Sports Medicine

, Volume 32, Issue 12, pp 741–760 | Cite as

Exercise and the Treatment of Clinical Depression in Adults

Recent Findings and Future Directions
  • Alisha L. Brosse
  • Erin S. Sheets
  • Heather S. Lett
  • James A. Blumenthal
Leading Article

Abstract

This article critically reviews the evidence that exercise is effective in treating depression in adults. Depression is recognised as a mood state, clinical syndrome and psychiatric condition, and traditional methods for assessing depression (e.g. standard interviews, questionnaires) are described. In order to place exercise therapy into context, more established methods for treating clinical depression are discussed. Observational (e.g. cross-sectional and correlational) and interventional studies of exercise are reviewed in healthy adults, those with comorbid medical conditions, and patients with major depression. Potential mechanisms by which exercise may reduce depression are described, and directions for future research in the area are suggested. The available evidence provides considerable support for the value of exercise in reducing depressive symptoms in both healthy and clinical populations. However, many studies have significant methodological limitations. Thus, more data from carefully conducted clinical trials are needed before exercise can be recommended as an alternative to more traditional, empirically validated pharmacological and behavioural therapies.

References

  1. 1.
    Greist JH, Klein MH, Eischens RR, et al. Running as treatment for depression. Compr Psychiatry 1979; 20 (1): 41–54PubMedCrossRefGoogle Scholar
  2. 2.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: American Psychiatric Association, 1994Google Scholar
  3. 3.
    Spitzer RL, Endicott J, Robins E. Research diagnostic criteria: rationale and reliability. Arch Gen Psychiatry 1978; 35 (6): 773–82PubMedCrossRefGoogle Scholar
  4. 4.
    World Health Organization. ICD-10 classification of mental and behavioural disorders: clinical description and diagnostic guidelines. Geneva: World Health Organization, 1992Google Scholar
  5. 5.
    First M, Spitzer L, Gibbon M, et al. Structured Clinical Interview for Axis I DSM-IV Disorders. Washington, DC: American Psychiatric Press, 1995Google Scholar
  6. 6.
    Endicott J, Spitzer RL. A diagnostic interview: the Schedule for Affective Disorders and Schizophrenia. Arch Gen Psychiatry 1978; 35: 837–44PubMedCrossRefGoogle Scholar
  7. 7.
    Robins LN, Helzer JE, Croughan J, et al. National Institute of Mental Health Diagnostic Interview Schedule: its history, characteristics, and validity. Arch Gen Psychiatry 1981; 38: 381–9PubMedCrossRefGoogle Scholar
  8. 8.
    World Health Organization. Composite International Diagnostic Interview (CIDI), Version 1.0. Geneva: World Health Organization, 1990Google Scholar
  9. 9.
    Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960; 12: 56–62CrossRefGoogle Scholar
  10. 10.
    Montgomery SA, Asberg M. A new depression scale designed to be sensitive to change. Br J Psychiatry 1979; 134: 382–9PubMedCrossRefGoogle Scholar
  11. 11.
    Beck AT, Ward CH, Mendelsohn M, et al. An inventory for measuring depression. Arch Gen Psychiatry 1961; 4: 561–71PubMedCrossRefGoogle Scholar
  12. 12.
    Beck AT, Steer RA, Brown GK. Beck Depression Inventory manual. 2nd ed. San Antonio (TX): The Psychological Corporation, 1996Google Scholar
  13. 13.
    Radloff LS. The CES-D Scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1977; 1: 385–401CrossRefGoogle Scholar
  14. 14.
    Derogatis LR. SCL-90R administration, scoring, and procedures manual. Baltimore (MD): John Hopkins University Press, 1977Google Scholar
  15. 15.
    Zung WW. A self-rating depression scale. Arch Gen Psychiatry 1965; 12: 63–70PubMedCrossRefGoogle Scholar
  16. 16.
    Boyd JH, Weissman MM, Thompson WD, et al. Screening for depression in a community sample: understanding the discrepancies between depression symptom and diagnostic scales. Arch Gen Psychiatry 1982; 39: 1195–200PubMedCrossRefGoogle Scholar
  17. 17.
    Lee CK, Kwak YS, Yamamoto J, et al. Psychiatric epidemiology in Korea. Part II: urban and rural differences. J Nerv Ment Dis 1990; 178: 247–52PubMedCrossRefGoogle Scholar
  18. 18.
    Kessler RC, McGonagle KA, Zhao S, et al. Lifetime and 12- month prevalence of DSM-III-R psychiatric disorders in the United States. Arch Gen Psychiatry 1994; 51: 8–19PubMedCrossRefGoogle Scholar
  19. 19.
