University of Edinburgh, Centre for Population Health Sciences, Doorway 1, Medical Quad, Teviot Place, Edinburgh EH8 9AG, UK.
J Affect Disord. 2013 Feb 15;145(1):21-8. doi: 10.1016/j.jad.2012.07.001. Epub 2012 Aug 4.
Altered physical activity is an important feature of depression. It is manifested in psychomotor retardation, agitation and withdrawal from engagement in normal activities. Modern devices for activity monitoring (actigraphs) make it possible to monitor physical activity unobtrusively but the validity of actigraphy as an indicator of mood state is uncertain. We carried out a systematic review of digital actigraphy in patients with depression to investigate the associations between measured physical activity and depression.
Systematic review and meta-analysis. Studies were identified from Medline, EMBASE and Psycinfo databases and included if they were either case control or longitudinal studies of actigraphy in adults aged between 18 and 65 diagnosed with a depressive disorder. Outcomes were daytime and night-time activity and actigraphic measures of sleep.
We identified 19 eligible papers from 16 studies (412 patients). Case control studies showed less daytime activity in patients with depression (standardised mean difference -0.76, 95% confidence intervals -1.05 to -0.47). Longitudinal studies showed moderate increase in daytime activity (0.53, 0.20 to 0.87) and a reduction in night-time activity (-0.36, -0.65 to -0.06) over the course of treatment.
All study participants were unblinded. Only seven papers included patients treated in the community.
Actigraphy is a potentially valuable source of additional information about patients with depression. However, there are no clear guidelines for use of actigraphy in studies of patients with depression. Further studies should investigate patients treated in the community. Additional work to develop algorithms for differentiating behaviour patterns is also needed.
体力活动改变是抑郁的一个重要特征。它表现为精神运动迟缓、激越和从正常活动中退缩。现代活动监测设备（活动记录仪）可以在不引人注目的情况下监测体力活动，但活动记录仪作为情绪状态的指标的有效性尚不确定。我们对抑郁症患者的数字活动记录仪进行了系统评价，以调查测量的体力活动与抑郁之间的关系。
系统评价和荟萃分析。从 Medline、EMBASE 和 Psycinfo 数据库中确定研究，如果它们是在 18 至 65 岁之间被诊断为抑郁症的成年人中进行的活动记录仪病例对照或纵向研究，则将其纳入研究。结果是白天和夜间活动以及活动记录仪测量的睡眠。
我们从 16 项研究中确定了 19 篇符合条件的论文（412 名患者）。病例对照研究表明，抑郁症患者白天活动较少（标准化均数差-0.76，95%置信区间-1.05 至-0.47）。纵向研究表明，在治疗过程中，白天活动适度增加（0.53，0.20 至 0.87），夜间活动减少（-0.36，-0.65 至-0.06）。
所有研究参与者均未设盲。只有 7 篇论文包括在社区中接受治疗的患者。
活动记录仪是了解抑郁症患者的潜在有价值的额外信息来源。然而，目前尚无关于在抑郁症患者研究中使用活动记录仪的明确指南。需要进一步研究社区中接受治疗的患者。还需要开展更多的工作来开发区分行为模式的算法。
