EXERCISE & DEPRESSION--EPIDEMIOLOGY & CLINICAL STUDIES

描述(改编自申请人的摘要)：建议的研究将 在两个不同的人群中检查两个相关的问题。总而言之， 人口，体力活动和运动之间的剂量效应是什么？ 适应抑郁症状和心理健康吗？在……里面 被诊断为轻度至中度严重抑郁障碍的参与者 (MDD)，运动作为一种治疗的疗效是什么？其基本原理是 这些研究内容如下。最近的一份共识声明记录了 由于各种原因，抑郁症在社区中得不到足够的治疗 包括缺乏有效的替代治疗方法。锻炼，一种可能的 替代治疗，已被证明与较少的抑郁有关 观察性研究中的症状，并已被证明为 心理疗法对轻、中度抑郁症患者有效 短期内对重度抑郁症患者有效的辅助治疗 实验和准实验研究。然而，临床实践 重度抑郁症的治疗指南没有将运动列为 可能的治疗方法或治疗的附件，因为有证据表明 运动治疗的疗效还不是来自随机对照 临床试验。最近的一项综述呼吁进行观察性研究来检查 大截面和纵向的剂量-效应关系 有足够的抑郁症和体力活动测量的分析，以及 健身。此外，随机临床研究需要使用足够的 对照和活动剂量，以测试剂量-反应关系 锻炼是治疗抑郁症的有效方法。建议进行的研究 将解决这些缺陷。主要研究假设为：(1) 运动与抑郁症状之间存在剂量-反应关系 和心理健康；以及(2)锻炼是有效的治疗方法 适用于轻度至中度MDD。对于第一个假设，基于人口的 方法将使用健美操中心纵向研究数据的子集 来自诊所就诊(n=8,345)和邮寄调查(n=13,627)在1990年和 1995年为13,329人)。这一阶段的横断面和纵向分析 将立即开始，同时开始第二阶段的规划。这个 第二阶段，随机临床治疗研究，将检查 运动治疗轻中度疾病的疗效及量效关系 抑郁症患者140例，年龄在20-40岁之间。实验研究为2x2 设计采用运动安慰剂对照。所有疗程均为3个月。 持续时间和3个月的额外随访。我们相信这些研究 将提供科学理解所需的基本信息 运动与抑郁的关系，并将提供是否运动的证据 是治疗轻度至中度MOD的有效替代疗法。

DESCRIPTION (Adapted from applicant's abstract): The proposed studies will examine two related questions in two different population. In a general population, what are the dose-response effects between physical activity and fitness to symptoms of depression and psychological well-being? In participants with diagnosed mild to moderate major depressive disorder (MDD), what is the efficacy of exercise as a treatment? The rationale for these studies is as follows. A recent consensus statement documents that depression is undertreated in the community for a variety of reasons including a lack of effective alternative treatments. Exercise, a possible alternative treatment, has been shown to be related to fewer depressive symptoms in observational studies and has been demonstrated to be as efficacious as psychotherapy in patients with mild to moderate depression or an effective adjunct in more severely depressed patients in short term experimental an quasi-experimental studies. However, the Clinical Practice Guidelines for Treatment of Major Depression do not list exercise as a possible treatment or an adjunction to treatment because evidence for the efficacy for exercise treatment does not yet come from randomized controlled clinical trials. A recent review calls for observational studies to examine the dose-response relation in both large cross-sectional and longitudinal analyses that have adequate measures of depression and physical activity and fitness. In addition, randomized clinical studies need to use adequate controls and doses of activity to test the dose-response relation of exercise as an efficacious treatment for depression. The proposed studies will address these deficiencies. The primary research hypotheses are: (1) there are dose-response relations between exercise and depressive symptoms and psychological well-being; and (2) exercise is an efficacious treatment for mild to moderate MDD. For the first hypothesis, the population-based approach will use a subset of the Aerobics Center Longitudinal Study data from clinic visits (n=8,345) and mail-back surveys (n=13,627 in 1990 and n=13,329 in 1995). This phase of cross-sectional and longitudinal analyses will start immediately while planning begins for the second phase. The second phase, a randomized clinical treatment study, will examine the efficacy and dose-response relation of exercise in treating mild to moderate depression in 140 adults 20-40 years old. The experimental study is a 2 x 2 design with an exercise placebo control. All treatments will be 3 months in duration with 3 months of additional follow-up. We believe these studies will provide basic information needed for scientific understanding of the exercise depression relation and will provide evidence of whether exercise is an effective alternative treatment for mild to moderate levels of MOD.