VISN 4 Mental Illness, Research, Education, and Clinical Center, Corporal Michael J. Crescenz VA Medical Center, 5800 Woodland Ave, Philadelphia, PA 19130, United States; Yale School of Medicine, New Haven, CT, United States.
VISN 4 Mental Illness, Research, Education, and Clinical Center, Corporal Michael J. Crescenz VA Medical Center, 5800 Woodland Ave, Philadelphia, PA 19130, United States; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
J Affect Disord. 2022 Mar 1;300:334-340. doi: 10.1016/j.jad.2021.12.116. Epub 2022 Jan 1.
Although the benefits of exercise on Major Depressive Disorder (MDD) are well established, longitudinal studies of objectively measured activity in clinical populations are needed to establish specific guidelines for exercise by persons with moderate-to-severe depression. This study examines the association between objectively assessed daily step count and depressive symptoms over a 24-week follow- up period in outpatients receiving treatment for moderate-to-severe depression.
Participants were US Veterans with MDD enrolled in the Precision Medicine in Mental Health Care study (PRIME Care), a pragmatic, multi-site, randomized, controlled trial that examines the utility of genetic testing in the context of pharmacotherapy for MDD. Participants were a subset (N = 66) enrolled in actigraphy (using GT9X ActiGraph) monitoring component of the trial. Daily steps were examined as a predictor of depressive symptoms over 4-, 8-, 12-, 18-, and 24-weeks.
On average, participants took 3,460 (±1,768) steps per day. In generalized linear mixed models, an increase in 1,000 steps per day was associated with a 0.6-point decrease in depressive symptom severity at the subsequent follow-up assessment.
Activity monitoring was observational and causal inferences cannot be made between daily steps and subsequent depressive symptom severity. Results may not generalize to non-treatment-seeking populations.
Study findings provide an initial metric for persons with clinically significant MDD, of whom most do not get sufficient daily activity. The findings can inform future trials aimed at determining how much daily activity is needed to improve symptoms in individuals with MDD.
虽然运动对重度抑郁症（MDD）的益处已得到充分证实，但仍需要对临床人群进行客观测量活动的纵向研究，以确定中度至重度抑郁症患者的具体运动指南。本研究考察了在接受中度至重度抑郁症治疗的门诊患者中，24 周随访期间，客观评估的每日步数与抑郁症状之间的关联。
参与者为参加心理健康关怀精准医学研究（PRIME Care）的美国退伍军人，这是一项实用的、多地点的、随机对照试验，研究了基因检测在 MDD 药物治疗背景下的效用。参与者是该试验的一部分（N=66），他们参加了活动监测组件（使用 GT9X ActiGraph）。每天的步数被作为 4、8、12、18 和 24 周时抑郁症状的预测指标进行检查。
平均而言，参与者每天走 3460（±1768）步。在广义线性混合模型中，每天增加 1000 步与随后的随访评估中抑郁症状严重程度降低 0.6 分相关。
活动监测是观察性的，不能在每天的步数和随后的抑郁症状严重程度之间做出因果推断。结果可能不适用于非寻求治疗的人群。
研究结果为具有临床显著 MDD 的人提供了一个初始指标，其中大多数人没有获得足够的日常活动。这些发现可以为旨在确定 MDD 个体需要多少日常活动来改善症状的未来试验提供信息。
