Effects of exercise training on older patients with major depression
Effects of exercise training on older patients with major depression
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DOI：
10.1001/archinte.159.19.2349
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发表时间：
1999-10-25
影响因子：
--
通讯作者：
Krishnan, KR
中科院分区：
文献类型：
--
作者：
Blumenthal, JA;Babyak, MA;Krishnan, KR
背景资料：以前的观察性和干预性研究表明，定期体育锻炼可能与抑郁症症状减轻有关。然而，运动训练在多大程度上可以减轻老年抑郁症（MDD）患者的抑郁症状还没有得到系统的评估。目的：评估有氧运动计划与标准药物治疗相比的有效性（即，抗抑郁药）治疗老年患者的抑郁症，我们进行了一项为期16周的随机对照试验。五十六例男性和女性MDD患者（年龄大于或等于50岁）被随机分配到有氧运动、抗抑郁药（盐酸舍曲林）或运动和药物联合治疗组。采用《精神疾病诊断与统计手册》第四版抑郁症诊断标准、汉密尔顿抑郁量表（HAM-D）和贝克抑郁量表（BDI）对受试者治疗前后抑郁症状进行综合评估，包括抑郁障碍的存在和严重程度。次要结果的措施包括有氧能力，生活满意度，自尊，焦虑，和功能失调cognitions.Results：治疗16周后，组没有统计学差异HAM-D或BDI评分（P = 0.67）;调整基线水平的抑郁症产生了一个基本相同的结果。生长曲线模型显示，所有组的HAM-D和BDI评分均出现统计学和临床显著性降低。然而，单独接受药物治疗的患者表现出最快的初始反应;在接受联合治疗的患者中，那些抑郁症状不太严重的患者最初表现出更快的反应，比那些最初更严重的抑郁symptoms.Conclusions：运动训练计划可以被认为是一种替代抗抑郁药治疗老年人抑郁症。虽然抗抑郁药可能比运动更快地促进初始治疗反应，但治疗16周后，运动在减少MDD患者的抑郁方面同样有效。
Background: Previous observational and interventional studies have suggested that regular physical exercise may be associated with reduced symptoms of depression. However, the extent to which exercise training may reduce depressive symptoms in older patients with major depressive disorder (MDD) has not been systematically evaluated.Objective: To assess the effectiveness of an aerobic exercise program compared with standard medication (ie, antidepressants) for treatment of MDD in older patients, we conducted a 16-week randomized controlled trial.Methods: One hundred fifty-six men and women with MDD (age, greater than or equal to 50 years) were assigned randomly to a program of aerobic exercise, antidepressants (sertraline hydrochloride), or combined exercise and medication. Subjects underwent comprehensive evaluations of depression, including the presence and severity of MDD using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria and Hamilton Rating Scale for Depression (HAM-D) and Beck Depression Inventory (BDI) scores before and after treatment. Secondary out-come measures included aerobic capacity, life satisfaction, self-esteem, anxiety, and dysfunctional cognitions.Results: After 16 weeks of treatment, the groups did not differ statistically on HAM-D or BDI scores (P = .67); adjustment for baseline levels of depression yielded an essentially identical result. Growth curve models revealed that all groups exhibited statistically and clinically significant reductions on HAM-D and BDI scores. However, patients receiving medication alone exhibited the fastest initial response; among patients receiving combination therapy, those with less severe depressive symptoms initially showed a more rapid response than those with initially more severe depressive symptoms.Conclusions: An exercise training program may be considered an alternative to antidepressants for treatment of depression in older persons. Although antidepressants may facilitate a more rapid initial therapeutic response than exercise, after 16 weeks of treatment exercise was equally effective in reducing depression among patients with MDD.