    Regier DA, Narrow WE, Rae DS, et al. The de facto US mental and addictive disorders service system: Epidemiologic Catchment Area prospective 1-year prevalence rates of disorders and services. Arch Gen Psychiatry 1993; 50 (2): 85–94PubMedCrossRefGoogle Scholar
  20. 20.
    Kaelber CT, Moul DE, Farmer ME. Epidemiology of depression. In: Beckham EE, Leber WR, editors. Handbook of depression. New York: Guilford Press, 1995: 3–35Google Scholar
  21. 21.
    Lehmann HE. Clinical evaluation and natural course of depression. J Clin Psychiatry 1983; 44: 5–10PubMedGoogle Scholar
  22. 22.
    Mueller TI, Leon AC. Recovery, chronicity, and levels of psychopathology in major depression. Psychiatr Clin North Am 1996; 19 (1): 85–102PubMedCrossRefGoogle Scholar
  23. 23.
    Johnson J, Weissman MM, Klerman GL. Service utilization and social morbidity associated with depressive symptoms in the community. JAMA 1992; 267 (11): 1478–83PubMedCrossRefGoogle Scholar
  24. 24.
    Wells KB, Stewart A, Hays RD, et al. The functioning and well-being of depressed patients: results from the Medical Outcomes Study. JAMA 1989; 262 (7): 914–9PubMedCrossRefGoogle Scholar
  25. 25.
    Greenberg PE, Stiglin LE, Finkelstein SN, et al. The economic burden of depression in 1990. J Clin Psychiatry 1993; 54 (11): 405–18PubMedGoogle Scholar
  26. 26.
    Katon W, Sullivan MD. Depression and chronicmedical illness. J Clin Psychiatry 1990; 51: 3–14PubMedGoogle Scholar
  27. 27.
    Frasure-Smith N, Lesperance F, Talajic M. Depression following myocardial infarction: impact on 6-month survival. JAMA 1993; 270 (15): 1819–25PubMedCrossRefGoogle Scholar
  28. 28.
    Jiang W, Alexander J, Christopher E, et al. Relationship of depression to increased risk of mortality and rehospitalization in patients with congestive heart failure. Arch Intern Med 2001; 161 (15): 1849–56PubMedCrossRefGoogle Scholar
  29. 29.
    Lustman PJ, Anderson RJ, Freedland KE, et al. Depression and poor glycemic control: a meta-analytic review of the literature. Diabetes Care 2000; 23 (7): 934–42PubMedCrossRefGoogle Scholar
  30. 30.
    Ciechanowski PS, Katon WJ, Russo JE. Depression and diabetes: impact of depressive symptoms on adherence, function, and costs. Arch Int Med 2000; 160 (21): 3278–85CrossRefGoogle Scholar
  31. 31.
    DiMatteo MR, Lepper HS, Croghan TW. Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med 2000; 160 (14): 2101–7PubMedCrossRefGoogle Scholar
  32. 32.
    Hirschfeld RM, Keller MB, Panico S, et al. The National Depressive and Manic-Depressive Association consensus statement on the undertreatment of depression. JAMA 1997; 277 (4): 333–40PubMedCrossRefGoogle Scholar
  33. 33.
    Mohr DC, Goodkin DE, Likosky W, et al. Treatment of depression improves adherence to interferon beta-1b therapy for multiple sclerosis. Arch Neurol 1997; 54 (5): 531–3PubMedCrossRefGoogle Scholar
  34. 34.
    Simon G, Von Korff M, Barlow W. Health care costs in primary care patients with recognized depression. Arch Gen Psychiatry 1995; 52: 850–6PubMedCrossRefGoogle Scholar
  35. 35.
    Unutzer J, Patrick DL, Simon G, et al. Depressive symptoms and the cost of health services in HMO patients aged 65 years and older: a 4-year prospective study. JAMA 1997; 277 (20): 1618–23PubMedCrossRefGoogle Scholar
  36. 36.
    Electroconvulsive therapy. NIH Consensus Statement [online]. Available from URL: http://concensus.nih.gov/cons/051/051_statement.htm/ [Accessed 2002 May 10]
  37. 37.
    Terman M, Terman JS, Quitkin FM, et al. Light therapy for seasonal affective disorder: a review of efficacy. Neuropsychopharmacology 1989; 2 (1): 1–22PubMedCrossRefGoogle Scholar
  38. 38.
    Gaster B, Holroyd J. St John’s wort for depression: a systematic review. Arch Intern Med 2000; 160 (2): 152–6PubMedCrossRefGoogle Scholar
  39. 39.
    Linde K, Ramirez G, Mulrow CD, et al. St John’s wort for depression: an overview and meta-analysis of randomised clinical trials. BMJ 1996; 313 (7052): 253–8PubMedCrossRefGoogle Scholar
  40. 40.
