health and Reduces Cardiovascular Mortality in Depressed Populations: A Literature Overview. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5545. [PMID: 32751902 PMCID: PMC7432205 DOI: 10.3390/ijerph17155545] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/23/2020] [Accepted: 07/27/2020] [Indexed: 12/31/2022]
Abstract
Major depression is associated with premature mortality, largely explained by heightened cardiovascular burden. This narrative review summarizes secondary literature (i.e., reviews and meta-analyses) on this topic, considering physical exercise as a potential tool to counteract this alarming phenomenon. Compared to healthy controls, individuals with depression consistently present heightened cardiovascular risk, including "classical" risk factors and dysregulation of pertinent homeostatic systems (immune system, hypothalamic-pituitary-adrenal axis and autonomic nervous system). Ultimately, both genetic background and behavioral abnormalities contribute to explain the link between depression and cardiovascular mortality. Physical inactivity is particularly common in depressed populations and may represent an elective therapeutic target to address premature mortality. Exercise-based interventions, in fact, have proven effective reducing cardiovascular risk and mortality through different mechanisms, although evidence still needs to be replicated in depressed populations. Notably, exercise also directly improves depressive symptoms. Despite its potential, however, exercise remains under-prescribed to depressed individuals. Public health may be the ideal setting to develop and disseminate initiatives that promote the prescription and delivery of exercise-based interventions, with a particular focus on their cost-effectiveness.
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Argolo FC, Gadelha A, Pan PM, Bressan RA. Time-driven interventions for affective disorders: on resonance and the Oberth effect. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2020; 42:113-114. [PMID: 32520168 DOI: 10.1590/2237-6089-2019-0067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 10/06/2019] [Indexed: 06/11/2023]
Affiliation(s)
- Felipe C Argolo
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Ary Gadelha
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Pedro M Pan
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Rodrigo A Bressan
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, SP, Brazil
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Barboza JJ, Soriano-Moreno AN, Copez-Lonzoy A, Pacheco-Mendoza J, Toro-Huamanchumo CJ. Disability and severe depression among Peruvian older adults: analysis of the Peru Demographic and Family Health Survey, ENDES 2017. BMC Psychiatry 2020; 20:253. [PMID: 32448117 PMCID: PMC7247146 DOI: 10.1186/s12888-020-02664-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 05/13/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Depression is considered a mental health-related disability that affects approximately 350 million people worldwide. On the other hand, it is estimated that 15% of the world's population lives with some form of disability, and this scenario is currently riddled with the global burden of mental disorders, non-communicable diseases and other age-related comorbidities. AIM To assess the association between disability and depression among Peruvian older adults. METHODS We used data from the 2017 Peru Demographic and Familiar Health Survey, with a focus on adults aged 50 years and older. Whereas the presence of disability was assessed using different questions of the survey, depression was measured with the Patient Health Questionnaire-9 (PHQ-9). We calculated the adjusted prevalence ratios (aPR) using Poisson regression models with log link function, with their respective 95% confidence intervals (95% CI). RESULTS From the study population, 5% had a disability. In addition, 43.3% were screened positive for depression (13.2% for moderately severe/severe). After adjusting for confounding variables, disability was associated with moderate and severe depression (aPR: 1.06; 95% CI: 1.01-1.11, aPR: 1.10; 95% CI: 1.05-1.15). CONCLUSION Disability was positively associated with moderate and severe depression. Public health policies should address the early diagnosis and rehabilitation of patients with any of these problems. Likewise, coping strategies should be promoted among families of persons with disabilities.
