On the road to exercise as medicine for depressive symptoms in young people.
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ABSTRACT:
SUBMITTER: Philippot A
PROVIDER: S-EPMC11320005 | biostudies-literature | 2024 Jul
REPOSITORIES: biostudies-literature
Publications
On the road to exercise as medicine for depressive symptoms in young people.
Philippot Arnaud A Bleyenheuft Yannick Y Dubois Vincent V Tecco Juan Martin JM Van Damme Tine T Vancampfort Davy D
Translational pediatrics 20240729 7
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Project description:BackgroundAlthough previous studies on information and communication technology (ICT)-based intervention on mental health among adolescents with depressive symptoms have already been combined in a number of systematic reviews, coherent information is still missing about interventions used, participants' engagement of these interventions, and how these interventions work.ObjectiveWe conducted a systematic review and meta-analysis of trials to describe the effectiveness of Web-based interventions to support adolescents with depression or depressive symptoms, anxiety, and stress. We also explored the content of the interventions, as there has previously been a lack of coherent understanding of the detailed content of the Web-based interventions for these purposes.MethodsWe included parallel randomized controlled trials targeted at adolescents, or young people in the age range of 10 and 24 years, with symptoms or diagnoses of depression and anxiety. The interventions were from original studies aimed to support mental health among adolescents, and they were delivered via Web-based information and communication technology.ResultsOut of 2087 records identified, 27 papers (22 studies) met the inclusion criteria. On the basis of a narrative analysis of 22 studies, a variety of Web-based interventions were found; the most commonly used intervention was based on cognitive behavioral therapy. Meta-analysis was further conducted with 15 studies (4979 participants). At the end of the intervention, a statistically significant improvement was found in the intervention group (10 studies) regarding depressive symptoms (P=.02, median 1.68, 95% CI 3.11-0.25) and after 6 months (3 studies; P=.01, median 1.78, 95% CI 3.20-0.37). Anxiety symptoms (8 studies; P<.001, median 1.47, 95% CI 2.36-0.59) and moods and feelings (2 studies; P=.04, median 5.55, 95% CI 10.88-0.22) improved as well in the Web-based intervention group, but there was no difference in stress scores. However, adolescents in the intervention group left the study early more often, both in short-term studies (11 studies; P=.007, median 1.31, 95% CI 1.08-1.58) and mid-term studies (3 studies; P=.02, median 1.65, 95% CI 1.09-2.49). We did not find any studies that had assessed the costs of the Web-based interventions.ConclusionsDespite widely reported promises that information technology use is beneficial to adolescents with depression, the results of our review show only short-term effects on adolescents' mental well-being, whereas long-term effects remain questionable because of the limited number of studies reviewed. Information about the economic benefits of Web-based interventions is still lacking. The quality of the studies, especially biases related to attrition rates and selective reporting, still needs serious attention.
| S-EPMC5741826 | biostudies-literature
Project description:ImportanceDepressive symptoms have increased among US adolescents since 2010. It remains unclear as to what extent this increase will persist into young adulthood, potentially turning the youth mental health crisis into a young adult mental health crisis.ObjectiveTo test the association between birth cohort and adolescent depressive symptoms at ages 18, 19 to 20, and 21 to 22 years and changes in these symptoms by cohort.Design, setting, and participantsThis panel cohort study analyzed data from the Monitoring the Future longitudinal survey from 1990 to 2019, including birth cohorts from 1972 to 2001. Survey respondents were recruited from US high schools in 12th grade and were approximately aged 18 years (at baseline) through age 21 to 22 years (during mail and web follow-up). Data analysis was conducted from April to October 2023.ExposureDepressive symptoms score (>12 vs ≤12, with >12 representing top-decile scores) on a scale examining affective items (eg, "Life often seems meaningless").Main outcomes and measuresHigh (vs lower) depressive symptoms at ages 19 to 20 years and 21 to 22 years.ResultsThe 36 552 respondents included 18 597 females (50.5%), and most reported having a parent who graduated from college (44.8%). Among females, 19.1% (95% CI, 16.7%-21.4%) of the most recent birth cohort (born: 1997-2001) had high depressive symptoms at age 18 years, higher than any previous birth cohort. While prevalence declined by age 21 to 22 years, it remained higher than previous cohorts at that age. Among males, 13.4% (95% CI, 11.2%-15.6%) of the most recent birth cohort had high depressive symptoms at age 18 years, and prevalence increased through young adulthood. Males with high baseline depressive symptoms had 10.24 (95% CI, 7.01-14.97) times the odds of symptoms at age 19 to 20 years and 6.20 (95% CI, 3.93-9.78) times the odds of symptoms at age 21 to 22 years. Females with high baseline depressive symptoms had 9.16 (95% CI, 6.57-12.76) times the odds of symptoms at age 19 to 20 years and 7.28 (95% CI, 4.92-10.78) times the odds of symptoms at age 21 to 22 years. The magnitude of the associations did not vary over time. Population attributable fractions indicated that the total proportion of young adult symptoms associated with depressive symptoms at age 18 years among females has increased; in the most recent birth cohort, 55.25% (95% CI, 38.11%-65.13%) of depressive symptoms at age 21 to 22 years were associated with symptoms at age 18 years.Conclusions and relevanceThis panel cohort study found that increases in depressive symptoms in adolescence persisted into young adulthood, suggesting the need for primary prevention and mental health resources during the adolescent years.