    Rosenbaum JF, Fava M, Falk WE, et al. An open-label pilot study of oral S-adenosyl-L-methionine in major depression: interim results. Psychopharmacol Bull 1988; 24 (1): 189–94PubMedGoogle Scholar
  41. 41.
    McLeod MN, Gaynes BN, Golden RN. Chromium potentiation of antidepressant pharmacotherapy for dysthymic disorder in 5 patients. J Clin Psychiatry 1999; 60 (4): 237–40PubMedCrossRefGoogle Scholar
  42. 42.
    Lewinsohn PM, Gotlib IH. Behavioral theory and treatment of depression. In: Beckham EE, Leber WR, editors. Handbook of depression. New York: The Guilford Press, 1995: 352–75Google Scholar
  43. 43.
    Beck AT, Rush AJ, Shaw BF, et al. Cognitive therapy of depression. New York: The Guilford Press, 1979Google Scholar
  44. 44.
    Klerman GL, Weissman MM, Rounsaville BJ, et al. Interpersonal psychotherapy of depression. New York: Basic Books Inc., 1984Google Scholar
  45. 45.
    Craighead WE, Hart AB, Craighead LW, et al. Psychosocial treatments for major depressive disorder. In: Nathan P, Gorman JM, editors. A guide to treatments that work. New York: Oxford University Press, 2002: 245–61Google Scholar
  46. 46.
    Kupfer DJ, Frank E, Perel JM, et al. Five-year outcome for maintenance therapies in recurrent depression. Arch Gen Psychiatry 1992; 49 (10): 769–73PubMedCrossRefGoogle Scholar
  47. 47.
    Keller MB, Beardslee W, Lavori PW, et al. Course of major depression in non-referred adolescents: a retrospective study. J Affect Disord 1988; 15: 235–43PubMedCrossRefGoogle Scholar
  48. 48.
    Lewinsohn PM, Clarke GN, Seeley JR, et al. Major depression in community adolescents: age at onset, episode duration, and time to recurrence. J Am Acad Child Adolesc Psychiatry 1994; 33 (6): 809–18PubMedCrossRefGoogle Scholar
  49. 49.
    Roberts RE, Vernon SW. Depression in the community: prevalence and treatment. Arch Gen Psychiatry 1982; 39: 1407–9PubMedCrossRefGoogle Scholar
  50. 50.
    Weissman MM, Myers JK, Thompson WD. Depression and its treatment in a US urban community - 1975–1976. Arch Gen Psychiatry 1981; 38: 417–21PubMedCrossRefGoogle Scholar
  51. 51.
    Taber CW, Thomas CL. Taber’s cyclopedic medical dictionary. Philadelphia (PA): Davis, 1981Google Scholar
  52. 52.
    Bhui K, Fletcher A. Common mood and anxiety states: gender differences in the protective effect of physical activity. Soc Psychiatry Psychiatr Epidemiol 2000; 35 (1): 28–35PubMedCrossRefGoogle Scholar
  53. 53.
    DeForge BR, Sobal J, Krick JP. Relation of perceived health with psychosocial variables in elderly osteoarthritis patients. Psychol Rep 1989; 64: 147–56CrossRefGoogle Scholar
  54. 54.
    Hassmen P, Koivula N, Uutela A. Physical exercise and psychological well-being: a population study in Finland. Prev Med 2000; 30 (1): 17–25PubMedCrossRefGoogle Scholar
  55. 55.
    Krause N, Goldenhar L, Liang J, et al. Stress and exercise among the Japanese elderly. Soc Sci Med 1993; 36 (11): 1429–41PubMedCrossRefGoogle Scholar
  56. 56.
    Moore KA, Babyak MA, Wood CE, et al. The association between physical activity and depression in older depressed adults. J Aging Phys Act 1999; 7: 55–61Google Scholar
  57. 57.
    Ruuskanen JM, Ruoppila I. Physical activity and psychological well-being among people aged 65 to 84 years. Age Ageing 1995; 24: 292–6PubMedCrossRefGoogle Scholar
  58. 58.
    Stephens T. Physical activity and mental health in the United States and Canada: evidence from four population surveys. Prev Med 1988; 17: 35–47PubMedCrossRefGoogle Scholar
  59. 59.
    Weyerer S. Physical inactivity and depression in the community: evidence from the Upper Bavarian Field Study. Int J Sports Med 1992; 13 (6): 492–6PubMedCrossRefGoogle Scholar
  60. 60.
    Camacho TC, Roberts RE, Lazarus NB, et al. Physical activity and depression: evidence from the Alameda County study. Am J Epidemiol 1991; 134: 220–31PubMedGoogle Scholar
  61. 61.
    Farmer ME, Locke BZ, Moscicki EK, et al. Physical activity and depressive symptoms: the NHANES I epidemiologic follow-up study. Am J Epidemiol 1988; 128: 1340–51PubMedGoogle Scholar
  62. 62.
