Integrating physical activity into the treatment of depression in adults: A qualitative enquiry

Abstract

Around 246 million people globally suffer from depression. Physical activity (PA) can reduce the risk of depression by 30% and is recognised as an effective treatment for mild‐to‐moderate depression (MMD). However, a high proportion of patients with MMD are currently inactive and the implementation of PA as an adherent treatment for MMD is not well understood. This study contributes to a growing body of research exploring how to support people who are experiencing MMD to increase their PA levels (i.e. initiation and maintenance). It investigated which factors individuals with MMD perceived to be important for integrating PA into the treatment of depression in adults. In‐depth interviews were carried out with individuals with MMD (N = 6), and data were analysed using thematic analysis. Two main theories of social capital that of Bourdieu and Putnam informed the discussion of findings. The initiation and maintenance of PA were linked to individual factors including health (i.e. nature of depression; comorbidities); abilities and tastes; socioeconomic status (e.g. financial position) and positive encouragement. In addition, maintenance emerged as dependent upon the choice, enjoyment, and meaningfulness of PA itself, and, for those who engaged in group PA, on social capital. PA interventions need to be personalised. This goes beyond a simple exercise prescription based on functional ability, but instead takes into account the needs, desires and capabilities of the whole person. The nature of MMD, the wider physical and socio‐economic context and the social capital that is available to the individual also need to be harnessed.

Step away from depression—results from a multicenter randomized clinical trial with a pedometer intervention during and after inpatient treatment of depression

“…Adherence problems were reported already in other PA trials with depressive patients [66,67]. Therefore, our results are in line with other researchers suggesting that adherence to PA interventions should be supported by behavior change interventions [28,[68][69][70][71]. For instance, developing concrete action plans, barrier management and working with situational cues might be useful adherenceincreasing strategies to be implemented in PA interventions.…”

“…This is in line with studies showing that patients need more support to maintain motivation and to develop volitional strategies [84,85]. Regular supervision of the program would be promising [23,68] and patients of our study made this wish (see Supplementary Materials S10). Additionally, emotional reactions [86] and smartphone use as a tool option [87] should be considered.…”