Effects of adjunctive exercise on physiological and psychological parameters in depression: A randomized pilot trial

Kerling, Arno; Tegtbur, Uwe; Gützlaff, E.; Kück, Momme; Borchert, Luise; Ateş, Zeynep; Bohlen, Anne von; Frieling, Helge; Hüper, Katja; Hartung, Dagmar; Schweiger, Ulrich; Kahl, Kai G.

doi:10.1016/j.jad.2015.01.006

Cited by 80 publications

(61 citation statements)

References 42 publications

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“…The duration of the interventions ranged from 10 days to 6 months, the frequency from daily to twice a week. Across the interventional studies, 50 …”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Our review identified 23 studies and found: (1) cardiorespiratory fitness in people with SMI is, irrespective of the diagnosis, significantly impaired compared with ageand sex-matched healthy controls, (2) first-episode status and inpatient setting were the most important moderators for better fitness levels, and (3) aerobic exercise significantly increased cardiorespiratory fitness, which was significantly better than control conditions. Exercise participation resulted in a pooled mean increase in predicted VO 2 max or VO 2 peak of 2.95 mL/kg/min (95 % CI [41] 0.468 0.156 0.779 0.003 Krogh et al [33] 0.453 0.282 0.625 0.000 Krogh et al [29] 0.442 0.269 0.615 0.000 Rosenbaum et al [45] 0.427 -0.047 0.901 0.077 Kerling et al [50] 0.411 0.145 0.677 0.002 Bredin et al [39] 0 2.21-3.69 mL/kg/min, p \ 0.001). Such improvements in cardiorespiratory fitness are of high clinical relevance.…”

Section: General Findingsmentioning

confidence: 99%

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Cardiorespiratory Fitness in Severe Mental Illness: A Systematic Review and Meta-analysis

et al. 2016

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Background Cardiorespiratory fitness (CRF) among people with severe mental illness (SMI) (i.e., schizophrenia, bipolar disorder, and major depressive disorder) is a critical clinical risk factor given its relationship to cardiovascular disease and premature mortality.Objectives This study aimed to: (1) investigate the mean CRF in people with SMI versus healthy controls; (2) explore moderators of CRF; and (3) investigate whether CRF improved with exercise interventions and establish if fitness improves more than body mass index following exercise interventions. Methods Major electronic databases were searched systematically. A meta-analysis calculating Hedges' g statistic was undertaken.Results Across 23 eligible studies, pooled mean CRF was 28.7 mL/kg/min [95 % confidence interval (CI) 27.3 to 30.0 mL/kg/min, p\0.001, n = 980]. People with SMI had significantly lower CRF compared with controls (n = 310) (Hedges' g = -1.01, 95 % CI -1.18 to -0.85, p \ 0.001). There were no differences between diagnostic subgroups. In a multivariate regression, first-episode (b = 6.6, 95 % CI 0.6-12.6) and inpatient (b = 5.3, 95 % CI 1.6-9.0) status were significant predictors of higher CRF. Exercise improved CRF (Hedges' g = 0.33, 95 % CI = 0.21-0.45, p = 0.001), but did not reduce body mass index. Higher CRF improvements were observed following interventions at high intensity, with higher frequency (at least three times per week) and supervised by qualified personnel (i.e., physiotherapists and exercise physiologists). Conclusion The multidisciplinary treatment of people with SMI should include a focus on improving fitness to reduce all-cause mortality. Qualified healthcare professionals supporting people with SMI in maintaining an active lifestyle should be included as part of multidisciplinary teams in mental health treatment.

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“…The duration of the interventions ranged from 10 days to 6 months, the frequency from daily to twice a week. Across the interventional studies, 50 …”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Section: General Findingsmentioning

confidence: 99%

Cardiorespiratory Fitness in Severe Mental Illness: A Systematic Review and Meta-analysis

et al. 2016

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Section: Introductionmentioning

confidence: 99%

“…The duration of the exercise period varied from 10 days (Knubben et al, 2007; Legrand and Neff, 2016), to 6 weeks (Kerling et al, 2015), 10 weeks (Mather et al, 2002), 3 months (Mota-Pereira et al, 2011), 4 months (Carneiro et al, 2015), 6 months (Murri et al (2015), 8 months (Pilu et al, 2007), 12 months (Chalder et al, 2012), to throughout a hospitalization period (undefined time period) (Schuch et al, 2011, 2015). Control groups included antidepressants only (Mather et al, 2002; Pilu et al, 2007; Mota-Pereira et al, 2011; Schuch et al, 2011, 2015; Chalder et al, 2012; Carneiro et al, 2015; Kerling et al, 2015), light exercise with both exercise groups receiving antidepressants (Knubben et al, 2007; Legrand and Neff, 2016), and antidepressants only (Murri et al, 2015). The exercise mode included mostly aerobics (Knubben et al, 2007; Mota-Pereira et al, 2011; Schuch et al, 2011, 2015; Kerling et al, 2015; Murri et al, 2015; Legrand and Neff, 2016) or aerobic and strength (Pilu et al, 2007); aerobic, strength, and stretching exercises (Mather et al, 2002 ) ; aerobics and strength exercises, games and dancing (Carneiro et al, 2015), and facilitated physical activity chosen and performed individually by participants (Chalder et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Is the Comparison between Exercise and Pharmacologic Treatment of Depression in the Clinical Practice Guideline of the American College of Physicians Evidence-Based?