    Lampinen P, Heikkinen RL, Ruoppila I. Changes in intensity of physical exercise as predictors of depressive symptoms among older adults: an eight-year follow-up. Prev Med 2000; 30 (5): 371–80PubMedCrossRefGoogle Scholar
  63. 63.
    Mobily KE, Rubenstein LM, Lemke JH, et al. Walking and depression in a cohort of older adults: the Iowa 65+ Rural Health Study. J Aging Phys Act 1996; 4: 119–35Google Scholar
  64. 64.
    Paffenbarger Jr RS, Lee IM, Leung R. Physical activity and personal characteristics associated with depression and suicide in American college men. Acta Psychiatr Scand Suppl 1994; 377: 16–22PubMedCrossRefGoogle Scholar
  65. 65.
    DiLorenzo TM, Bargman EP, Stucky-Ropp R, et al. Long-term effects of aerobic exercise on psychological outcomes. Prev Med 1999; 28 (1): 75–85PubMedCrossRefGoogle Scholar
  66. 66.
    Roth DL, Holmes DS. Influence of aerobic exercise training and relaxation training on physical and psychologic health following stressful life events. Psychosom Med 1987; 49 (4): 355–65PubMedGoogle Scholar
  67. 67.
    Blumenthal JA, Emery CF, Madden DJ, et al. Cardiovascular and behavioral effects of aerobic exercise training in healthy older men and women. J Gerontol 1989; 44 (5): M147–57CrossRefGoogle Scholar
  68. 68.
    King AC, Taylor CB, Haskell WL. Effects of differing intensities and formats of 12 months of exercise training on psychological outcomes in older adults. Health Psychol 1993; 12 (4): 292–300PubMedCrossRefGoogle Scholar
  69. 69.
    Norvell N, Martin D, Salamon A. Psychological and physiological benefits of passive and aerobic exercise in sedentary middle-aged women. J Nerv Ment Dis 1991; 179 (9): 573–4PubMedCrossRefGoogle Scholar
  70. 70.
    Hughes JR, Casal DC, Leon AS. Psychological effects of exercise: a randomized cross-over trial. J Psychosom Res 1986; 30 (3): 355–60PubMedCrossRefGoogle Scholar
  71. 71.
    Palmer LK. Effects of a walking program on attributional style, depression, and self-esteem in women. Percept Mot Skills 1995; 81 (3): 891–8PubMedCrossRefGoogle Scholar
  72. 72.
    Emery CF, Gatz M. Psychological and cognitive effects of an exercise program for community-residing older adults. Gerontologist 1990; 30 (2): 184–8PubMedCrossRefGoogle Scholar
  73. 73.
    Gitlin LN, Lawton MP, Windsor-Landsberg LA, et al. In search of psychological benefits: exercise in healthy older adults. J Aging Health 1992; 4 (2): 174–92CrossRefGoogle Scholar
  74. 74.
    McMurdo ME, Burnett L. Randomised controlled trial of exercise in the elderly. Gerontology 1992; 38 (5): 292–8PubMedCrossRefGoogle Scholar
  75. 75.
    Lennox SS, Bedell JR, Stone AA. The effect of exercise on normal mood. J Psychosom Res 1990; 34 (6): 629–36PubMedCrossRefGoogle Scholar
  76. 76.
    Brown DR, Wang Y, Ward A, et al. Chronic psychological effects of exercise and exercise plus cognitive strategies. Med Sci Sports Exerc 1995; 27 (5): 765–75PubMedGoogle Scholar
  77. 77.
    Moses J, Steptoe A, Mathews A, et al. The effects of exercise training on mental well-being in the normal population: a controlled trial. J Psychosom Res 1989; 33 (1): 47–61PubMedCrossRefGoogle Scholar
  78. 78.
    King AC, Taylor CB, Haskell WL, et al. Influence of regular aerobic exercise on psychological health: a randomized, controlled trial of healthy middle-aged adults. Health Psychol 1989; 8 (3): 305–24PubMedCrossRefGoogle Scholar
  79. 79.
    Wenger NK, Froelicher ES, Smith LK, et al. Cardiac rehabilitation: clinical practice guideline No. 17. Rockville (MD): U.S. Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research and the National Heart, Lung, and Blood Institute, 1995Google Scholar
  80. 80.
    Stern MJ, Cleary P. The National Exercise and Heart Disease Project: long-term psychosocial outcome. Arch Intern Med 1982; 142 (6): 1093–7PubMedCrossRefGoogle Scholar
  81. 81.
    Lavie CJ, Milani RV. Benefits of cardiac rehabilitation and exercise training in elderly women. Am J Cardiol 1997; 79 (5): 664–6PubMedCrossRefGoogle Scholar
  82. 82.
