Top

Sport Sciences for Health

Published in:

01-06-2020 | Affective Disorder | Original Article

The effect of aerobic exercise on various symptoms of depression: the mediating role of quality of life

Authors: Jafar Askari, Alireza Saberi-Kakhki, Hamidreza Taheri, Seyyed Mojtaba Yassini, Afsaneh Hassanbeigi

Published in: Sport Sciences for Health | Issue 2/2020

Abstract

Purpose

The aim of this study is to assess the effect of aerobic exercise on the three categories of somatic, affective and cognitive symptoms of depression, and to evaluate the mediating role of quality of life (QOL) domains on this effectiveness.

Methods

Thirty-one female outpatients suffering from major depressive disorder aged 20-50 years were divided into intervention (n = 15) and control (n = 16) groups. The intervention group received an aerobic exercise program consisting of 36 one-hour sessions, three times a week in the gym with an intensity of 50–70% maximum heart rate and the control group received only routine treatment. Beck Depression Inventory-II and the World Health Organization Quality of Life-BREF questionnaire were used.

Results

Post-intervention results showed a significant reduction in the intensity of the three somatic (p < 0.001), affective (p < 0.001) and cognitive (p < 0.013) symptoms of depression and a significant improvement in the psychological health (p < 0.002) and social relationships (p < 0.003) domains of QOL in the intervention group compared with the control group. No significant difference was found in other domains of QOL between the two groups.

Conclusions

Aerobic exercise, as a multi-dimensional adjunctive treatment along with routine care, can further improve all three categories of somatic, affective, and cognitive symptoms of depression, especially by enhancing the psychological health and social relationships domains of QOL.

Zeng Q, Xu Y, Wang WC (2013) Quality of life in outpatients with depression in China. J Affect Disord 150:513–521. https://doi.org/10.1016/j.jad.2013.04.052 CrossRefPubMed

American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders (DSM-V), 5th edn. American Psychiatric Publishing, ArlingtonCrossRef

Ranjbar E, Memari AH, Hafizi S, Shayestehfar M, Mirfazeli FS, Eshghi MA (2015) Depression and exercise: a clinical review and management guideline. Asian J Sports Med 6(2):e24055. https://doi.org/10.5812/asjsm.6(2)2015.24055 CrossRefPubMedPubMedCentral

Willey JZ, Paik MC, Sacco R, Elkind MSV, Boden-Albala B (2010) Social determinants of physical inactivity in the Northern Manhattan Study (NOMAS). J Community Health 35(6):602–608. https://doi.org/10.1007/s10900-010-9249-2 CrossRefPubMedPubMedCentral

Schuch FB, Vasconcelos-Moreno MP, Borowsky C, Zimmermann AB, Rocha NS, Fleck MP (2015) Exercise and severe major depression: effect on symptom severity and quality of life at discharge in an inpatient cohort. J Psychiatry Res 61:25–32. https://doi.org/10.1016/j.jpsychires.2014.11.005 CrossRef

Nemeroff CB (2007) The burden of severe depression: a review of diagnostic challenges and treatment alternatives. J Psychiatry Res 41:189–206. https://doi.org/10.1016/j.jpsychires.2006.05.008 CrossRef

Pilu A, Sorba M, Hardoy M, Floris A, Mannu F, Seruis M, Velluti C, Carpiniello B, Salvi M, Carta M (2007) Efficacy of physical activity in the adjunctive treatment of major depressive disorders: preliminary results. Clin Pract Epidemiol Ment Health 3(1):8. https://doi.org/10.1186/1745-0179-3-8 CrossRefPubMedPubMedCentral

Mota-Pereira J, Silverio J, Carvalho S, Ribeiro JC, Fonte D, Ramos J (2011) Moderate exercise improves depression parameters in treatment-resistant patients with major depressive disorder. J Psychiatry Res 45(8):1005–1011. https://doi.org/10.1016/j.jpsychires.2011.02.005 CrossRef

Mura G, Moro MF, Patten SB, Carta MG (2014) Exercise as an add-on strategy for the treatment of major depressive disorder: a systematic review. CNS Spectr 19:1–13. https://doi.org/10.1017/s1092852913000953 CrossRef

10.