| S-EPMC11325205 | biostudies-literature
Project description:BackgroundTheoretically, behavioural activation may have a valuable role to play in the treatment of depression among young people with emerging/early psychosis, however we lack trial evidence concerning its acceptability and feasibility. This study will establish the feasibility of clinician-delivered behavioural activation as an adjunct to standard care for this population. We aim to train and support clinicians in delivering behavioural activation to improve depressive symptoms in young people with early/emerging psychosis. Our objectives are to: Establish the number of young people with early/emerging psychosis with clinically meaningful depression symptoms.Establish the proportion of clinicians that complete the behavioural activation training and are deemed to be competent.Determine the proportion of eligible participants approached who agree to consent to the research.Determine the proportion of participants that complete baseline measures, complete behavioural activation treatment (attending for at least fifteen minutes in a minimum of eight sessions), and complete follow-up measures (immediately post-intervention and at 3 months follow-up).Establish clinicians' fidelity to treatment (by recording randomly selected treatment sessions and completing a fidelity checklist).Calculate preliminary efficacy of behavioural activation against primary and secondary outcomes.Explore participants' experiences of facilitating behavioural activation (clinicians) and receiving behavioural activation (young people with emerging/early psychosis).MethodThis is a pilot controlled clinical trial with a two-arm parallel-group study. Approximately 60 young people with emerging/early psychosis will be randomly allocated to either behavioural activation treatment plus standard care or standard care alone. The primary outcome: depressive symptoms; and secondary outcomes: negative symptoms, overall psychiatric symptoms, medication side effects and functioning, will be assessed at baseline, post-intervention and at 3-months follow-up. The protocol is registered with the Australian New Zealand Clinical Trials Registry (reference number: ACTRN12622000756729).DiscussionThe findings will inform the design of a full-scale randomised controlled trial.
| S-EPMC9858082 | biostudies-literature
Project description:BACKGROUND:Among adults, depressive symptoms are associated with higher rates of cardiovascular disease; however, the evidence is mixed regarding the association between depressive symptoms and hypertension, especially among young adults. The deleterious effects of some antidepressant medications on blood pressure may contribute to mixed findings. METHODS:Adolescents enrolled in Add Health (N = 11,183) (1994-2008) completed an abbreviated Center for Epidemiologic Studies Depression Scale at three waves (mean ages, 16, 22, and 29). Antidepressant use was measured at age 22 and at age 29. Hypertension at age 29 was defined as measured systolic blood pressure of 140 mm Hg or greater, diastolic blood pressure of 90 mm Hg or greater, or staff-inventoried anti-hypertensive medication use. RESULTS:The prevalence of hypertension at age 29 was 20%. High depressive symptoms in adolescence or young adulthood were not associated with hypertension in young adulthood. Antidepressant use at age 29 was associated with increased prevalence of hypertension (prevalence ratio [PR], 1.4; 95% CI, 1.2, 1.7) and an interaction with sex was observed (PRMen, 1.6; 95% CI, 1.2, 2.0; PRWomen, 1.2; 95% CI, 0.89, 1.6; pinteraction = 0.0227). Selective serotonin reuptake inhibitor and non-selective serotonin reuptake inhibitor antidepressant use were associated with hypertension (PRSSRI, 1.3; 95% CI, 1.0, 1.6; PRnon-SSRI, 1.6; 95% CI, 1.2, 2.1). CONCLUSIONS:In this sample, antidepressant use, but not depressive symptoms, was associated with hypertension in young adulthood. Further research is recommended to examine joint and independent relationships between depression and antidepressant use and hypertension among young adults. See video abstract at, http://links.lww.com/EDE/B355.
