Abstract
Psychiatric disorders are associated with a higher prevalence of cardiovascular disease and mortality. Regular exercise has been shown to reduce depressive symptoms and improve arterial stiffness as a biomarker of cardiovascular risk. We aimed to investigate the effects of different exercise modalities on depression severity index and arterial stiffness in patients suffering from unipolar depression. 34 patients suffering from unipolar depression [female: 25, male: 9, age: 37.8, Beck-Depression-Inventory-II (BDI-II) score: 31.0] were enrolled in this two-armed randomized controlled trial. Central hemodynamics, augmentation index at heart rate 75/min (AIx@75) and aortic pulse wave velocity (PWV) were obtained by an oscillometric monitoring device. Maximal bicycle ergometer exercise testing yielded maximal fitness parameters. Patients were assigned to either high-intensity low volume (HILV) or moderate continuous aerobic training (MCT). Both intervention groups trained three times a week during a 4-week intervention period. BDI-II were filled out by the patients before and after the intervention period. We found moderate interaction effects on depression severity reduction [Formula: see text]. HILV showed a 85% beneficial effect in lowering BDI-II scores compared to MCT (HILV: pre: 28.8 (9.5), post: 15.5 (8.5), SMD = 1.48), MCT: (pre: 33.8 (8.5), post: 22.6 (7.5), SMD = 1.40). Reduction of AIx@75 was more pronounced after MCT (SMD = 0.61) compared to HILV (SMD = 0.08), showing 37% possibly beneficial effects of MCT over HILV. PWV remained unchanged in both training groups. Both training regimes showed large effects on the reduction of depressive symptoms. While HILV was more effective in lowering depression severity, MCT was more effective in additionally lowering peripheral arterial stiffness. Exercise should be considered an important strategy for preventive as well as rehabilitative treatment in depression.
Highlights
Depression is a widespread public-health problem and one of the leading causes of disease burden worldwide [1] affecting an estimated 350 million people [2]
In the ANCOVA analysis, taking baseline values into account, we found relevant but small interaction effects on depression severity reduction (p = 0.07; η2p = 0.10)
high-intensity low volume (HILV) showed a likelihood of meaningful effect of 85% likely beneficial compared to moderate continuous aerobic training (MCT) (Table 4)
Summary
Depression is a widespread public-health problem and one of the leading causes of disease burden worldwide [1] affecting an estimated 350 million people [2]. Depression affects health status more than somatic diseases such as coronary artery disease (CAD), diabetes, or musculoskeletal disease such as arthritis [1]. Guidelines from the National Institute of Health and Care Excellence (NICE) recommend cognitive behavioral therapy as treatment of choice for mild to moderate depression, followed by antidepressant medication [3]. NICE and WHO guidelines both recommend regular exercise, in the standard treatment of depression [2, 3, 5]. Regular exercise has been shown to reduce depressive symptoms and improve arterial stiffness as a biomarker of cardiovascular risk. We aimed to investigate the effects of different exercise modalities on depression severity index and arterial stiffness in patients suffering from unipolar depression
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