Netz

2017

Front. Pharmacol.

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Major depression disorder is most commonly treated with antidepressants. However, due to their side effects clinicians seek non-pharmacologic options, and one of these is exercise. The literature on the benefits of exercise for depression is extensive. Nevertheless, two recent reviews focusing on antidepressants vs. other therapies as a basis for clinical practice guidelines recommended mainly antidepressants, excluding exercise as a viable choice for treatment of depression. The aim of this perspective is to analyze the literature exploring the reasons for this discrepancy. Two categories of publications were examined: randomized controlled trials (RCTs) and meta-analyses or systematic reviews. Based on this reassessment, RCTs comparing exercise to antidepressants reported that exercise and antidepressants were equally effective. RCTs comparing exercise combined with antidepressants to antidepressants only reported a significant improvement in depression following exercise as an adjunctive treatment. Almost all the reviews examining exercise vs. other treatments of depression, including antidepressants, support the use of exercise in the treatment of depression, at least as an adjunctive therapy. The two reviews examining pharmacologic vs. non-pharmacologic therapies as a basis for clinical practice guidelines examined limited evidence on exercise vs. antidepressants. In addition, it is possible that academics and health care practitioners are skeptical of viewing exercise as medicine. Maybe, there is a reluctance to accept that changes in lifestyle as opposed to pharmacological treatment can alter biological mechanisms. Longitudinal studies are needed for assessing the effectiveness of exercise in real clinical settings, as well as studies exploring dose-response relationship between exercise and depression.

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“…Some of the studies carried out so far on the effect of adding aerobic exercise to the usual medical treatment protocol (the use of antidepressants and ECT) compared with only usual medical treatment showed a significant improvement in the rate of depression in the exercise groups [7] [8] [9] [10] [11]. According to Dunn, Trivedi, Kampert, Clark, & Chambliss [12], an important point here is that the use of high intensity exercise (75% -85% HR max ) is not plausible in patients with depression and does not agree with the public health recommendations.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Aerobic Exercise on Different Symptoms of Depression: An Investigation of Psychological Mechanisms of Stress and Coping

Askari¹,

Kakhki²,

Taheri³

et al. 2017

OJMP

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Objectives: Considering the growing need for encouraging greater use of a variety of non-pharmacological methods in treating depression, the aim of this quasi experimental study was to examine the effect of aerobic exercise on triple categories of affective, cognitive and somatic symptoms of depression and to investigate its psychological mediators of perceived stress and coping strategies. Methods: Forty five female outpatients with major depressive disorder were divided into three groups including exercise + usual pharmacotherapy (n = 15), psychotherapy + usual pharmacotherapy (n = 14) and a control group receiving only usual pharmacotherapy (n = 16). The exercise used was included 36 one hour session (three sessions per week) with a low to medium intensity of 50% to 70% of the maximal heart rate. The psychotherapy used in this study was the behavioral activation treatment for depression revised. The Persian version of Beck Depression Inventory-II, Perceived Stress Scale and Coping Inventory for Stressful Situations were applied to assess the pre-and post-intervention depression, perceived stress, and coping strategies. Results: The findings indicated a significant decrease in the post-intervention scores of all three categories of affective, cognitive and somatic symptoms of depression and the perceived stress level in the adjunctive exercise and psychotherapy conditions compared with the control condition (p = 0.001), but there was no significant difference between the exercise and psychotherapy groups. In addition, no significant improvement was observed regarding the problem-centered, emotion-centered and avoidant-centered stress coping methods in the post-intervention scores of the exercise group compared with the control group. Conclusion: An adjunctive aerobic exercise program can be as effective as adding the psychotherapy to usual pharmacotherapy in further imHow to cite this paper: Askari, J., Saberi-Kakhki, A., Taheri 87provement in all three categories of depression symptoms especially mediated by reducing the amount of perceived stress, but not through any significant change in cognitive-behavioral coping strategies.

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Effects of adjunctive exercise on physiological and psychological parameters in depression: A randomized pilot trial

Cited by 80 publications

References 42 publications

Cardiorespiratory Fitness in Severe Mental Illness: A Systematic Review and Meta-analysis

Cardiorespiratory Fitness in Severe Mental Illness: A Systematic Review and Meta-analysis

Is the Comparison between Exercise and Pharmacologic Treatment of Depression in the Clinical Practice Guideline of the American College of Physicians Evidence-Based?

The Effect of Aerobic Exercise on Different Symptoms of Depression: An Investigation of Psychological Mechanisms of Stress and Coping

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