    Lavie CJ, Milani RV. Effects of cardiac rehabilitation and exercise training programs in patients > or = 75 years of age. Am J Cardiol 1996; 78 (6): 675–7PubMedCrossRefGoogle Scholar
  83. 83.
    Milani RV, Lavie CJ, Cassidy MM. Effects of cardiac rehabilitation and exercise training programs on depression in patients after major coronary events. Am Heart J 1996; 132 (4): 726–32PubMedCrossRefGoogle Scholar
  84. 84.
    Lavie CJ, Milani RV. Effects of cardiac rehabilitation and exercise training on exercise capacity, coronary risk factors, behavioral characteristics, and quality of life in women. Am J Cardiol 1995; 75 (5): 340–3PubMedCrossRefGoogle Scholar
  85. 85.
    Beniamini Y, Rubenstein JJ, Zaichkowsky LD, et al. Effects of high-intensity strength training on quality-of-life parameters in cardiac rehabilitation patients. Am J Cardiol 1997; 80 (7): 841–6PubMedCrossRefGoogle Scholar
  86. 86.
    Blumenthal JA, Emery CF, Rejeski WJ. The effects of exercise training on psychosocial functioning after myocardial infarction. J Cardiopulm Rehabil 1988; 8 (5): 183–93CrossRefGoogle Scholar
  87. 87.
    Lavie CJ, Milani RV, Cassidy MM, et al. Effects of cardiac rehabilitation and exercise training programs in women with depression. Am J Cardiol 1999; 83 (10): 1480–3PubMedCrossRefGoogle Scholar
  88. 88.
    Lavie CJ, Milani RV. Effects of cardiac rehabilitation and exercise training programs on coronary patients with high levels of hostility. Mayo Clin Proc 1999; 74 (10): 959–66PubMedGoogle Scholar
  89. 89.
    Maines TY, Lavie CJ, Milani RV, et al. Effects of cardiac rehabilitation and exercise programs on exercise capacity, coronary risk factors, behavior, and quality of life in patients with coronary artery disease. South Med J 1997; 90 (1): 43–9PubMedCrossRefGoogle Scholar
  90. 90.
    Milani RV, Lavie CJ. Behavioral differences and effects of cardiac rehabilitation in diabetic patients following cardiac events. Am J Med 1996; 100 (5): 517–23PubMedCrossRefGoogle Scholar
  91. 91.
    Milani RV, Lavie CJ. Prevalence and effects of cardiac rehabilitation on depression in the elderly with coronary heart disease. Am J Cardiol 1998; 81 (10): 1233–6PubMedCrossRefGoogle Scholar
  92. 92.
    Taylor CB, Houston-Miller N, Ahn DK, et al. The effects of exercise training programs on psychosocial improvement in uncomplicated postmyocardial infarction patients. J Psychosom Res 1986; 30 (5): 581–7PubMedCrossRefGoogle Scholar
  93. 93.
    Withers NJ, Rudkin ST, White RJ. Anxiety and depression in severe chronic obstructive pulmonary disease: the effects of pulmonary rehabilitation. J Cardiopulm Rehabil 1999; 19 (6): 362–5PubMedCrossRefGoogle Scholar
  94. 94.
    White RJ, Rudkin ST, Ashley J, et al. Outpatient pulmonary rehabilitation in severe chronic obstructive pulmonary disease. J R Coll Physicians Lond 1997; 31 (5): 541–5PubMedGoogle Scholar
  95. 95.
    Emery CF, Schein RL, Hauck ER, et al. Psychological and cognitive outcomes of a randomized trial of exercise among patients with chronic obstructive pulmonary disease. Health Psychol 1998; 17 (3): 232–40PubMedCrossRefGoogle Scholar
  96. 96.
    Emery CF, Leatherman NE, Burker EJ, et al. Psychological outcomes of a pulmonary rehabilitation program. Chest 1991; 100 (3): 613–7PubMedCrossRefGoogle Scholar
  97. 97.
    Agle DP, Baum GL, Chester EH, et al. Multidiscipline treatment of chronic pulmonary insufficiency. 1. Psychologic aspects of rehabilitation. Psychosom Med 1973; 35 (1): 41–9PubMedGoogle Scholar
  98. 98.
    Ries AL, Kaplan RM, Limberg TM, et al. Effects of pulmonary rehabilitation on physiologic and psychosocial outcomes in patients with chronic obstructive pulmonary disease. Ann Intern Med 1995; 122 (11): 823–32PubMedGoogle Scholar
  99. 99.
    Ojanen M, Lahdensuo A, Laitinen J, et al. Psychosocial changes in patients participating in a chronic obstructive pulmonary disease rehabilitation program. Respiration 1993; 60 (2): 96–102PubMedCrossRefGoogle Scholar
  100. 100.
