Department of Rehabilitation Medicine, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi 371-8511, Japan.
Biopsychosoc Med. 2013 Dec 6;7(1):18. doi: 10.1186/1751-0759-7-18.
The efficacy of physical exercise as an augmentation to pharmacotherapy with antidepressants for depressive patients has been documented. However, to clarify the effectiveness of exercise in the treatment of depression, it is necessary to distinguish the effect of the exercise itself from the effect of group dynamics. Furthermore, an objective measurement for estimation of the effect is needed. Previous reports adopted a series of group exercises as the exercise intervention and mainly psychometric instruments for the measurement of effectiveness. Therefore, this clinical study was done to examine the effectiveness of a single session of individual exercise on depressive symptoms by assessing the change in saliva free cortisol level, which reflects hypothalamic-pituitary-adrenocortical axis function that is disturbed in depressive patients.
Eighteen medicated patients, who met the DSM-IV-TR criteria for major depressive disorder, were examined for the change in saliva free cortisol levels and the change in subjective depressive symptoms before and after pedaling a bicycle ergometer for fifteen minutes. Within a month after the exercise session, participants conducted a non-exercise control session, which was sitting quietly at the same time of day as the exercise session.
Depressed patients who participated in this study were in remission or in mild depressive state. However, they suffered chronic depression and had disturbed quality of life. The saliva free cortisol level and subjective depressive symptoms significantly decreased after the exercise session. Moreover, the changes in these variables were significantly, positively correlated. On the other hand, although the subjective depressive symptoms improved in the control session, the saliva free cortisol level did not change.
For the first time in depressive patients, we were able to show a decrease in the saliva free cortisol level due to physical exercise, accompanied by the improvement of subjective depressive symptoms. This identified a possible influence of exercise on the hypothalamic-pituitary-adrenal axis in depression.These results suggest the utility of assessing the effect of physical exercise by saliva free cortisol level in depressive patients who suffer from bio-psycho-social disability.
运动锻炼作为抗抑郁药物治疗的辅助手段对于抑郁患者的疗效已得到证实。然而，为了明确运动锻炼在治疗抑郁中的有效性，有必要区分运动本身的效果和团体动力的效果。此外，还需要一种客观的测量方法来评估效果。之前的报告采用了一系列团体运动作为运动干预，并主要使用心理计量学工具来测量效果。因此，本临床研究通过评估唾液游离皮质醇水平的变化来检查单次个体运动对抑郁症状的影响，因为抑郁患者的下丘脑-垂体-肾上腺皮质轴功能受到干扰，而唾液游离皮质醇水平反映了这一功能。
18 名符合 DSM-IV-TR 重性抑郁障碍标准的服药患者接受了检查，以评估他们在骑自行车 15 分钟前后唾液游离皮质醇水平和主观抑郁症状的变化。在运动疗程一个月后，参与者进行了非运动对照疗程，即在与运动疗程相同的时间安静地坐着。
参加本研究的抑郁患者处于缓解或轻度抑郁状态。然而，他们患有慢性抑郁症，生活质量受到影响。运动疗程后，唾液游离皮质醇水平和主观抑郁症状显著降低。此外，这些变量的变化呈显著正相关。另一方面，虽然对照组中的主观抑郁症状有所改善，但唾液游离皮质醇水平没有变化。
我们首次在抑郁患者中显示了由于身体锻炼导致的唾液游离皮质醇水平降低，同时主观抑郁症状也得到改善。这表明运动对抑郁患者的下丘脑-垂体-肾上腺轴可能产生影响。这些结果提示，评估身体锻炼对患有生物-心理-社会障碍的抑郁患者的影响时，可以使用唾液游离皮质醇水平进行评估。
