Rahman Md Shafiqur, Zhao Xuan, Liu Jia Jia, Torres Enid Quintana, Tibert Babylonia, Kumar Parvin, Kaldo Viktor, Lindefors Nils, Forsell Yvonne, Lavebratt Catharina
Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
Neurogenetics Unit, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Mol Neuropsychiatry. 2019 Feb;4(4):196-203. doi: 10.1159/000494699. Epub 2018 Dec 19.
Cortisol hypersecretion plays a role in depression pathophysiology. Internet-based cognitive behavioural therapy (ICBT) and physical exercise (PE) are new treatment alternatives for depression, and their long-lasting effect on cortisol is unknown. We investigated cortisol level changes after 12 weeks of ICBT, PE or treatment as usual (TAU).
The present pre-post repeated measure study analysed data derived from a randomised controlled trial evaluating the effects of 12 weeks' interventions of ICBT, PE and TAU in depressed primary care patients (Sweden 2011-2013) and aimed at prospectively evaluating the within-group effects of ICBT, PE and TAU on diurnal salivary cortisol levels in a small representative subsample ( = 56, 38 and 27, respectively).
We found a marked flattening of the diurnal cortisol slope ( = 0.004) and a reduced cortisol level at awakening ( = 0.017) after 12 weeks of PE treatment. No apparent effects of ICBT or TAU interventions were seen on diurnal cortisol levels.
PE reduced the rate of cortisol level decline across the day in depressed adults. ICBT and TAU treatments had no detectable effects on diurnal cortisol levels. Larger samples are required for the detection and comparison of smaller effects of PE, ICBT and TAU on diurnal cortisol levels.
皮质醇分泌过多在抑郁症病理生理学中起作用。基于互联网的认知行为疗法（ICBT）和体育锻炼（PE）是抑郁症的新治疗选择，它们对皮质醇的长期影响尚不清楚。我们研究了ICBT、PE或常规治疗（TAU）12周后皮质醇水平的变化。
本前后重复测量研究分析了来自一项随机对照试验的数据，该试验评估了ICBT、PE和TAU对抑郁症初级护理患者（瑞典，2011 - 2013年）进行12周干预的效果，并旨在前瞻性评估ICBT、PE和TAU对一个小代表性子样本（分别为n = 56、38和27）日间唾液皮质醇水平的组内效应。
我们发现体育锻炼治疗12周后，日间皮质醇斜率显著变平（P = 0.004），觉醒时皮质醇水平降低（P = 0.017）。未观察到ICBT或TAU干预对日间皮质醇水平有明显影响。
体育锻炼降低了抑郁成年人全天皮质醇水平下降的速率。ICBT和TAU治疗对日间皮质醇水平没有可检测到的影响。需要更大的样本量来检测和比较体育锻炼、ICBT和TAU对日间皮质醇水平的较小影响。
