Published: Nov 11, 2013 | Updated: Nov 12, 2013
By Cole Petrochko, Staff Writer, MedPage Today

Full Story:  http://www.medpagetoday.com/MeetingCoverage/SFN/42852

SAN DIEGO — Young adults with major depressive disorder seemed to resolve depression after a 12-week exercise program with a motivational component, researchers reported here.

In a small, pilot study of depressed 18- to 24-year-olds, exercise was associated with declines in depression severity of 63%, where 83% of participants were no longer considered depressed at the end of the 12-week program, according to Robin Callister, PhD, of the University of Newcastle in Callaghan, Australia, and colleagues.

Changes in Beck Depression Inventory scores were significantly associated with changes in upper body strength (r=0.69, P=0.001) and gym session attendance (r=0.39, P<0.001), which showed that the fitness component, rather than the motivational component, was associated with the improvements in depression scores, Callister said during an oral presentation at the Society for Neurology meeting.

However, session moderator Hector Caruncho, PhD, of the University of Saskatchewan in Canada, suggested that the motivational component of Callister’s research was likely the reason for its success, highlighting that depressed patients generally don’t feel up to getting out of bed in the morning, much less participating in an exercise therapy intervention.

Research from 2008 showed that exercise was not associated with reductions in depression and anxiety in the general population. However, more recent research has shown thatexercise had modest effects on depression, but that these outcomes were muted in more well-designed studies.

Researchers have also drawn modest associations between depression reduction in heart failure patients with exercise, as well as in patients with multiple sclerosis.

The authors’ pilot study recruited 13 young adults (mean age 20.7) with major depressive disorder to investigate the feasibility and preliminary — a point emphasized by Callister during her presentation — efficacy of a 12-week exercise training program with a short motivational interview component.

Participants were excluded if they were suicidal at enrollment, had a psychotic disorder or brain injury, had a severe eating disorder, or if they were unable to exercise.

Those enrolled were primarily recruited through online social media advertising or university campus fliers and were followed up with via telephone screening. Depression was measured through a clinical diagnosis through criteria in the Diagnostic and Statistical Manual of Mental Disorders V and graded by severity through the Beck Depression Inventory II.

Participants were the subject to a brief, single-session motivational interview where a clinical psychologist reinforced motivation to exercise, helped them set goals, evaluated barriers to regular excise and strategies to overcome those barriers, identified sources of social support, and overall attempted to empower the young adult.

They then underwent a 12-week exercise program that included small groups of three to six participants who met with a personal trainer three times weekly. They also wore pedometers to measure step counts, completed daily online mood and physical activity reports, and had twice-weekly mood screenings.

The exercise program was broken up into three blocks of increasing intensity over the first 2 weeks, the next 5 weeks, and the final 5 weeks. Callister noted that participants wanted the intensity of workouts to increase earlier in the study.

At a 6-month follow-up, all but one participant reported mild depression, while the lone participant still suffered from major depression.

Callister cautioned that there was no control group in their research, but did add that a follow-up, randomized, controlled trial was underway. In this follow-up study, participants will be randomized to motivational interview with or without a physical activity component, with active enrollment to the physical activity component after the study period.