Universitäres Partnerspital der Med. Fakultät Basel
P.2.b.027 - ECNP 2016
Aerobic Exercise as Add-on Treatment in Depressed Inpatients Improves
Cognitive Domains but has no Additional Effect on Symptom Severity
Christian Imboden1, Johannes Beck2, Markus Gerber3, Uwe Pühse3, Edith Holsboer-Trachsler2, Martin Hatzinger1,4
1Psychiatric
Services Solothurn
University Hospital Basel
3Department of Sport Science and Health, University of Basel
4University of Basel
2Psychiatric
[email protected]
Objectives: Aerobic exercise has medium effects on symptom severity in mild to moderate depression. Effects are lower in studies with high methodical standards
and if patients are concomitantly treated with antidepressants [1]. Additionally, there is growing evidence on positive effects on cognitive variables[2]. However,
data on cognitive effects of aerobic exercise in depression are still scarce. Thus, we started this project to evaluate the effect of aerobic exercise on cognitive
variables in depressed inpatients.
Sample description
Methods:
• Inpatients with a diagnosis of depression and a
• score >16 in the 17-item Hamilton Depression Scale (HDRS-17)
Random assignment to either:
• endurance exercise on indoor bicycles (17.5kcal/kg/week) (=exercise)
at 60-75% of maximal heartrate
• a standardized stretching and coordination program
(=control)
3 times per week for 6 consecutive weeks as add-on therapy to multimodal antidepressant
intreatment.
N
Age
female sex (%)
Past depressive episodes
Duration of current episode [weeks]
HDRS-17 pre
Diagnosis
Bipolar Depression
first MDD
3
15
33
37.9
17
2.7
20.4
21.4
±13.1
(52%)
±5.4
±21.2
±3.6
recurrant MDD
15
No significant group differences at baseline (ANOVA, Chi2)
Patients were recruited on the depression wards of the Psychiatric University Hospital Basel, Switzerland and the Psychiatric Services Solothurn, Switzerland
between October 2013 and February 2016. Cognitive variables were measured with the TAP-test V. 2.3.
Working memory
Alertness: stability of performance
500
*
400
300
200
100
0
baseline
25
45
40
35
30
25
20
15
10
5
0
post (TP2)
exercise
20
control
HDRS--17 score
600
SD of reaction time [ms]
median reaction time [ms]
700
Symptom severity
15
10
5
0
baseline
post (TP2)
baseline
1 week
2 weeks post (TP2)
Graph error bars=SEM *= p<.05 vs. control SD=standard deviation
Results: Thirty-three patients were recruited into the study (17 controls, 16 intervention group). After 6 weeks, mean HDRS-17 decreased significantly to 8.6
(±6.7) with no significant group difference. Moreover, there were no significant group differences for cognitive variables at baseline. At TP2, median reaction time
for working memory was significantly lower in the intervention group 508.8 (±133.1) vs. 622.0 (±152.2) in controls (Mann-U-Whitney-test p=.037, r=.36).
Standard deviation of Alertness with warning signal showed a trend to a group difference between intervention 32.2 (±19.1) vs. 37.5 (±14.8) in controls (p=.063,
r=.32). We also found a trend for a time effect in working memory for the intervention group between TP1 and TP2 (mean difference: -62.1, p=.093, r=-.42,
Wilcoxon rank-sum test), the control group showed no trend over time (mean difference: 37.7, p=.136, r=.36).
Conclusions:
• Aerobic exercise as an add-on treatment to a multimodal program for depressed inpatients showed to have medium effects on reaction time in working
memory. Therefore, regular exercise may contribute to an improved course of cognitive symptoms among clinically depressed patients.
• This study showed no additional effects of exercise on symptom-severity. However, this may be due to ceiling effects caused by an already highly effective
multimodal treatment regime.
Disclosure: This study was financed by grants of the Gottfried & Julia Bangerter-Rhyner Foundation, the Helsana health insurance company and the canton of
Solothurn
References:
1. Kvam S, Kleppe CL, Nordhus IH, Hovland A. Exercise as a treatment for depression: A meta-analysis. J Affect Disord 2016 May 20;202:67-86.
2. Knochel C, Oertel-Knochel V, O'Dwyer L, Prvulovic D, Alves G, Kollmann B, et al. Cognitive and behavioural effects of physical exercise in psychiatric
patients. Prog Neurobiol 2012 Jan;96(1):46-68.