Department of Child and Adolescent Psychiatry Psychosomatic and Psychotherapy, University Hospital of Cologne, Cologne, Germany.
Department of Medical Statistics, Informatics and Epidemiology (IMSIE), University of Cologne, Cologne, Germany.
Eur Child Adolesc Psychiatry. 2022 Jul;31(7):1-14. doi: 10.1007/s00787-021-01742-5. Epub 2021 Mar 12.
Recent meta-analyses reveal a moderate effect of physical activity (PA) in the treatment of adolescent depression. However, not only the underlying neurobiological mechanisms, also the influences of placebo-related motivational factors (beliefs and expectancies in sporting, enjoyment and prior sports experiences), are still unclear. Based on the data of our prior study "Mood Vibes", we hypothesized that placebo-inherent factors like positive prior sports experiences and motivational factors, (positive beliefs, expectancies, and enjoyment related to PA), would increase the effects of an add-on exercise-therapy in juvenile depression. From 64 included depressed adolescents, 41 underwent an intensive add-on PA-therapy. Motivational factors were assessed using sport-specific scales. The changes in depression scores under treatment were rated by self-rating scale (German "Childhood Depression Inventory", (DIKJ)). A mixed model for repeated measures (MMRM) was used to analyze the effects of the different motivational variates on DIKJ. While prior sports experiences had no impact, motivational factors showed a significant effect on PA-induced changes in DIKJ scores (p = 0.002). The demotivated participants improved less, whereas it was sufficient to be neutral towards sporting to benefit significantly more. Motivational placebo-related factors (beliefs, expectancies and enjoyment regarding PA) affected the outcomes of an exercise treatment in depressed adolescents. Yet, a neutral mindset was sufficient to profit more from PA. Prior sporting in the sense of positive conditioning and as a protective factor did not play a role. Knowledge about these influences could in a second step help to develop tailored therapies.
最近的荟萃分析显示，身体活动 (PA) 在青少年抑郁症的治疗中具有中等效果。然而，不仅是潜在的神经生物学机制，安慰剂相关的激励因素（对运动的信念和期望、享受和先前的运动经验）的影响仍不清楚。基于我们之前的研究“Mood Vibes”的数据，我们假设安慰剂固有的因素，如积极的先前运动经验和激励因素（与 PA 相关的积极信念、期望和享受），将增加青少年抑郁症附加运动疗法的效果。在纳入的 64 名抑郁青少年中，有 41 名接受了强化附加 PA 治疗。使用特定于运动的量表评估激励因素。治疗下抑郁评分的变化由自评量表（德语“儿童抑郁量表”（DIKJ））评定。使用重复测量混合模型（MMRM）分析不同激励变量对 DIKJ 的影响。虽然先前的运动经验没有影响，但激励因素对 PA 引起的 DIKJ 评分变化有显著影响（p = 0.002）。动力不足的参与者改善较少，而对运动持中立态度则可以显著获益更多。与 PA 相关的激励安慰剂相关因素（对 PA 的信念、期望和享受）影响了抑郁青少年运动治疗的结果。然而，中立的心态足以从 PA 中获益更多。积极条件作用和保护因素意义上的先前运动没有发挥作用。了解这些影响可以帮助我们在第二步中制定针对性的治疗方案。
