Exercise as a treatment for depression: A meta-analysis adjusting for publication bias
Exercise as a treatment for depression: A meta-analysis adjusting for publication bias
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DOI：
10.1016/j.jpsychires.2016.02.023
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发表时间：
2016-06-01
影响因子：
4.8
通讯作者：
Stubbs, Brendon
中科院分区：
文献类型：
--
作者：
Schuch, Felipe B.;Vancampfort, Davy;Stubbs, Brendon
运动对抑郁症的影响一直是一个有争议的问题。荟萃分析显示了一系列的效应大小。纳入标准和异质性都可能影响所报道的效应大小。出版偏见的程度和影响也是未知的。随机对照试验(RCT)是从Cochrane最近的一次审查和对主要电子数据库的搜索中确定的，时间为2013年1月至2015年8月。我们纳入了抑郁症患者的运动干预RCT(包括那些被诊断为严重抑郁障碍(MDD)或抑郁症状评级的人)，比较运动和对照条件。进行随机效应Meta分析，计算标准化均数差(SMD，95%可信区间；CI)、元回归、修剪和填充，并进行失效安全分析。纳入25项随机对照试验，比较运动和对照组，包括9名患有MDD的受试者。总体而言，锻炼对抑郁有很大且显著的影响(经出版物偏差调整后的SMD=1.11(95%可信区间0.79-1.43))，故障安全数为1057。大多数调整后的分析表明，发表偏差会导致SMD被低估。在有监督和无监督的形式下，发现对MDD的干预效果更大，利用中等强度和剧烈强度的有氧运动。在MDD中，中等强度的有氧运动和由运动专业人员监督的干预效果更大。运动对抑郁症患者(包括MDD)有很强的抗抑郁作用。以前的荟萃分析可能低估了运动的好处，这是由于发表的偏见。我们的数据有力地支持了运动是一种基于证据的抑郁症治疗的说法。(C)2016爱思唯尔有限公司。保留所有权利。
The effects of exercise on depression have been a source of contentious debate. Meta-analyses have demonstrated a range of effect sizes. Both inclusion criteria and heterogeneity may influence the effect sizes reported. The extent and influence of publication bias is also unknown. Randomized controlled trials (RCTs) were identified from a recent Cochrane review and searches of major electronic databases from 01/2013 to 08/2015. We included RCTs of exercise interventions in people with depression (including those with a diagnosis of major depressive disorder (MDD) or ratings on depressive symptoms), comparing exercise versus control conditions. A random effects meta-analysis calculating the standardized mean difference (SMD, 95% confidence interval; CI), meta-regressions, trim and fill and fail-safe n analyses were conducted. Twenty-five RCTs were included comparing exercise versus control comparison groups, including 9 examining participants with MDD. Overall, exercise had a large and significant effect on depression (SMD adjusted for publication bias = 1.11 (95% CI 0.79-1.43)) with a fail-safe number of 1057. Most adjusted analyses suggested publication bias led to an underestimated SMD. Larger effects were found for interventions in MDD, utilising aerobic exercise, at moderate and vigorous intensities, in a supervised and unsupervised format. In MDD, larger effects were found for moderate intensity, aerobic exercise, and interventions supervised by exercise professionals. Exercise has a large and significant antidepressant effect in people with depression (including MDD). Previous meta-analyses may have underestimated the benefits of exercise due to publication bias. Our data strongly support the claim that exercise is an evidence-based treatment for depression. (C) 2016 Elsevier Ltd. All rights reserved.