Stanton R, Reaburn P (2014) Exercise and the treatment of depression: a review of the exercise program variables. J Sci Med Sport 17:177–182. https://doi.org/10.1016/j.jsams.2013.03.010 CrossRefPubMed

11.

Edwards MK, Loprinzi PD (2016) Effects of a sedentary behavior-inducing randomized controlled intervention on depression and mood profile in active young adults. Mayo Clin Proc 91:984–998. https://doi.org/10.1016/j.mayocp.2016.03.021 CrossRefPubMed

12.

Hallgren M, Stubbs B, Vancampfort D, Lundin A, Jaakallio P, Forsell Y (2017) Treatment guidelines for depression: greater emphasis on physical activity is needed. Eur Psychiatry 40:1–3. https://doi.org/10.1016/j.eurpsy.2016.08.011 CrossRefPubMed

13.

Sylvia LG, Friedman ES, Kocsis JH, Bernstein EE, Brody BD, Kinrys G, Kemp DE, Shelton RC, McElroy SL, Bobo WV, Kamali M, McInnis MG, Tohen M, Bowden CL, Ketter TA, Deckersbach T, Calabrese JR, Thase ME, Reilly-Harrington NA, Singh V, Rabideau DJ, Nierenberg AA (2013) Association of exercise with quality of life and mood symptoms in a comparative effectiveness study of bipolar disorder. J Affect Disord 151:722–727. https://doi.org/10.1016/j.jad.2013.07.031 CrossRefPubMed

14.

Danielsson L, Papoulias I, Petersson EL, Carlsson J, Waern M (2014) Exercise or basic body awareness therapy as add-on treatment for major depression: a controlled study. J Affect Disord 168:98–106. https://doi.org/10.1016/j.jad.2014.06.049 CrossRefPubMed

15.

Morres ID, Hatzigeorgiadis A, Stathi A, Comoutos N, Arpin-Cribbie C, Krommidas C, Theodorakis Y (2019) Aerobic exercise for adult patients with major depressive disorder in mental health services: a systematic review and meta-analysis. Depress Anxiety 36:39–53. https://doi.org/10.1002/da.22842 CrossRefPubMed

16.

Veale D, Le Fevre K, Pantelis C, de Souza V, Mann A, Sargeant A (1992) Aerobic exercise in the adjunctive treatment of depression: a randomized controlled trial. J R Soc Med 85(9):541–544. https://doi.org/10.1177/014107689208500910 CrossRefPubMedPubMedCentral

17.

Kerse N, Hayman KJ, Moyes SA, Peri K, Robinson E, Dowell A, Kolt GS, Elley CR, Hatcher S, Kiata L, Wiles J, Keeling S, Parsons J, Arroll B (2010) Home-based activity program for older people with depressive symptoms: DeLLITE—a randomized controlled trial. Ann Fam Med 8:214–223CrossRef

18.

Murri MB, Ekkekakis P, Menchetti M, Neviani F, Trevisani F, Tedeschi S, Latessa PM, Nerozzi E, Ermini G, Zocchi D, Squatrito S, Toni G, Cabassi A, Neri M, Zanetidou S, Amore M (2018) Physical exercise for late-life depression: effects on symptom dimensions and time course. J Affect Disord 230:65–70. https://doi.org/10.1016/j.jad.2018.01.004 CrossRefPubMed

19.

Schuch FB, Vancampfort D, Rosenbaum S, Richards J, Ward PB, Stubbs B (2016) Exercise improves physical and psychological quality of life in people with depression: a meta-analysis including the evaluation of control group response. Psychiatry Res 241:47–54. https://doi.org/10.1016/j.psychres.2016.04.054 CrossRefPubMed

20.

Ra JS, Gang M (2016) Depression moderates between physical activity and quality of life in low-income children. Appl Nurs Res 29:18–22. https://doi.org/10.1016/j.apnr.2015.06.004 CrossRef

21.