    Hakkinen A, Hakkinen K, Hannonen P, et al. Strength training induced adaptations in neuromuscular function of premenopausal women with fibromyalgia; comparison with healthy women. Ann Rheum Dis 2001; 60 (1): 21–6PubMedCrossRefGoogle Scholar
  101. 101.
    Jentoft E, Kvalvik A, Ngshoel A. Effects of pool-based and land-based aerobic exercise on women with fibromyalgia/ chronic widespread muscle pain. Arthritis Rheum 2001; 45 (1): 42–7PubMedCrossRefGoogle Scholar
  102. 102.
    Meyer BB, Lemley KJ. Utilizing exercise to affect the symptomology of fibromyalgia: a pilot study. Med Sci Sports Exerc 2000; 32 (10): 1691–7PubMedCrossRefGoogle Scholar
  103. 103.
    Wigers SH, Stiles TC, Vogel PA. Effects of aerobic exercise versus stress management treatment in fibromyalgia: a 4.5 year prospective study. Scand J Rheumatol 1996; 25 (2): 77–86PubMedCrossRefGoogle Scholar
  104. 104.
    Penninx BW, Rejeski WJ, Pandya J, et al. Exercise and depressive symptoms: a comparison of aerobic and resistance exercise effects on emotional and physical function in older persons with high and low depressive symptomatology. J Gerontol B Psychol Sci Soc Sci 2002; 57 (2): 124–32CrossRefGoogle Scholar
  105. 105.
    Noreau L, Moffet H, Drolet M, et al. Dance-based exercise program in rheumatoid arthritis: feasibility in individuals with American College of Rheumatology functional class III disease. Am J Phys Med Rehabil 1997; 76 (2): 109–13PubMedCrossRefGoogle Scholar
  106. 106.
    Noreau L, Martineau H, Roy L, et al. Effects of a modified dance-based exercise on cardiorespiratory fitness, psychological state and health status of persons with rheumatoid arthritis. Am J Phys Med Rehabil 1995; 74 (1): 19–27PubMedCrossRefGoogle Scholar
  107. 107.
    Perlman SG, Connell KJ, Clark A, et al. Dance-based aerobic exercise for rheumatoid arthritis. Arthritis Care Res 1990; 3 (1): 29–35PubMedGoogle Scholar
  108. 108.
    Minor MA, Hewett JE, Webel RR, et al. Efficacy of physical conditioning exercise in patients with rheumatoid arthritis and osteoarthritis. Arthritis Rheum 1989; 32 (11): 1396–405PubMedCrossRefGoogle Scholar
  109. 109.
    Daltroy LH, Robb-Nicholson C, Iversen MD, et al. Effectiveness of minimally supervised home aerobic training in patients with systemic rheumatic disease. Br J Rheumatol 1995; 34 (11): 1064–9PubMedCrossRefGoogle Scholar
  110. 110.
    Patrick DL, Ramsey SD, Spencer AC, et al. Economic evaluation of aquatic exercise for persons with osteoarthritis. Med Care 2001; 39 (5): 413–24PubMedCrossRefGoogle Scholar
  111. 111.
    MacVicar MG, Winningham ML. Promoting the functional capacity of cancer patients. Cancer Bull 1986; 38: 235–9Google Scholar
  112. 112.
    Mock V, Dow KH, Meares CJ, et al. Effects of exercise on fatigue, physical functioning, and emotional distress during radiation therapy for breast cancer. Oncol Nurs Forum 1997; 24 (6): 991–1000PubMedGoogle Scholar
  113. 113.
    Decker WA, Turner-McGlade J, Fehir KM. Psychosocial aspects and the physiological effects of a cardiopulmonary exercise program in patients undergoing bone marrow transplantation (BMT) for acute leukemia (AL). Transplant Proc 1989; 21 (1 Pt 3): 3068–9PubMedGoogle Scholar
  114. 114.
    Segar ML, Katch VL, Roth RS, et al. The effect of aerobic exercise on self-esteem and depressive and anxiety symptoms among breast cancer survivors. Oncol Nurs Forum 1998; 25 (1): 107–13 PubMedGoogle Scholar
  115. 115.
    Porock D, Kristjanson LJ, Tinnelly K, et al. An exercise intervention for advanced cancer patients experiencing fatigue: a pilot study. J Palliat Care 2000; 16 (3): 30–6PubMedGoogle Scholar
  116. 116.
    Wearden AJ, Morriss RK, Mullis R, et al. Randomised, doubleblind, placebo-controlled treatment trial of fluoxetine and graded exercise for chronic fatigue syndrome. Br J Psychiatry 1998; 172: 485–90PubMedCrossRefGoogle Scholar
  117. 117.
    Petajan JH, Gappmaier E, White AT, et al. Impact of aerobic training on fitness and quality of life inmultiple sclerosis. Ann Neurol 1996; 39 (4): 432–41PubMedCrossRefGoogle Scholar
  118. 118.
