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评估基于运动的干预措施对具有跨诊断抑郁症状人群功能的影响:随机对照试验的系统评价。

Evaluating the effect of exercise-based interventions on functioning in people with transdiagnostic depressive symptoms: A systematic review of randomised controlled trials.

机构信息

Department of Psychiatry and Forensic Medicine, Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Mental Health Research Group, Hospital del Mar Research Institute, Barcelona, Spain; Centre for Biomedical Research in Mental Health Network (CIBERSAM), Madrid, Spain.

Mental Health Research Group, Hospital del Mar Research Institute, Barcelona, Spain; Department of Psychology, School of Medicine and Health Sciences, Carl von Ossietzky University, Oldenburg, Germany.

出版信息

J Affect Disord. 2024 Apr 15;351:231-242. doi: 10.1016/j.jad.2024.01.191. Epub 2024 Jan 24.


DOI:10.1016/j.jad.2024.01.191
PMID:38278328
Abstract

BACKGROUND: Depressive symptoms are associated with various conditions and can exacerbate the outcome of somatic diseases. Transdiagnostic symptom-based approaches provide treatment flexibility, and exercise has demonstrated benefits beyond clinical symptoms. This work aimed to synthesise and establish the effects of exercise-based interventions on global functioning and quality of life in adults with transdiagnostic depressive symptoms, as well as their impact on clinical symptoms. METHODS: A systematic review was conducted following PRISMA guidelines. PubMed, Scopus and PsycINFO databases were searched from inception to April 2023. Eligibility criteria included randomised controlled trials involving adults with transdiagnostic depressive symptoms who received exercise-based interventions and provided details of the interventions. Comparators included treatment as usual or other active control groups. The Cochrane quality assessment tool was used for quality assessment. RESULTS: Fifteen articles involving 2064 participants were included. Data on study design, sample, intervention characteristics, and outcomes were extracted. Several trials demonstrated the expected positive effects of exercise on functioning (7/15). Most results supported the benefits of adjunctive exercise interventions on illness outcomes. LIMITATIONS: The studies had methodological limitations, including small sample sizes and an underrepresentation of somatic diseases. CONCLUSIONS: The functional consequences of exercise-based interventions targeting depressive symptoms are often understudied. Incorporating exercise routinely as an add-on treatment for transdiagnostic depressive symptoms could improve overall functioning, quality of life, and symptom severity. There is a need to expand the focus of exercise-based interventions to incorporate functional outcomes. Future research should address the methodological limitations and include a wider range of participants, including those with somatic diseases.

摘要

背景:抑郁症状与各种疾病有关,并可能使躯体疾病的预后恶化。基于症状的跨诊断方法提供了治疗的灵活性,而运动已被证明除了临床症状之外还有益处。本研究旨在综合评估并确定基于运动的干预措施对患有跨诊断抑郁症状的成年人的整体功能和生活质量的影响,以及对临床症状的影响。

方法:按照 PRISMA 指南进行系统综述。从建库至 2023 年 4 月,检索了 PubMed、Scopus 和 PsycINFO 数据库。纳入标准包括:涉及接受基于运动的干预措施且详细描述干预措施的患有跨诊断抑郁症状的成年人的随机对照试验;对照组包括常规治疗或其他活性对照组。使用 Cochrane 质量评估工具进行质量评估。

结果:纳入了 15 篇文章,涉及 2064 名参与者。提取了研究设计、样本、干预特征和结局的数据。几项试验表明运动对功能有预期的积极影响(7/15)。大多数结果支持辅助运动干预对疾病结局的益处。

局限性:这些研究存在方法学局限性,包括样本量小且躯体疾病代表性不足。

结论:针对抑郁症状的基于运动的干预措施的功能后果往往研究不足。将运动常规纳入跨诊断抑郁症状的附加治疗可能会改善整体功能、生活质量和症状严重程度。需要扩大基于运动的干预措施的重点,纳入功能结局。未来的研究应解决方法学上的局限性,并纳入更广泛的参与者,包括患有躯体疾病的参与者。

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