| S-EPMC5980764 | biostudies-literature
Project description:BackgroundThere is little research on differences in Emotional Intelligence (EI) ability at different stages of adult development. The few published studies tend not to use older adult samples. Previous studies on EI ability and age have shown contradictory results. Our main objective was to evaluate results in EI ability across different stages of adult development, taking into account gender, depressive symptoms, and educational level.MethodsWe interviewed 166 participants (108 women), 66 of whom were aged 18-30 years, 53 aged 31-60 years, and 40 aged 61-76 years. All were either working or enrolled in colleges at the time of the study. The assessment tools used were the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT), a test that assesses performance-based EI, and the Centre for Epidemiologic Studies-Depression (CES-D) scale, a tool to evaluate depressive symptoms.ResultsYoung people, women, and participants with a higher educational level achieved higher scores on the MSCEIT. Additionally, depressive symptomatology was only partially associated with the MSCEIT (i.e., with the using emotions branch). However, a subsequent joint analysis of the independent effects of variables age, gender, educational level, and depressive symptomatology and their interactions on MSCEIT total suggests that only educational level and depressive symptomatology were associated with EI ability, with the direct relationship between age and gender with MSCEIT disappearing. Additionally, our study indicated an interaction effect between age and depressive symptoms, showing that participants in age cohorts 18-30 and 31-60 and without depressive symptoms have a higher EI ability.DiscussionOur study suggests that the direct effects of age and gender on EI ability across adult development, using a wide age range, can change or disappear when effects of educational level and depressive symptomatology, and their interactions, are controlled for. Our results also suggest that EI ability is a protective factor against depression in some age cohorts. This novel aspect of our study does not appear in the previous literature. However, prospective studies are needed to verify these findings and examine whether other psychological variables could determine the relations between age, gender and EI ability across adult development.
| S-EPMC6476293 | biostudies-literature
Project description:Introduction: The interrelationship between social support, depressive symptoms, stress and self-esteem in young adults remains unclear. This study aims to test the mediating role of self-esteem in the relationship between social support and depressive symptoms and the moderating role of perceived stress in the relationship between the two. This is important to inform components of future intervention development targeting youth depression. Methods: Three hundred forty-four (N = 344) young adults in Cyprus aged 17-26 (78% female) completed measures of self-esteem, social support, depressive symptoms, and perceived stress. Structural equation models were used to examine the interactions between social support and depressive psychopathology, whereas mediational analyses were run to examine the mediating role of self-esteem. Latent moderated mediation models were applied to examine the potentially moderating role of perceived stress. Results: Perceived social support from family and friends were significantly related to lower depressive symptoms. Self-esteem fully mediated the relationship between perceived family support and depressive symptoms. Perceived stress moderated the model, and perceived social support was found to be more protective against depressive symptoms when moderate levels of stress were presented. Conclusion: The study demonstrates that social support is protective against depressive symptoms. Self-esteem and perceived stress are important mechanisms that interact with this effect. Implications include the efforts to increase perceived family support during college years and management of stress levels before working with depressive symptoms.
| S-EPMC6340372 | biostudies-literature
Project description:People living with HIV are at three times greater risk for depressive symptoms. Inflammation is a notable predictor of depression, and people with HIV exhibit chronic inflammation despite antiretroviral therapy. We hypothesised that inflammatory biomarkers may mediate the association between HIV status and depressive symptoms. Participants (N = 60, 53% girls, median [interquartile range (IQR)] age 15.5 [15.0, 16.0] years, 70% living with HIV, of whom 90.5% were virally-suppressed) completed the nine-item Patient Health Questionnaire (PHQ-9). We measured choline and myo-inositol in basal ganglia, midfrontal gray matter, and peritrigonal white matter using magnetic resonance spectroscopy, and 16 inflammatory proteins in blood serum using ELISA and Luminex™ multiplex immunoassays. Using structural equation mediation modelling, we calculated standardised indirect effect estimates with 95% confidence intervals. Median [IQR] total PHQ-9 score was 3 [0, 7]. HIV status was significantly associated with total PHQ-9 score (B = 3.32, p = 0.022). Participants with HIV showed a higher choline-to-creatine ratio in the basal ganglia than those without HIV (β = 0.86, pFDR = 0.035). In blood serum, participants with HIV showed higher monocyte chemoattractant protein-1 (MCP-1, β = 0.59, pFDR = 0.040), higher chitinase-3 like-1 (YKL-40, β = 0.73, pFDR = 0.032), and lower interleukin-1beta (IL-1β, β = -0.67, pFDR = 0.047) than those without HIV. There were no significant associations of any biomarkers with total PHQ-9 score. None of the indirect effects were significant, mediating <13.1% of the association. Findings remained consistent when accounting for age, gender, and time between neuroimaging and PHQ-9 administration. Using a robust analytical approach in a community-based sample, we have shown that participants living with HIV reported greater depressive symptoms than those without HIV, but we did not find that neuroimaging and blood biomarkers of inflammation significantly mediated this association. Further studies with participants experiencing severe depression may help to elucidate the links between HIV, inflammation, and depression.
