Baumeister Sebastian E, Leitzmann Michael F, Bahls Martin, Dörr Marcus, Schmid Daniela, Schomerus Georg, Appel Katja, Markus Marcello R P, Völzke Henry, Gläser Sven, Grabe Hans-Jörgen
Department of Epidemiology and Preventive Medicine, University of Regensburg, Franz-Josef-Strauß-Allee 11, D-93053 Regensburg, Germany.
Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.
J Clin Psychiatry. 2017 Jan;78(1):e41-e47. doi: 10.4088/JCP.15m10474.
Physical activity and cardiorespiratory fitness may help prevent depression and anxiety. Previous studies have been limited by error-prone measurements. We examined whether self-reported physical activity domains and peak exercise capacity (peakVO₂) are associated with incident and recurrent major depressive disorder (MDD), depressive symptoms, and anxiety disorders.
This was a prospective population-based study of 1,080 adult men and women (25-83 years) with a median follow-up of 4.5 years and measures of physical activity during leisure time, sports, and work (Baecke questionnaire); a measure of depressive symptoms (Beck Depression Inventory II); symptom-limited cycle ergometer testing (peakVO₂, oxygen uptake at anaerobic threshold [VO₂@AT], maximum power output at peak exertion); and a structured psychiatric interview (Munich Composite International Diagnostic Interview). Baseline data were collected between 2002 and 2006, and follow-up data, between 2007 and 2010.
After adjustment for age, sex, education, smoking, alcohol consumption, and waist circumference, the relative risks for incident MDD per standard deviation (SD) increase in leisure-time physical activity, physical activity during sport, physical activity at work, peakVO₂, VO₂@AT, and maximum power output were 1.002 (95% confidence interval, 0.90 to 1.12), 1.02 (0.90 to 1.15), 0.94 (0.80 to 1.10), 0.71 (0.52 to 0.98), 0.83 (0.66 to 1.04), and 0.71 (0.52 to 0.96), respectively. PeakVO₂, VO₂@AT, and maximum power output were associated with recurrent MDD, depressive symptoms, and anxiety. PeakVO₂ was more strongly related to the co-occurrence of MDD and anxiety (adjusted odds ratio [OR] = 0.45 [0.24 to 0.84]) than depression or anxiety alone (OR = 0.71 [0.53 to 0.94]).
Greater cardiorespiratory fitness but not domain-specific physical activity was associated with a lower incidence of MDD and clinical anxiety.
身体活动和心肺适能可能有助于预防抑郁和焦虑。既往研究受测量易出错的限制。我们研究了自我报告的身体活动领域和峰值运动能力（峰值摄氧量）是否与新发和复发性重度抑郁症（MDD）、抑郁症状及焦虑症相关。
这是一项基于人群的前瞻性研究，纳入1080名成年男性和女性（25 - 83岁），中位随访时间为4.5年，测量了休闲时间、运动和工作期间的身体活动（贝克问卷）；抑郁症状测量（贝克抑郁量表第二版）；症状限制的蹬车运动测试（峰值摄氧量、无氧阈摄氧量、最大用力时的最大功率输出）；以及结构化精神科访谈（慕尼黑综合国际诊断访谈）。2002年至2006年收集基线数据，2007年至2010年收集随访数据。
在调整年龄、性别、教育程度、吸烟、饮酒和腰围后，休闲时间身体活动、运动期间身体活动、工作期间身体活动、峰值摄氧量、无氧阈摄氧量和最大功率输出每增加一个标准差，新发MDD的相对风险分别为1.002（95%置信区间，0.90至1.12）、1.02（0.90至1.15）、0.94（0.80至1.10）、0.71（0.52至0.98）、0.83（0.66至1.04）和0.71（0.52至0.96）。峰值摄氧量、无氧阈摄氧量和最大功率输出与复发性MDD、抑郁症状及焦虑相关。峰值摄氧量与MDD和焦虑共病的相关性（调整后的优势比[OR]=0.45[0.24至0.84]）比单独的抑郁或焦虑更强（OR = 0.71[0.53至0.94]）。
更高的心肺适能而非特定领域的身体活动与MDD和临床焦虑的较低发病率相关。
