Md Zemberi Nur Fatin Nabilah, Ismail Muhammad Mokhzani, Abdullah Mohammad Farris Iman Leong
Lifestyle Science Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Pulau Pinang, Malaysia.
Malays J Med Sci. 2020 Oct;27(5):5-23. doi: 10.21315/mjms2020.27.5.2. Epub 2020 Oct 27.
There is an increasing evidence supporting the efficacy of exercise interventions in the treatment of depression, which is a growing global health concern. However, data on the efficacy of exercise as the primary treatment for depression are scarce. This narrative review explored the efficacy of exercise interventions as the primary treatment for depressive disorders. A comprehensive search for English-language literature published between January 1965 and November 2019 was conducted via PubMed, Google Scholar, Scopus, Web of Science, PsycINFO, EMBASE, Cochrane database and Medline. Thirteen randomised control trials (RCTs) were included in the final analysis. Their results indicated that supervised aerobic exercise and high-intensity progressive resistance training (PRT) were effective in ameliorating depressive symptoms as the primary treatment compared with control groups, but they were not superior to other active treatments, such as antidepressants and cognitive behavioural therapy. Aerobic exercise and high-intensity PRT may be a promising primary treatment for depression as they may induce biopsychosocial effects (effects on neurotrophic factor, pro-inflammatory cytokines, monoamine, the hypothalamic-pituitary-adrenal axis, self-efficacy, mastery experience, adaptive coping and social interaction), which may ameliorate the severity of depressive symptoms. However, future RCTs with more comprehensive and well-designed methodologies are warranted to confirm our findings.
越来越多的证据支持运动干预在治疗抑郁症方面的疗效，抑郁症是一个日益受到全球关注的健康问题。然而，关于运动作为抑郁症主要治疗方法疗效的数据却很稀少。本叙述性综述探讨了运动干预作为抑郁症主要治疗方法的疗效。通过PubMed、谷歌学术、Scopus、科学网、PsycINFO、EMBASE、Cochrane数据库和Medline对1965年1月至2019年11月发表的英文文献进行了全面检索。最终分析纳入了13项随机对照试验（RCT）。结果表明，与对照组相比，有监督的有氧运动和高强度渐进性抗阻训练（PRT）作为主要治疗方法在改善抑郁症状方面是有效的，但并不优于其他积极治疗方法，如抗抑郁药和认知行为疗法。有氧运动和高强度PRT可能是一种有前景的抑郁症主要治疗方法，因为它们可能产生生物心理社会效应（对神经营养因子、促炎细胞因子、单胺、下丘脑-垂体-肾上腺轴、自我效能感、掌握经验、适应性应对和社会互动的影响），这可能会减轻抑郁症状的严重程度。然而，需要未来采用更全面、设计更完善方法的随机对照试验来证实我们的发现。