Atlantis E, Chow CM, Kirby A, Fiatarone SM (2004) An effective exercise-based intervention for improving mental health and quality of life measures: a randomized controlled trial. Prev Med 39:424–434. https://doi.org/10.1016/j.ypmed.2004.02.007 CrossRefPubMed

22.

Joseph RP, Royse KE, Benitez TJ, Pekmezi DW (2014) Physical activity and quality of life among university students: exploring self-efficacy, self-esteem, and affect as potential mediators. Qual Life Res 23:661–669. https://doi.org/10.1007/s11136-013-0492-8 CrossRef

23.

Heesch KC, van Gellecum YR, Burton NW, van Uffelen JGZ, Brown WJ (2015) Physical activity, walking, and quality of life in women with depressive symptoms. Am J Prev Med 48:281–291. https://doi.org/10.1016/j.amepre.2014.09.030 CrossRefPubMed

24.

Aigner M, Forster-Streffleur S, Prause W, Freidl M, Weiss M, Bach M (2006) What does the WHOQOL-Bref measure? Measurement overlap between quality of life and depressive symptomatology in chronic somatoform pain disorder. Soc Psychiatry Psychiatr Epidemiol 41:81–86. https://doi.org/10.1007/s00127-005-0997-8 CrossRefPubMed

25.

Craft LL (2005) Exercise and clinical depression: examining two psychological mechanisms. Psychol Sport Exerc 6:151–171. https://doi.org/10.1016/j.psychsport.2003.11.003 CrossRef

26.

Tanaka H, Monahan KD, Seals DR (2001) Age-predicted maximal heart rate revisited. J Am Coll Cardiol 37:153–156. https://doi.org/10.1016/s0735-1097(00)01054-8 CrossRef

27.

American College of Sports Medicine (2010) ACSM’s guidelines for exercise testing and prescription, 8th edn. Wolters Kluwer/Lippincott Williams and Wilkins, Philadelphia

28.

Ghassemzadeh H, Mojtabai R, Karamghadiri N, Ebrahimkhani N (2005) Psychometric properties of a Persian-language version of the Beck Depression Inventory- Second edition: BDI-2-Persian. Depress Anxiety 21:185–192. https://doi.org/10.1002/da.20070 CrossRefPubMed

29.

Nedjat S, Montazeri A, Holakouie K, Mohammad K, Majdzadeh R (2008) Psychometric properties of the Iranian interview-administered version of the World Health Organization’s Quality of Life Questionnaire (WHOQOL-BREF): a population-based study. BMC Health Serv Res 8:61. https://doi.org/10.1186/1472-6963-8-61 CrossRefPubMedPubMedCentral

30.

Rethorst CD, Sunderajan P, Greer TL, Grannemann BD, Nakonezny PA, Carmody TJ, Trivedi MH (2013) Does exercise improve self-reported sleep quality in non-remitted major depressive disorder? Psychol Med 43:699–709. https://doi.org/10.1017/s0033291712001675 CrossRefPubMed

31.

Hoffman BM, Babyak MA, Sherwood A, Hill EE, Patidar SM, Doraiswamy PM, Blumenthal J (2009) Effects of aerobic exercise on sexual functioning in depressed adults. Ment Health Phys Act 2:23–28. https://doi.org/10.1016/j.mhpa.2008.12.001 CrossRef

32.

Zschucke E, Renneberg B, Dimeo F, Wüstenberg T, Ströhle A (2015) The stress-buffering effect of acute exercise: evidence for HPA axis negative feedback. Psychoneuroendocrinology 51:414–425CrossRef

33.

Garber MC (2017) Exercise as a stress coping mechanism in a pharmacy student population. Am J Pharm Educ 81(3):50. https://doi.org/10.5688/ajpe81350 CrossRefPubMedPubMedCentral

34.

