身体活动与抑郁发生：前瞻性队列研究的荟萃分析。
Physical Activity and Incident Depression: A Meta-Analysis of Prospective Cohort Studies.
机构信息
From La Salle University, Canoas, Brazil; the School of Physical Education, Physiotherapy, and Dance and the Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; KU Leuven-University of Leuven, Department of Rehabilitation Sciences, and University Psychiatric Center, Leuven-Kortenberg, Belgium; the NICM Health Research Institute, School of Science and Health, University of Western Sydney, Sydney, Australia; the School of Psychiatry, University of New South Wales Sydney, Black Dog Institute, and Schizophrenia Research Unit, Ingham Institute of Applied Medical Research, Sydney, Australia; the Department of Public Health Sciences, Karolinska Institute, Stockholm; the Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil; the Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; the Department of Psychiatry, University of Toronto, and the Centre for Addiction and Mental Health, Toronto; the Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; and the Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London.
出版信息
Am J Psychiatry. 2018 Jul 1;175(7):631-648. doi: 10.1176/appi.ajp.2018.17111194. Epub 2018 Apr 25.
OBJECTIVE
The authors examined the prospective relationship between physical activity and incident depression and explored potential moderators.
METHOD
Prospective cohort studies evaluating incident depression were searched from database inception through Oct. 18, 2017, on PubMed, PsycINFO, Embase, and SPORTDiscus. Demographic and clinical data, data on physical activity and depression assessments, and odds ratios, relative risks, and hazard ratios with 95% confidence intervals were extracted. Random-effects meta-analyses were conducted, and the potential sources of heterogeneity were explored. Methodological quality was assessed using the Newcastle-Ottawa Scale.
RESULTS
A total of 49 unique prospective studies (N=266,939; median proportion of males across studies, 47%) were followed up for 1,837,794 person-years. Compared with people with low levels of physical activity, those with high levels had lower odds of developing depression (adjusted odds ratio=0.83, 95% CI=0.79, 0.88; I=0.00). Furthermore, physical activity had a protective effect against the emergence of depression in youths (adjusted odds ratio=0.90, 95% CI=0.83, 0.98), in adults (adjusted odds ratio=0.78, 95% CI=0.70, 0.87), and in elderly persons (adjusted odds ratio=0.79, 95% CI=0.72, 0.86). Protective effects against depression were found across geographical regions, with adjusted odds ratios ranging from 0.65 to 0.84 in Asia, Europe, North America, and Oceania, and against increased incidence of positive screen for depressive symptoms (adjusted odds ratio=0.84, 95% CI=0.79, 0.89) or major depression diagnosis (adjusted odds ratio=0.86, 95% CI=0.75, 0.98). No moderators were identified. Results were consistent for unadjusted odds ratios and for adjusted and unadjusted relative risks/hazard ratios. Overall study quality was moderate to high (Newcastle-Ottawa Scale score, 6.3). Although significant publication bias was found, adjusting for this did not change the magnitude of the associations.
CONCLUSIONS
Available evidence supports the notion that physical activity can confer protection against the emergence of depression regardless of age and geographical region.
目的
作者研究了体力活动与新发抑郁症之间的前瞻性关系，并探讨了潜在的调节因素。
方法
从数据库创建到 2017 年 10 月 18 日，通过 PubMed、PsycINFO、Embase 和 SPORTDiscus 搜索评估新发抑郁症的前瞻性队列研究。提取人口统计学和临床数据、体力活动和抑郁评估数据、以及优势比、相对风险和 95%置信区间的风险比。进行随机效应荟萃分析，并探讨异质性的潜在来源。使用纽卡斯尔-渥太华量表评估方法学质量。
结果
共纳入 49 项独特的前瞻性研究（N=266939；研究中男性的中位数比例为 47%），随访 1837794 人年。与体力活动水平低的人相比，体力活动水平高的人患抑郁症的几率较低（调整后的优势比=0.83，95%CI=0.79，0.88；I=0.00）。此外，体力活动对青少年（调整后的优势比=0.90，95%CI=0.83，0.98）、成年人（调整后的优势比=0.78，95%CI=0.70，0.87）和老年人（调整后的优势比=0.79，95%CI=0.72，0.86）的抑郁发生具有保护作用。在亚洲、欧洲、北美和大洋洲，针对抑郁症状阳性筛查（调整后的优势比=0.84，95%CI=0.79，0.89）或重度抑郁症诊断（调整后的优势比=0.86，95%CI=0.75，0.98）的发生率增加，也发现了对抑郁症的保护作用。未发现调节因素。未调整的优势比和调整后的和未调整的相对风险/风险比的结果一致。总体研究质量为中高度（纽卡斯尔-渥太华量表评分 6.3）。尽管存在显著的发表偏倚，但进行调整并未改变关联的幅度。
结论
现有证据支持体力活动可以预防抑郁症的发生，无论年龄和地理位置如何。
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