Department of Biobehavioral Sciences, Teachers College, Columbia University, 525 West 120th Street, New York, NY, 10027, USA.
VA Boston Healthcare System, 150 South Huntington Ave, Boston, MA, 02130, USA.
BMC Psychiatry. 2022 Apr 21;22(1):283. doi: 10.1186/s12888-022-03935-x.
Depression is under-recognized in Black men, who are less likely to seek or have access to psychiatric treatment. Resistance training (RT; i.e., weight lifting) can improve depressive symptoms and may be more acceptable to Black men, but its effects have not been examined for Black men with depressive symptoms.
Fifty Black men with depressive symptoms were randomized to either (a) 12 weeks of RT (coupled with Behavioral Activation techniques to promote adherence) or (b) an attention-control group (Health, Wellness, and Education; HWE). Both groups met twice/week for 12 weeks, and follow-up assessments were done at end-of-treatment (EOT) and 6 months after enrollment. Changes in physical activity and muscular strength were collected as a manipulation check. The primary outcome was interviewer assessed symptoms of depression using the Quick Inventory of Depression Symptomology (QIDS). Secondary outcomes included self-reported depressive symptoms, anxiety, and stress. The association between change in QIDS from baseline to EOT and concurrent changes in physical activity and muscular strength in the RT group were explored as an initial assessment of mechanism. Longitudinal mixed effects regression models with subject-specific intercepts were used to examine intervention effects.
A sample with high rates of medical comorbidities (e.g., 44% HIV positive), substance use (e.g., 34% smoking), and negative social determinates of health (e.g., 50% unemployed) was enrolled. Recruitment, engagement, and retention data indicate that the intervention and design were feasible. The RT group showed greater gains in self-reported exercise (b = 270.94, SE = 105.69, p = .01) and muscular strength (b = 11.71, SE = 4.23, p = .01 for upper body and b = 4.24, SE = 2.02, p = .04 for lower body) than the HWE group. The RT group had greater reductions in QIDS scores at both EOT (b = -3.00, SE = 1.34, p = .01) and 6 months (b = -2.63, SE = 1.81, p = .04). The RT group showed a greater reduction in anxiety at EOT (b = -2.67, SE = 1.06, p = .02). Findings regarding self-reported depressive symptoms and stress were non-significant, but in the expected direction with effect sizes in the small to medium range. In the RT group, improvement on the QIDS between baseline and EOT was associated with concurrent improvements in physical activity (b = 21.03, SE = 11.16, p = .02) and muscular strength (b = 1.27, SE = .44, p = .03 for upper body and b = .75, SE = .14, p = .03 for lower body).
Results suggest that RT is feasible and may be efficacious for reducing depressive symptoms among underserved urban Black men.
ClinicalTrial.gov #: NCT03107039 (Registered 11/04/2017).
黑人男性中抑郁的识别率较低，他们寻求或获得精神科治疗的可能性较小。阻力训练（RT；即举重）可以改善抑郁症状，可能更受黑人男性的欢迎，但尚未研究过 RT 对有抑郁症状的黑人男性的影响。
50 名有抑郁症状的黑人男性被随机分配到（a）12 周的 RT（结合行为激活技术以促进依从性）或（b）对照组（健康、健康和教育；HWE）。两组均每两周会面一次，共 12 周，随访评估在治疗结束时（EOT）和入组后 6 个月进行。收集身体活动和肌肉力量的变化作为操作检查。主要结果是使用快速抑郁症状清单（QIDS）访谈评估抑郁症状。次要结果包括自我报告的抑郁症状、焦虑和压力。探索 RT 组从基线到 EOT 时 QIDS 的变化与同期身体活动和肌肉力量变化之间的关系，作为对机制的初步评估。使用具有个体特定截距的纵向混合效应回归模型来检查干预效果。
招募了具有较高医疗合并症（例如，44% HIV 阳性）、物质使用（例如，34%吸烟）和负面社会健康决定因素（例如，50%失业）的高比例的参与者。招募、参与和保留数据表明干预和设计是可行的。RT 组在自我报告的运动（b=270.94，SE=105.69，p=0.01）和肌肉力量（b=11.71，SE=4.23，p=0.01 用于上半身和 b=4.24，SE=2.02，p=0.04 用于下半身）方面的获益均大于 HWE 组。RT 组在 EOT 时（b=−3.00，SE=1.34，p=0.01）和 6 个月时（b=−2.63，SE=1.81，p=0.04）的 QIDS 评分降低更大。RT 组在 EOT 时焦虑程度降低（b=−2.67，SE=1.06，p=0.02）。关于自我报告的抑郁症状和压力的发现无统计学意义，但在预期的方向上，效应大小在小到中等范围内。在 RT 组中，基线和 EOT 之间 QIDS 的改善与同期身体活动（b=21.03，SE=11.16，p=0.02）和肌肉力量（b=1.27，SE=0.44，p=0.03 用于上半身和 b=0.75，SE=0.14，p=0.03 用于下半身）的改善相关。
结果表明，RT 对于减少服务不足的城市黑人男性的抑郁症状是可行且有效的。
ClinicalTrials.gov 编号：NCT03107039（2017 年 11 月 4 日注册）。