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Affiliation(s)
- Joshuan J. Barboza
- grid.441908.00000 0001 1969 0652Universidad San Ignacio de Loyola, Unidad de Revisiones Sistemáticas y Meta-análisis, Lima, Peru
| | | | - Anthony Copez-Lonzoy
- grid.441908.00000 0001 1969 0652Universidad San Ignacio de Loyola, Unidad de Investigación en Bibliometría, Lima, Peru ,Asociación Peruana de Profesionales de las Adicciones – APPADIC, Lima, Peru
| | - Josmel Pacheco-Mendoza
- grid.441908.00000 0001 1969 0652Universidad San Ignacio de Loyola, Unidad de Investigación en Bibliometría, Lima, Peru
| | - Carlos J. Toro-Huamanchumo
- grid.441908.00000 0001 1969 0652Universidad San Ignacio de Loyola, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Av. La Fontana 750, La Molina, Lima, Peru
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Ross RE, Saladin ME, George MS, Gregory CM. High-Intensity Aerobic Exercise Acutely Increases Brain-derived Neurotrophic Factor. Med Sci Sports Exerc 2020; 51:1698-1709. [PMID: 30829963 DOI: 10.1249/mss.0000000000001969] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Aerobic exercise (AEx) exerts antidepressant effects, although the neurobiological mechanisms underlying such effects are not well understood. Reduced brain-derived neurotrophic factor (BDNF) and elevated cortisol have been implicated in the pathophysiology of depression and appear to normalize with antidepressant treatment. Thus, BDNF and cortisol may serve as biological targets for developing AEx as an antidepressant treatment. PURPOSE This study examined the effects of AEx, of different intensities, on serum BDNF and cortisol in individuals with and without depression. METHODS Thirteen participants with depression (10 females; age = 27.2 ± 6.9 yr; Montgomery-Äsberg Depression Rating Scale = 21.7 ± 4.7) and 13 control participants (10 females; age 27.2 ± 7.2 yr; Montgomery-Äsberg Depression Rating Scale = 0.5 ± 0.9) participated. Experimental visits consisted of 15 min of low-intensity cycling (LO) at 35% heart rate reserve, high-intensity cycling (HI) at 70% heart rate reserve, or sitting (CON). During each visit, blood samples were obtained at baseline, immediately postexercise (IP), and then every 15 min postexercise for 1 h (15P, 30P, 45P, and 60P). Group, condition, and time differences in BDNF and cortisol were assessed. RESULTS There were no group differences in cortisol and BDNF. Secondary analysis revealed that BDNF increased in an intensity-dependent nature at IP, and cortisol was significantly elevated at 15P after HI. Changes in BDNF and cortisol showed significant linear relationships with changes in HR. CONCLUSION HI AEx can elicit acute, transient increases in BDNF and cortisol in young, healthy, and physically active, nondepressed and mild to moderately depressed individuals. This work suggests that AEx has potential to significantly affect the central nervous system function, and the magnitude of such effect may be directly driven by exercise intensity.
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Affiliation(s)
- Ryan E Ross
- Department of Health Sciences and Research, Medical University of South Carolina, Charleston, SC.,Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC
| | - Michael E Saladin
- Department of Health Sciences and Research, Medical University of South Carolina, Charleston, SC
| | - Mark S George
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC.,Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Chris M Gregory
- Department of Health Sciences and Research, Medical University of South Carolina, Charleston, SC.,Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC
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Yang F, Cao X, Sun X, Wen H, Qiu J, Xiao H. Hair Cortisol Is Associated With Social Support and Symptoms in Schizophrenia. Front Psychiatry 2020; 11:572656. [PMID: 33192700 PMCID: PMC7541838 DOI: 10.3389/fpsyt.2020.572656] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/07/2020] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Psychosocial stressors may worsen psychotic symptoms in schizophrenia, while social support could protect against the effects of stress in schizophrenia. Hypothalamus-pituitary-adrenal axis dysfunction has been associated with schizophrenia. Hair cortisol concentrations (HCC) allow assessment of cumulative cortisol secretion over the preceding 3 months. The relationship between HCC, psychosocial stressors, social support, and the clinical characteristics of schizophrenia needs to be explored. METHODS One hundred nine schizophrenia patients and 86 healthy controls between the ages of 18 and 60 were enrolled in the study. Three-centimeter samples of hair were collected from the scalp and HCC were measured using ELISA kits. Linear regression and factor analysis were employed to examine the relationship between HCC, childhood trauma, the number of stressful life events (SLE), the amount of social support in the 3 months prior to the hair cortisol assessment and clinical characteristics of schizophrenia. RESULTS Schizophrenia patients experience more SLE in their lifetime, receive less social support, and have lower HCC in the recent 3 months compared to healthy controls. In the schizophrenia patients, HCC are positively associated with the amount of social support and negatively associated with the severity of delusions. The interaction between social support and SLE predicts decreased HCC. Factor analysis shows that a subgroup of schizophrenia patients who experience childhood trauma and SLE are characterized by decreased HCC. CONCLUSIONS Findings indicate social support could be a moderator for the relationship between SLE and HCC which may attenuate the effects of SLE in schizophrenia.