| S-EPMC10883559 | biostudies-literature
Project description:ObjectivesThe aim of this study is to evaluate the effect of a high-intensity functional exercise program on depressive symptoms among older care facility residents with dementia.MethodsResidents (n = 186) with a diagnosis of dementia, age ≥ 65 years, Mini-Mental State Examination score ≥ 10, and dependence in activities of daily living were included. Participants were randomized to a high-intensity functional exercise program or a non-exercise control activity conducted 45 min every other weekday for 4 months. The 15-item Geriatric Depression Scale (GDS) and the Montgomery-Åsberg Depression Rating Scale (MADRS) were administered by blinded assessors at baseline, 4, and 7 months.ResultsNo difference between the exercise and control activity was found in GDS or MADRS score at 4 or 7 months. Among participants with GDS scores ≥ 5, reductions in GDS score were observed in the exercise and control groups at 4 months (-1.58, P = 0.001 and -1.54, P = 0.004) and 7 months (-1.25, P = 0.01 and -1.45, P = 0.007). Among participants with MADRS scores ≥ 7, a reduction in MADRS score was observed at 4 months in the control group (-2.80, P = 0.009) and at 7 months in the exercise and control groups (-3.17, P = 0.003 and -3.34, P = 0.002).ConclusionsA 4-month high-intensity functional exercise program has no superior effect on depressive symptoms relative to a control activity among older people with dementia living in residential care facilities. Exercise and non-exercise group activities may reduce high levels of depressive symptoms.
| S-EPMC5215547 | biostudies-literature
Project description:Background>Patients with functional gastrointestinal disorders have a high psychiatric co-morbidity. This study aimed to investigate and characterise gastrointestinal symptoms in relation to depressive symptoms and trait anxiety in a well-defined population of young adult psychiatric outpatients and healthy controls.MethodsGastrointestinal symptoms were assessed with the Gastrointestinal Symptom Rating Scale for Irritable Bowel Syndrome (GSRS-IBS). Depressive symptoms were assessed with the Montgomery-Åsberg Depression Rating Scale- Self assessment (MADRS-S). Trait anxiety was estimated with three of the Swedish universities of Personality (SSP) scales: Somatic trait anxiety, Psychic trait anxiety and Stress susceptibility. Self-ratings were collected from 491 young adult psychiatric outpatients and 85 healthy controls. Gastrointestinal symptom severity was compared between patients with and without current psychotropic medication and controls. Associations between gastrointestinal symptoms, depressive symptoms and trait anxiety were assessed using Spearman's coefficients and generalized linear models adjusting for possible confounders (sex, body mass index, bulimia nervosa).ResultsPatients, with and without current psychotropic medication, reported significantly more gastrointestinal symptoms than controls. In the generalized linear models, total MADRS-S score (p < 0.001), Somatic trait anxiety (p < 0.001), Psychic trait anxiety (p = 0.002) and Stress susceptibility (p = 0.002) were independent predictors of the total GSRS-IBS score. Further exploratory analysis using unsupervised learning revealed a diverse spectrum of symptoms that clustered into six groups.ConclusionGastrointestinal symptoms are both highly prevalent and diverse in young adult psychiatric outpatients, regardless of current psychotropic medication. Depressive symptom severity and degree of trait anxiety are independently related to the total gastrointestinal symptom burden.
| S-EPMC7661167 | biostudies-literature
Project description:Adolescents with perinatal HIV (PHIV) may be at higher risk of anxiety and depression than HIV negative young people. We investigated prevalence of anxiety and depression symptoms in 283 PHIV and 96 HIV-affected (HIV-negative) young people in England recruited into the Adolescents and Adults Living with Perinatal HIV (AALPHI) cohort. We used Hospital Anxiety and Depression Scale (HADS) scores and linear regression investigated predictors of higher (worse) scores.115 (41%) and 29 (30%) PHIV and HIV-affected young people were male, median age was 16 [interquartile range 15,18] and 16 [14,18] years and 241 (85%) and 71 (74%) were black African, respectively. There were no differences in anxiety and depression scores between PHIV and HIV-affected participants. Predictors of higher anxiety scores were a higher number of carers in childhood, speaking a language other than English at home, lower self-esteem, ever thinking life was not worth living and lower social functioning. Predictors of higher depression scores were male sex, death of one/both parents, school exclusion, lower self-esteem and lower social functioning. In conclusion, HIV status was not associated with anxiety or depression scores, but findings highlight the need to identify and support young people at higher risk of anxiety and depression.
| S-EPMC5989154 | biostudies-literature