Gourgouvelis Joanne, Yielder Paul, Clarke Sandra T, Behbahani Hushyar, Murphy Bernadette Ann
University of Ontario Institute of Technology, Oshawa, ON, Canada.
Front Psychiatry. 2018 Mar 6;9:37. doi: 10.3389/fpsyt.2018.00037. eCollection 2018.
The aim of this study is to investigate the effects of exercise as an add-on therapy with antidepressant medication and cognitive behavioral group therapy (CBGT) on treatment outcomes in low-active major depressive disorder (MDD) patients. We also explored whether exercise reduces the residual symptoms of depression, notably cognitive impairment and poor sleep quality, and aimed to identify putative biochemical markers related to treatment response.
Sixteen low-active MDD patients were recruited from a mental health day treatment program at a local hospital. Eight medicated patients performed an 8-week exercise intervention in addition to CBGT, and eight medicated patients attended the CBGT only. Twenty-two low-active, healthy participants with no history of mental health illness were also recruited to provide normal healthy values for comparison.
Results showed that exercise resulted in greater reduction in depression symptoms ( = 0.007, = 2.06), with 75% of the patients showing either a therapeutic response or a complete remission of symptoms vs. 25% of those who did not exercise. In addition, exercise was associated with greater improvements in sleep quality ( = 0.046, = 1.28) and cognitive function ( = 0.046, = 1.08). The exercise group also had a significant increase in plasma brain-derived neurotrophic factor (BDNF), = 0.003, = 6.46, that was associated with improvements in depression scores ( = 0.002, = 0.50) and sleep quality ( = 0.011, = 0.38).
We provide evidence that exercise as an add-on to conventional antidepressant therapies improved the efficacy of standard treatment interventions. Our results suggest that plasma BDNF levels and sleep quality appear to be good indicators of treatment response and potential biomarkers associated with the clinical recovery of MDD.
本研究旨在调查运动作为抗抑郁药物和认知行为团体治疗（CBGT）的附加疗法对低活动水平重度抑郁症（MDD）患者治疗结果的影响。我们还探讨了运动是否能减轻抑郁的残留症状，特别是认知障碍和睡眠质量差，并旨在确定与治疗反应相关的假定生化标志物。
从当地医院的心理健康日间治疗项目中招募了16名低活动水平的MDD患者。8名接受药物治疗的患者除了参加CBGT外，还进行了为期8周的运动干预，另外8名接受药物治疗的患者仅参加了CBGT。还招募了22名没有心理健康疾病史的低活动水平健康参与者，以提供正常健康值进行比较。
结果显示，运动导致抑郁症状的减轻更为显著（P = 0.007，Cohen's d = 2.06），75%的患者表现出治疗反应或症状完全缓解，而未运动的患者中这一比例为25%。此外，运动与睡眠质量（P = 0.046，Cohen's d = 1.28）和认知功能（P = 0.046，Cohen's d = 1.08）的更大改善相关。运动组的血浆脑源性神经营养因子（BDNF）也显著增加，P = 0.003，Cohen's d = 6.46，这与抑郁评分的改善（P = 0.002，Cohen's d = 0.50）和睡眠质量的改善（P = 0.011，Cohen's d = 0.38）相关。
我们提供的证据表明，运动作为传统抗抑郁疗法的附加疗法提高了标准治疗干预的疗效。我们的结果表明，血浆BDNF水平和睡眠质量似乎是治疗反应的良好指标，以及与MDD临床康复相关的潜在生物标志物。
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