    Blumenthal JA, Babyak MA, Moore KA, et al. Effects of exercise training on older patients with major depression. Arch Intern Med 1999; 159 (19): 2349–56PubMedCrossRefGoogle Scholar
  119. 119.
    Doyne EJ, Ossip-Klein DJ, Bowman ED, et al. Running versus weight lifting in the treatment of depression. J Consult Clin Psychol 1987; 55 (5): 748–54PubMedCrossRefGoogle Scholar
  120. 120.
    Fremont J, Craighead LW. Aerobic exercise and cognitive therapy in the treatment of dysphoric moods. Cognit Ther Res 1987; 11 (2): 241–51CrossRefGoogle Scholar
  121. 121.
    Klein MH, Greist JH, Gurman AS, et al. A comparative outcome study of group psychotherapy vs exercise treatments for depression. Int J Ment Health 1985; 13 (3–4): 148–76Google Scholar
  122. 122.
    Martinsen EW, Hoffart A, Solberg O. Comparing aerobic with nonaerobic forms of exercise in the treatment of clinical depression: a randomized trial. Compr Psychiatry 1989; 30 (4): 324–31PubMedCrossRefGoogle Scholar
  123. 123.
    Martinsen EW, Medhus A, Sandvik L. Effects of aerobic exercise on depression: a controlled study. BMJ (Clin Res Ed) 1985; 291 (6488): 109CrossRefGoogle Scholar
  124. 124.
    McCann IL, Holmes DS. Influence of aerobic exercise on depression. J Pers Soc Psychol 1984; 46 (5): 1142–7PubMedCrossRefGoogle Scholar
  125. 125.
    McNeil JK, LeBlanc EM, Joyner M. The effect of exercise on depressive symptoms in the moderately depressed elderly. Psychol Aging 1991; 6 (3): 487–8PubMedCrossRefGoogle Scholar
  126. 126.
    Singh NA, Clemens KM, Fiatarone MA. A randomized controlled trial of progressive resistance training in depressed elders. J Gerontol A Bio Sci Med Sci 1997; 52 (1): M27–35CrossRefGoogle Scholar
  127. 127.
    Veale D, Le Fevre K, Pantelis C, et al. Aerobic exercise in the adjunctive treatment of depression: a randomized controlled trial. J R Soc Med 1992; 85 (9): 541–4PubMedGoogle Scholar
  128. 128.
    Singh NA, Clements KM, Singh MA. The efficacy of exercise as a long-term antidepressant in elderly subjects: a randomized, controlled trial. J Gerontol A Bio Sci Med Sci 2001; 56 (8): M497–504CrossRefGoogle Scholar
  129. 129.
    Martinsen EW. The role of aerobic exercise in the treatment of depression. Stress Med 1987; 3 (2): 93–100CrossRefGoogle Scholar
  130. 130.
    Martinsen EW. Physical activity and depression: clinical experience. Acta Psychiatr Scand Suppl 1994; 377: 23–7PubMedCrossRefGoogle Scholar
  131. 131.
    Babyak M, Blumenthal JA, Herman S, et al. Exercise treatment for major depression: maintenance of therapeutic benefit at 10 months. Psychosom Med 2000; 62 (5): 633–8PubMedGoogle Scholar
  132. 132.
    Iverson DC, Fielding JE, Crow RS, et al. The promotion of physical activity in the United States population: the status of programs in medical, worksite, community, and school settings. Public Health Rep 1985; 100 (2): 212–24PubMedGoogle Scholar
  133. 133.
    Blumenthal JA, Hart AB, Sherwood A, et al. Depression and vascular function in older adults: evaluating the benefits of exercise in a new study at Duke University. N C Med J 2001; 62 (2): 95–8PubMedGoogle Scholar
  134. 134.
    Craft LL, Landers DM. The effect of exercise on clinical depression and depression resulting from mental illness: a meta-analysis. J Sport Exerc Psych 1998; 20 (4): 339–57Google Scholar
  135. 135.
    Lawlor DA, Hopker SW. The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials. BMJ 2001; 322 (7289): 763–7PubMedCrossRefGoogle Scholar
  136. 136.
    North TC, McCullagh P, Tran ZV. Effect of exercise on depression. Exerc Sport Sci Rev 1990; 18: 379–415PubMedCrossRefGoogle Scholar
  137. 137.
    Delgado PL. Depression: the case for a monoamine deficiency. J Clin Psychiatry 2000; 61 Suppl. 6: 7–11PubMedGoogle Scholar
  138. 138.
    Delgado PL, Moreno FA. Role of norepinephrine in depression. J Clin Psychiatry 2000; 61 Suppl. 1: 5–12PubMedGoogle Scholar
  139. 139.
