Aerobic Exercise for Treatment of Adolescent Depression

为响应NIMH项目公告（PA-00-119）而提交的行为科学快速过渡跟踪奖（B/START）新提案与该资助机制的目标一致。我们要求一年的资金来开发和评估一种经验验证的成人和老年重度抑郁症（MDD）治疗方法的年龄向下扩展[进入青少年人群]。青少年重度抑郁症是一个重要的公共卫生问题。这种疾病的有效治疗方法的发展具有重大的公共卫生意义。虽然目前青少年重度抑郁症的治疗方法令人鼓舞，但研究表明，25%至45%的青少年对最新的干预措施（例如，认知行为疗法和选择性血清素再摄取抑制剂）没有反应。许多对照良好的研究表明，有监督的有氧运动与抗抑郁药物和心理社会干预治疗成人重度抑郁症一样有效。有氧运动干预有可能成为社会心理和精神药理学干预的可行替代或辅助治疗。然而，有氧运动治疗青少年重度抑郁症的可行性尚未得到系统的评估。该研究计划的目标是开发和评估一种为期12周的有氧运动干预治疗青少年重度抑郁症。共有16名抑郁症门诊青少年（13至17岁，包括在内）将被招募参加两个试点研究中的一个。第一项先导研究（n = 4）的主要目的是开发和测试一种手动有氧干预，并根据受试者反馈对其进行修改。第二项先导研究（n = 12）的目的是检验人工有氧干预在青少年重度抑郁症急性治疗中的可行性、可接受性、充分性和有效性。试点研究还将提供一个估计的效应大小，用于为该领域的未来研究提供动力。如果有经验支持，研究人员将在更大规模的临床试验中进一步开发和评估治疗方法。

This new proposal submitted in response to the NIMH Program Announcement (PA-00-119) for the Behavioral Science Track Award for Rapid Transition (B/START) is consonant with the goals of this funding mechanism. We request one year of funding to develop and evaluate an age-downward extension [into adolescent populations] of an empirically validated treatment for adult and geriatric major depressive disorder (MDD). Adolescent MDD is an important public health problem. The development of effective treatments for this disorder has significant public health implications. Although currently available treatments for adolescent MDD are encouraging, research shows that between 25% to 45% of adolescents fail to respond to state-of-the-art interventions (e.g., cognitive-behavior therapy and selective serotonin reuptake inhibitors). A number of well-controlled studies have shown that supervised aerobic exercise is as effective as antidepressant medication and psychosocial interventions for the treatment of adult MDD. An aerobic exercise intervention has the potential to be a viable alternative or adjunctive treatment to psychosocial and psychopharmacological interventions. However, the therapeutic viability of aerobic exercise for the treatment of adolescent MDD has not be systematically evaluated. The goal of the proposed research project is to develop and evaluate a 12-week supervised aerobic exercise intervention for the treatment of adolescent MDD. A total of sixteen depressed outpatient adolescents (ages 13 to 17, inclusive) will be recruited to participate in one of two pilot studies. The primary purpose of the first pilot study (n = 4) is to develop and test a manualized aerobic intervention and revise it according to subject feedback. The purpose of the second pilot study (n = 12) is to examine the feasibility, acceptability, sufficiency, and efficacy of the manualized aerobic intervention in the acute treatment of adolescent MDD. The pilot studies will also provide an estimated effect size that will be used to power future studies in this area. If empirically supported, the investigators will pursue further treatment development and evaluation in larger clinical trials.