抗抑郁药或跑步疗法：比较对抑郁症和焦虑症患者的身心健康的影响。

Antidepressants or running therapy: Comparing effects on mental and physical health in patients with depression and anxiety disorders.

机构信息

Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute & Amsterdam Neuroscience, Oldenaller 1, Amsterdam, the Netherlands.

出版信息

J Affect Disord. 2023 May 15;329:19-29. doi: 10.1016/j.jad.2023.02.064. Epub 2023 Feb 23.

DOI:10.1016/j.jad.2023.02.064

PMID:36828150

Abstract

BACKGROUND

Antidepressant medication and running therapy are both effective treatments for patients with depressive and anxiety disorders. However, they may work through different pathophysiological mechanisms and could differ in their impact on physical health. This study examined effects of antidepressants versus running therapy on both mental and physical health.

METHODS

According to a partially randomized patient preference design, 141 patients with depression and/or anxiety disorder were randomized or offered preferred 16-week treatment: antidepressant medication (escitalopram or sertraline) or group-based running therapy ≥2 per week. Baseline (T0) and post-treatment assessment at week 16 (T16) included mental (diagnosis status and symptom severity) and physical health indicators (metabolic and immune indicators, heart rate (variability), weight, lung function, hand grip strength, fitness).

RESULTS

Of the 141 participants (mean age 38.2 years; 58.2 % female), 45 participants received antidepressant medication and 96 underwent running therapy. Intention-to-treat analyses showed that remission rates at T16 were comparable (antidepressants: 44.8 %; running: 43.3 %; p = .881). However, the groups differed significantly on various changes in physical health: weight (d = 0.57; p = .001), waist circumference (d = 0.44; p = .011), systolic (d = 0.45; p = .011) and diastolic (d = 0.53; p = .002) blood pressure, heart rate (d = 0.36; p = .033) and heart rate variability (d = 0.48; p = .006).

LIMITATIONS

A minority of the participants was willing to be randomized; the running therapy was larger due to greater preference for this intervention.

CONCLUSIONS

While the interventions had comparable effects on mental health, running therapy outperformed antidepressants on physical health, due to both larger improvements in the running therapy group as well as larger deterioration in the antidepressant group.

TRIAL REGISTRATION

Trialregister.nl Number of identification: NTR3460.

摘要

背景

抗抑郁药物治疗和跑步疗法都是治疗抑郁和焦虑障碍患者的有效方法。然而，它们可能通过不同的病理生理机制发挥作用，并且对身体健康的影响可能不同。本研究旨在探讨抗抑郁药物与跑步疗法对心理健康和身体健康的影响。

方法

根据部分随机患者偏好设计，141 例抑郁和/或焦虑障碍患者被随机分配或提供首选的 16 周治疗：抗抑郁药物（依地普仑或舍曲林）或每周至少 2 次的基于小组的跑步疗法。基线（T0）和治疗 16 周后（T16）评估包括心理健康（诊断状态和症状严重程度）和身体健康指标（代谢和免疫指标、心率变异性、体重、肺功能、手握力、健康状况）。

结果

在 141 名参与者中（平均年龄 38.2 岁；58.2%为女性），45 名参与者接受抗抑郁药物治疗，96 名参与者接受跑步治疗。意向治疗分析显示，T16 时的缓解率相当（抗抑郁药物：44.8%；跑步：43.3%；p=0.881）。然而，两组在身体健康的各种变化上存在显著差异：体重（d=0.57；p=0.001）、腰围（d=0.44；p=0.011）、收缩压（d=0.45；p=0.011）和舒张压（d=0.53；p=0.002）、心率（d=0.36；p=0.033）和心率变异性（d=0.48；p=0.006）。