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Affiliation(s)
- Fuzhong Yang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xinyi Cao
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiujia Sun
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hui Wen
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jianyin Qiu
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hua Xiao
- State Key Laboratory of Microbial Metabolism, Joint International Research Laboratory of Metabolic & Developmental Sciences, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
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Zimmer P, Schmidt ME, Prentzell MT, Berdel B, Wiskemann J, Kellner KH, Debus J, Ulrich C, Opitz CA, Steindorf K. Resistance Exercise Reduces Kynurenine Pathway Metabolites in Breast Cancer Patients Undergoing Radiotherapy. Front Oncol 2019; 9:962. [PMID: 31612110 PMCID: PMC6773833 DOI: 10.3389/fonc.2019.00962] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 09/11/2019] [Indexed: 12/11/2022] Open
Abstract
Purpose: Evidence from preclinical studies and trials in healthy volunteers suggests that exercise may modulate the levels of tryptophan (TRP) metabolites along the kynurenine (KYN) pathway. As KYN and downstream KYN metabolites are known to promote cancer progression by inhibiting anti-tumor immune responses and by promoting the motility of cancer cells, we investigated if resistance exercise can also control the levels of KYN pathway metabolites in breast cancer patients undergoing radiotherapy (NCT01468766). Patients and Methods: Chemotherapy-naïve breast cancer patients (n = 96) were either randomized to an exercise/intervention group (IG) or a control group (CG). The IG participated in a 12-week supervised progressive resistance exercise program twice a week, whereas the CG received a supervised relaxation program. Serum levels of TRP and KYN as well as urine levels of kynurenic acid (KYNA) and neurotoxic quinolinic acid (QUINA) were assessed before (t0), after radiotherapy, and mid-term of the exercise intervention (t1) and after the exercise intervention (t2). Additionally, 24 healthy women (HIG) participated in the exercise program to investigate potential differences in its effects on KYN metabolites in comparison to the breast cancer patients. Results: At baseline (t0) the breast cancer patients showed a significantly elevated serum KYN/TRP ratio and urine QUINA/KYNA ratio, as well as increased urine QUINA levels in comparison to the healthy women. In response to exercise the healthy women and the breast cancer patients differed significantly in the levels of urine QUINA and the QUINA/KYNA ratio. Most importantly, serum KYN levels and the KYN/TRP ratio were significantly reduced in exercising patients (IG) compared to non-exercising patients (CG) both at t1 and t2. Conclusion: Resistance exercise may represent a potent non-pharmacological avenue to counteract an activation of the KYN pathway in breast cancer patients undergoing radiotherapy.
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Affiliation(s)
- Philipp Zimmer
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany.,Department for Molecular and Cellular Sports Medicine, Institute for Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Martina E Schmidt
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Mirja Tamara Prentzell
- DKTK Brain Cancer Metabolism Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Bianca Berdel
- DKTK Brain Cancer Metabolism Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Joachim Wiskemann
- Department of Medical Oncology, National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany
| | | | - Jürgen Debus
- Department of Radiation Oncology, National Center for Radiation Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), University Hospital Heidelberg, Heidelberg, Germany
| | - Cornelia Ulrich
- Department of Population Health Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | - Christiane A Opitz
- DKTK Brain Cancer Metabolism Group, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Neurology and National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
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