Research & Development Service, VA Boston Healthcare System, Boston, MA, USA.
Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
Ann Behav Med. 2023 Sep 13;57(10):855-865. doi: 10.1093/abm/kaad026.
Depression is known to limit physical activity (PA) among individuals with chronic obstructive pulmonary disease (COPD). However, whether and how depression influences the effectiveness of PA interventions is unknown.
The study examined the association between baseline depression symptoms and change in daily step count and whether group assignment to a web-based, pedometer-mediated PA intervention moderated the association between baseline depression symptoms and change in daily step count.
Secondary analysis included two cohorts of U.S. Veterans with COPD (n = 212; 97% male; mean age 69 ± 8 years) assessed at baseline and 3 months. Cohorts 1 and 2 were randomly assigned to the same PA intervention (n = 111) or a control group (n = 101). Multivariate regressions tested the main effects of baseline depression symptoms (BDI-II total and cognitive-affective and somatic subscales) on change in daily steps, as well as the interaction between baseline BDI-II and subscales and group assignment on change in daily steps.
Greater BDI-II total score (B = -31.8, SE = 14.48, p = .030) and somatic subscale scores (B = -99.82, SE = 35.76, p = .006) were associated with less improvement in daily step count. There was a significant interaction between baseline cognitive-affective subscale and the intervention predicting change in daily step count (B = -88.56, SE = 42.31, p = .038). When cognitive-affective subscale scores were ≥1 SD above the mean, the intervention was no longer associated with an increase in daily step count (p = .585).
Depression should be routinely assessed and targeted as part of PA promotion efforts.
抑郁症已知会限制患有慢性阻塞性肺疾病（COPD）的个体的身体活动（PA）。然而，抑郁症是否以及如何影响 PA 干预的效果尚不清楚。
本研究探讨了基线抑郁症状与每日步数变化之间的关系，以及是否将基于网络的计步器介导的 PA 干预分组分配到基线抑郁症状与每日步数变化之间的关系。
二次分析包括美国 COPD 退伍军人的两个队列（n=212；97%为男性；平均年龄 69±8 岁），在基线和 3 个月时进行评估。队列 1 和 2 被随机分配到相同的 PA 干预组（n=111）或对照组（n=101）。多元回归检验了基线抑郁症状（BDI-II 总分和认知-情感和躯体子量表）对每日步数变化的主要影响，以及基线 BDI-II 和子量表与分组分配对每日步数变化的交互作用。
BDI-II 总分（B=-31.8，SE=14.48，p=.030）和躯体子量表评分（B=-99.82，SE=35.76，p=.006）与每日步数的改善程度呈负相关。基线认知-情感子量表与干预预测每日步数变化之间存在显著的交互作用（B=-88.56，SE=42.31，p=.038）。当认知-情感子量表得分高于平均水平 1 个标准差时，干预与每日步数的增加不再相关（p=.585）。
应常规评估抑郁，并将其作为 PA 促进工作的一部分进行针对性治疗。
