Improving physical quality of life with group physical activity in the adjunctive treatment of major depressive disorder

Clinical Practice and Epidemiology in Mental Health - Tập 4 - Trang 1-6 - 2008
Mauro Giovanni Carta1,2, Maria Carolina Hardoy1,2, Alessandra Pilu1,3, Manlio Sorba1, Anna Laura Floris1,2, Francesca Ada Mannu1,2, Antonia Baum4, Alessandra Cappai1, Claudio Velluti3, Massimiliano Salvi3
1Department of Public Health, University of Cagliari, Cagliari, Italy and University Center for Research and Clinical Practice in Mental Health, University of Cagliari (Cagliari) and ASL 7 Iglesias (Iglesias), Italy
2Italian Society of Sport Psychiatry, Cagliari, Italy
3Orthopaedic Clinic, University of Cagliari, Cagliari, Italy
4Department of Psychiatry, Fairfax Hospital, Falls Church, USA

Tóm tắt

The aim of the study was to compare the change in quality of life over 32 weeks in depressed women assuming antidepressant drug with (experimental group) or without (control group) physical exercise from a study which results on objective dimension of outcome were already published. Trial with randomized naturalistic control. Patients selected from the clinical activity registries of a Psychiatric University Unit. Inclusion criteria: female, between 40 and 60 years, diagnosis of Major Depressive Disorders (MMD, DSM-IV TR) resistant to ongoing treatment. Exclusion criteria: diagnosis of psychotic disorders; any contraindications to physical activity. 30 patients (71.4% of the eligible) participated to the study. Cases: 10 randomized patients undergoing pharmacological treatment plus physical activity. Controls: 20 patients undergoing only pharmacological therapy. Quality of life was measured by means of WHOQOL-Bref. The patients that made physical activity had their WHOQOL-Bref physical score improved from T0 to T8, the differences was statistically significant. In the control group WHOQOL-Bref physical remains the same and, consequentially, the difference between T0 and T8 do not reach any statistical significance. The perceived quality of life in the other domains did not change during the treatment in both groups. Thus no other differences were found between and within groups. The data presented in the previous paper found that physical activity seems a good adjunctive treatment in the long term management of patients with MDD. These new data indicated that physical activity may also improve the perceived physical quality of life. The dimensions related with social functioning, environment and psychical well being seem do not improved, unexpectedly, during the trial. Two objective dimension not strictly related to the depressive symptoms improved: social functioning and Clinical Global Impression, this discrepancy with a subjective and objective dimension of the well being may supported the Goldberg point of view that subjective quality of life in bipolar and unipolar severe depression patients may not accurately reflect objective functional outcome status, potentially due to diminished insight, demoralization, or altered life expectations over time. It may be that physical activity improve the self perception of physical well being. The physical domains of WHOQOL-Bref inquiry about conditions as sleep, pain, energy, body satisfaction that seems frequently problematic also in remission due to the pharmacotherapy and may be risk factor for relapse/recurrence. Thus physical therapy seems to determinate improvement in depressive aspects not frequently responsive to the drug treatment.

Tài liệu tham khảo

Fava GA, Ruini C: Long-Term treatment of depression: there is more than drugs. Recent Prog Med. 2002, 93 (6): 343-5.

Trivedi MH, Greer TL, Grannemann BD, Chambliss HO, Jordan AN: Exercise as an augmentation strategy for treatment of major depression. J Psychiatr Pract. 2006, 12: 205-13. 10.1097/00131746-200607000-00002.

Pilu A, Sorba M, Hardoy MC, Floris AL, Mannu FA, Seruis ML, Velluti C, Carpiniello B, Salvi M, Carta MG: Efficacy of physical activity in the adjunctive treatment of major depressive disorders: preliminary results. Clinical Practice and Epidemiology in Mental Health. 2007, 3: 8-10.1186/1745-0179-3-8.

Aigner M, Förster-Streffleur S, Prause W, Freidl M, Weiss M, Bach M: What does the WHOQOL-Bref measure? Measurement overlap between quality of life and depressive symptomatology in chronic somatoform pain disorder. Soc Psychiatry Psychiatr Epidemiol. 2006, 41 (1): 81-6. 10.1007/s00127-005-0997-8.

Hays RD, Wells KB, Sherbourne CD, Rogers W, Spritzer K: Functioning and well-being outcomes of patients with depression compared with chronic general medical illnesses. Arch Gen Psychiatry. 1995, 52: 11-19.

