Hallgren Mats, Nakitanda Olivia Aya, Ekblom Örjan, Herring Matthew P, Owen Neville, Dunstan David, Helgadottir Björg, Forsell Yvonne
Division of Epidemiology and Public Health Intervention Research (EPHIR), Department of Public Health Sciences, Karolinska Institutet, Solna 171 77, Sweden.
Division of Epidemiology and Public Health Intervention Research (EPHIR), Department of Public Health Sciences, Karolinska Institutet, Solna 171 77, Sweden.
Prev Med. 2016 Jul;88:53-8. doi: 10.1016/j.ypmed.2016.03.021. Epub 2016 Apr 7.
Exercise is an efficacious stand-alone therapy for mild-to-moderate depression, but little is known about the influence of physical activity levels on responses to depression treatment. This study aimed to prospectively assess the association between self-reported habitual physical activity levels and depression severity following a 12-week intervention.
629 adults (75% women; aged 18-71years) with mild-to-moderate depression were recruited from primary care centres across Sweden and treated for 12weeks. The interventions included internet-based cognitive behavioural therapy (ICBT) and 'usual care' (CBT or supportive counselling). One third of all participants were taking anti-depressant medication. The primary outcome was the change in depression severity assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS). Habitual physical activity levels were self-rated and based on the estimated frequency, duration and intensity of total physical activity, including planned exercise, 'during a typical week'. Prospective associations were explored using linear regression models (percentage change) with 95% confidence intervals (CI's).
Following adjustment for relevant covariates, high levels of habitual physical activity were associated with larger relative reductions in depression severity compared to low physical activity (β=-9.19, 95% CI=-18.46, -0.09, p=0.052) and moderate physical activity (β=-10.81, 95% CI=-21.09, -0.53, p<0.05), respectively.
Adults who routinely engage in high levels of physical activity respond more favourably to CBT-focused depression treatments than adults who engage in low-to-moderate levels of activity. The optimal level of physical activity associated with reductions in depression severity corresponds to consensus recommendations for maximizing general health. One limitation is the use of self-reported physical activity data.
运动是治疗轻至中度抑郁症的一种有效独立疗法，但关于身体活动水平对抑郁症治疗反应的影响知之甚少。本研究旨在前瞻性评估自我报告的习惯性身体活动水平与12周干预后抑郁症严重程度之间的关联。
从瑞典各地的初级保健中心招募了629名患有轻至中度抑郁症的成年人（75%为女性；年龄18 - 71岁），并进行了12周的治疗。干预措施包括基于互联网的认知行为疗法（ICBT）和“常规护理”（CBT或支持性咨询）。所有参与者中有三分之一正在服用抗抑郁药物。主要结局是使用蒙哥马利-Åsberg抑郁评定量表（MADRS）评估的抑郁症严重程度变化。习惯性身体活动水平是自我评定的，基于“在典型一周内”包括计划锻炼在内的总体身体活动的估计频率、持续时间和强度。使用线性回归模型（百分比变化）和95%置信区间（CI）探索前瞻性关联。
在对相关协变量进行调整后，与低身体活动（β = -9.19，95% CI = -18.46，-0.09，p = 0.052）和中等身体活动（β = -10.81，95% CI = -21.09，-0.53，p < 0.05）相比，高水平的习惯性身体活动与抑郁症严重程度的相对更大降低相关。
经常进行高水平身体活动的成年人比进行低至中等水平活动的成年人对以CBT为重点的抑郁症治疗反应更有利。与抑郁症严重程度降低相关的最佳身体活动水平与最大化总体健康的共识建议相符。一个局限性是使用了自我报告的身体活动数据。
