EXERCISE & DEPRESSION--EPIDEMIOLOGY & CLINICAL STUDIES

描述（改编自申请人摘要）：拟定研究将 在两个不同的人群中研究两个相关的问题。 以一般 人口，什么是身体活动和 抑郁症症状和心理健康的适应性？ 在 被诊断为轻度至中度重度抑郁症的参与者 (MDD)运动作为一种治疗方法的功效是什么？ 的理由 这些研究如下。 最近的一份共识声明指出， 由于各种原因，抑郁症在社区中治疗不足 包括缺乏有效的替代疗法。 运动，一种可能的 替代治疗，已被证明与较少的抑郁症 观察性研究中的症状，并已被证明是 对轻度至中度抑郁症患者有效的心理治疗， 短期内对更严重的抑郁症患者有效的辅助治疗 实验性和准实验性研究。 然而，临床实践 《重度抑郁症治疗指南》没有将运动列为治疗抑郁症的一项重要措施。 可能的治疗或治疗的附加物，因为有证据表明， 运动治疗的有效性还没有来自随机对照 临床试验 最近的一项综述呼吁进行观察性研究， 大截面和纵向剂量反应关系 分析有足够的抑郁和身体活动的措施， 健身 此外，随机临床研究需要使用足够的 对照和剂量的活性，以测试剂量-反应关系 运动是治疗抑郁症的有效方法。 拟议的研究 将弥补这些缺陷。 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;（2）运动是一种有效的治疗方法 轻度到中度抑郁症 对于第一个假设，基于人口的 方法将使用有氧运动中心纵向研究数据的子集 从门诊（n= 8，345）和邮寄调查（n= 13，627，1990年和 1995年n= 13，329）。 这一阶段的横向和纵向分析 将立即开始，同时开始规划第二阶段。 的 第二阶段，随机临床治疗研究，将检查 运动治疗轻、中度抑郁症疗效及量效关系 140名20-40岁的成年人的抑郁症。 实验研究是一个2x2 运动安慰剂对照设计。 所有治疗将持续3个月， 3个月的额外随访。 我们相信这些研究 将提供科学了解所需的基本信息 运动与抑郁症的关系，并将为运动是否 是轻度至中度MOD的有效替代治疗方法。

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.