Diehr PH, Derleth AM, McKenna SP, Martin ML, Bushnell DM, Simon G, Patrick DL: Synchrony of change in depressive symptoms, health status, and quality of life in persons with clinical depression: Health and Quality of Life Outcomes. 2006, 4: 27-

American Psychiatric Association: Diagnostic and statistical manual of mental disorders, 4th edition, text revision (DSM-IV TR). 2000, Washington DC; American Psychiatric Press

First MB, Spitzer RL, Gibbon M, Williams JBW: Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition. (SCID-I/P). 2002, New York: Biometrics Research, New York State Psychiatric Institute

Hamilton M: A rating scale for depression. J Neurol Neurosurg Psychiat. 1960, 23: 56-62.

Guy W: Clinical Global Impression. ECDEU Assessment Manual for Psychopharmacology, revised. 1976, Rockville MD: US Department of Health Education and Welfare, 217-222.

American Psychiatric Association: Global Assessment of Functioning Scale (GAF). Asse V. American Psychiatric Association. Diagnostic and Statistical manual for Mental Disorders. (DSM IV). 1994, Washington DC; American Psychiatric Press, Fourth

World Health Organization: WHOQOL-Bref: Introduction, administration, scoring and assessment of the generic version. field trial version. 1996, Geneva: World Health Organization

World Health Organization: The World Health Organization Quality of Life assessment (WHOQOL) position paper from the World Health Organization. Soc Sci Med. 1995, 1403-1409.

World Health Organization: Development of the World Health Organization WHOQOL-Bref Quality of Life Assessment. The WHOQOL Group Psychol Med. 1998, 28: 551-558.

De Girolamo G, Rucci P, Scocco P, Becchi A, Coppa F, D'Addario A, Daru E, De Leo D, Galassi L, Mangelli L, Marson C, Neri G, Soldani L: Quality of life assessment: validation of the Italian version of the WHOQOL-Bref. Epidemiol Psichiatr Soc. 2000, 9: 45-55.

Goldberg JF, Harrow M: Subjective life satisfaction and objective functional outcome in bipolar and unipolar mood disorders: a longitudinal analysis. J Affect Disord. 2005, 89 (1–3): 79-89. 10.1016/j.jad.2005.08.008.

Moos RH, Cronkite RC: Symptom-based predictors of a 10-year chronic course of treated depression. J Nerv Ment Dis. 1999, 187 (6): 360-368. 10.1097/00005053-199906000-00005.

Sarbadhikari S, Saha A: Moderate exercise and chronic stress produce counteractive effects on different areas of the brain by acting through various neurotransmitter receptor subtypes: a hypothesis. Theor Biol Med Model. 2006, 23: 3-33.

Lobstein DD, Ismael AH, Rasmussen CL: Decreases in resting plasma beta-endorphin and depression scores after endurance training. J Sports Med Phys Fitness. 1991, 31 (4): 543-551.

Blumenthal JA, Babyak MA, Moore KA, Craighead WE, Herman S, Khatri P, Waugh R, Napolitano MA, Forman LM, Appelbaum M, Doraiswamy PM, Krishnan KR: Effects of Exercise Training on older Patient With Major Depression. Arch Intern Med. 1999, 159: 2349-2356. 10.1001/archinte.159.19.2349.

Brosse AL, Sheets ES, Lett HS, Blumenthal JA: Exercise and the treatment of clinical depression in adults: recent findings and future directions. Sports Med. 2002, 32: 741-760. 10.2165/00007256-200232120-00001.

Gullete ED, Blumenthal JA: Exercise Theraphy for the prevention and Treatment of depression. J Prac Psych And Behav Hlth. 1999, 5: 263-271.

Pennix BH, Rejeski WJ, Pandya J: Exercise and depression symptoms: A comparison of Aerobic and Resistance Exercise Effects on Emotional and Physical Function in Older Persons With High and Low Depressive Syntomatology. Journal of Gerontology: Psychological Sciences. 57B, No 2: 124-132.

Paizanis E, Hamon M, Lanfumey L: Hippocampal neurogenesis, depressive disorders, and antidepressant therapy. Neural Plast. 2007, 737-754.

Trejo JL, Llorens-Martín MV, Torres-Alemán I: The effects of exercise on spatial learning and anxiety-like behavior are mediated by an IGF-I-dependent mechanism related to hippocampal neurogenesis. Mol Cell Neurosci. 2007, 5-

Thông tin
Thông tin xuất bản

Clinical Practice and Epidemiology in Mental Health

Tập 4

1-6

Thông tin tác giả