Wijndaele K, Matton L, Duvigneaud N, Lefevre J, De Bourdeaudhuij I, Duquet W, Thomis M, Philippaerts RM (2007) Association between leisure time physical activity and stress, social support and coping: a cluster-analytical approach. Psychol Sport Exerc 8:425–440. https://doi.org/10.1016/j.psychsport.2006.08.001 CrossRef

35.

Compare A, Zarbo C, Shonin E, Van Gordon W, Marconi C (2014) Emotional regulation and depression: a potential mediator between heart and mind. Cardiovasc Psychiatry Neurol. https://doi.org/10.1155/2014/324374 CrossRefPubMedPubMedCentral

36.

Hearing CM, Chang WC, Szuhany KL, Deckersbach T, Nierenberg AA, Sylvia LG (2016) Physical exercise for treatment of mood disorders: a critical review. Curr Behav Neurosci Rep 3(4):350–359. https://doi.org/10.1007/s40473-016-0089-y CrossRefPubMedPubMedCentral

37.

Min JA, Yu JJ, Lee CU, Chae JH (2013) Cognitive emotion regulation strategies contributing to resilience in patients with depression and/or anxiety disorders. Compr Psychiatry 54(8):1190–1197. https://doi.org/10.1016/j.comppsych.2013.05.008 CrossRefPubMed

38.

Baune BT, Malhi GS, Morris G, Outhred T, Hamilton A, Das P, Bassett D, Berk M, Boyce P, Lyndon B, Mulder R, Parker G, Singh AB (2018) Cognition in depression: can we THINC-it better? J Affect Disord 225:559–562. https://doi.org/10.1016/j.jad.2017.08.080 CrossRefPubMed

39.

Nolen-Hoeksema S (2000) The role of rumination in depressive disorders and mixed anxiety/depressive symptoms. J Abnorm Psychol 109:504–511. https://doi.org/10.1037//0021-843X.109.3.504 CrossRefPubMed

40.

Elavsky S, McAuley E, Motl RW, Konopack JF, Marquez DX, Hu L, Jerome GJ, Diener E (2005) Physical activity enhances long-term quality of life in older adults: efficacy, esteem, and affective influences. Ann Behav Med 30:138–145. https://doi.org/10.1207/s15324796abm3002_6 CrossRefPubMed

41.

Smith AS, Wang Z (2014) Hypothalamic oxytocin mediates social buffering of the stress response. Biol Psychiatry 76:281. https://doi.org/10.1016/j.biopsych.2013.09.017 CrossRefPubMed

42.

Knochel C, Oertel-Knochel V, O’Dwyer L, Prvulovic D, Alves G, Kollmann B, Hampel H (2012) Cognitive and behavioural effects of physical exercise in psychiatric patients. Prog Neurobiol 96:46–68. https://doi.org/10.1016/j.pneurobio.2011.11.007 CrossRefPubMed

Title: The effect of aerobic exercise on various symptoms of depression: the mediating role of quality of life
Authors: Jafar Askari
Alireza Saberi-Kakhki
Hamidreza Taheri
Seyyed Mojtaba Yassini
Afsaneh Hassanbeigi
Publication date: 01-06-2020
Publisher: Springer Milan
Keywords: Affective Disorder
Affective Disorder
Published in: Sport Sciences for Health / Issue 2/2020
Print ISSN: 1824-7490
Electronic ISSN: 1825-1234
DOI: https://doi.org/10.1007/s11332-019-00601-w

At a glance: The STEP trials

Springer Medicine

The effect of aerobic exercise on various symptoms of depression: the mediating role of quality of life

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 2/2020

Motivation to CrossFit training: a narrative review

Dental erosion’ prevalence and its relation to isotonic drinks in athletes: a systematic review and meta-analysis

Physical activity and supervised exercise among hypertensives and normotensives: status and barriers

Effects of cluster training sets on muscle power and force–velocity relationship in postmenopausal women

10 km running race induces an elevation in the plasma myokine level of nonprofessional runners

Guided walking is more effective than suggested walking in reducing the blood pressure of hypertensive sedentary subjects and in modifying their lifestyle