EXERCISE DOSE-RESPONSE AND THE TREATMENT OF MAJOR DEPRESSION
2002; Lippincott Williams & Wilkins; Volume: 34; Issue: 5 Linguagem: Inglês
10.1097/00005768-200205001-01342
ISSN1530-0315
AutoresAndrea L. Dunn, Madhukar H. Trivedi, James B. Kampert, H A. O Neal, C. G. Clark,
ResumoAlthough depression is a treatable illness, only 23% of adults aged 18 years and older who suffer from depression seek treatment, which is far from the Healthy People 2010 goal of 50%. Reaching this goal will require a variety of efficacious and acceptable treatments. Exercise for treatment of depression has limited data to demonstrate efficacy, and there are no clinical studies that have examined the dose-response question. PURPOSE: The Exercise and Depression Study (DOSE) was designed to test the hypotheses that exercise is an efficacious treatment for mild to moderate levels of Major Depressive Disorder (MDD) and that there is a dose response gradient between the amount of exercise and decrease in depressive symptoms. METHODS: Eighty men (n = 20) and women (n = 60) between the ages of 20–45 y, who were diagnosed with mild to moderate MDD by means of a Hamilton Rating Scale for Depression (HRSD-17) and Structured Clinical Interview (SCID) confirmed by a psychiatrist were randomized to 1 of 5 treatment groups: 1) 7.0 kcal·kg−1·wk−1 in 3 day·wk−1;2) 7.0 kcal·kg−1·wk−1 in 5 day·wk−1; 3) 17.5 kcal·kg−1·wk−1 in 3 day·wk−1; 4) 17.5 kcal·kg−1·wk−1 in 5 day·wk−1; 5) 'exercise placebo' group (control group). The 2 independent variables manipulated were total energy expenditure (KKW) and frequency (DW). The primary outcome measure was the HRSD-17 at 12 weeks. RESULTS: The 17.5 KKW group had a 47% reduction in symptoms at 12 weeks compared with 30% for the 7.0 KKW group and 30% for the control group. This represents a reduction from a baseline HRSD of 16.0 to a score of 8.5 ± 0.9, 11.1 ± 0.9, and 11.2 ± 1.1 for 17.5 KKW, 7.0 KKW, and control groups respectively. All scores represent baseline-adjusted least-square mean scores ± SE. The differences between the 17.5 KKW and either 7.0 KKW or control conditions in adjusted HRSD scores at 12 weeks were significant (p < 0.04 and p < 0.05, respectively). There was no main effect of exercise frequency at 12 weeks. CONCLUSION: These results demonstrate that a higher dose but not a lower dose of energy expenditure can reduce symptoms of MDD. This dose of energy expenditure is within consensus public health recommendations for physical activity. Supported by NIH MH 57031 and Technogym
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