    Hirschfeld RM. History and evolution of the monoamine hypothesis of depression. J Clin Psychiatry 2000; 61 Suppl. 6: 4–6PubMedGoogle Scholar
  140. 140.
    Klimek V, Stockmeier C, Overholser J, et al. Reduced levels of norepinephrine transporters in the locus coeruleus in major depression. J Neurosci 1997; 17 (21): 8451–8PubMedGoogle Scholar
  141. 141.
    Charney DS. Monoamine dysfunction and the pathophysiology and treatment of depression. J Clin Psychiatry 1998; 59 Suppl. 14: 11–4PubMedGoogle Scholar
  142. 142.
    Schatzberg AF. Noradrenergic versus serotonergic antidepressants: predictors of treatment response. J Clin Psychiatry 1998; 59 Suppl. 14: 15–8PubMedGoogle Scholar
  143. 143.
    Dunn AL, Reigle TG, Youngstedt SD, et al. Brain norepinephrine and metabolites after treadmill training and wheel running in rats. Med Sci Sports Exerc 1996; 28 (2): 204–9PubMedCrossRefGoogle Scholar
  144. 144.
    Dishman RK. Brain monoamines, exercise, and behavioral stress: animal models. Med Sci Sports Exerc 1997; 29 (1): 63–74PubMedCrossRefGoogle Scholar
  145. 145.
    Dishman RK, Renner KJ, White-Welkley JE, et al. Treadmill exercise training augments brain norepinephrine response to familiar and novel stress. Brain Res Bull 2000; 52 (5): 337–42PubMedCrossRefGoogle Scholar
  146. 146.
    Chaouloff F. Physical exercise and brain monoamines: a review. Acta Physiol Scand 1989; 137 (1): 1–13PubMedCrossRefGoogle Scholar
  147. 147.
    Chaouloff F. Effects of acute physical exercise on central serotonergic systems. Med Sci Sports Exerc 1997; 29 (1): 58–62PubMedCrossRefGoogle Scholar
  148. 148.
    Lechin F, van der DB, Orozco B, et al. Plasma neurotransmitters, blood pressure, and heart rate during supine resting, orthostasis, and moderate exercise in dysthymic depressed patients. Biol Psychiatry 1995; 37 (12): 884–91PubMedCrossRefGoogle Scholar
  149. 149.
    Soares J, Naffah-Mazzacoratti MG, Cavalheiro EA. Increased serotonin levels in physically trained men. Braz J Med Bio Res 1994; 27 (7): 1635–8Google Scholar
  150. 150.
    Weicker H, Struder HK. Influence of exercise on serotonergic neuromodulation in the brain. Amino Acids 2001; 20 (1): 35–47PubMedCrossRefGoogle Scholar
  151. 151.
    Blomstrand E, Celsing F, Newsholme EA. Changes in plasma concentrations of aromatic and branched-chain amino acids during sustained exercise in man and their possible role in fatigue. Acta Physiol Scand 1988; 133 (1): 115–21PubMedCrossRefGoogle Scholar
  152. 152.
    Akil H, Haskett RF, Young EA, et al. Multiple HPA profiles in endogenous depression: effect of age and sex on cortisol and beta-endorphin. Biol Psychiatry 1993; 33 (2): 73–85PubMedCrossRefGoogle Scholar
  153. 153.
    Lesch KP, Laux G, Schulte HM, et al. Corticotropin and cortisol response to human CRH as a probe for HPA system integrity in major depressive disorder. Psychiatry Res 1988; 24 (1): 25–34PubMedCrossRefGoogle Scholar
  154. 154.
    Ehlert U, Gaab J, Heinrichs M. Psychoneuroendocrinological contributions to the etiology of depression, posttraumatic stress disorder, and stress-related bodily disorders: the role of the hypothalamus-pituitary-adrenal axis. Biol Psychol 2001; 57 (1–3): 141–52PubMedCrossRefGoogle Scholar
  155. 155.
    Gold PW, Goodwin FK, Chrousos GP. Clinical and biochemical manifestations of depression: relation to the neurobiology of stress -2. N Engl J Med 1988; 319 (7): 413–20PubMedCrossRefGoogle Scholar
  156. 156.
    Dienstbier RA. Behavioral correlates of sympathoadrenal reactivity: the toughness model. Med Sci Sports Exerc 1991; 23 (7): 846–52PubMedGoogle Scholar
  157. 157.
    Luger A, Deuster PA, Kyle SB, et al. Acute hypothalamicpituitary-adrenal responses to the stress of treadmill exercise: physiologic adaptations to physical training. N Engl J Med 1987; 316 (21): 1309–15PubMedCrossRefGoogle Scholar
  158. 158.
    Wittert GA, Livesey JH, Espiner EA, et al. Adaptation of the hypothalamopituitary adrenal axis to chronic exercise stress in humans. Med Sci Sports Exerc 1996; 28 (8): 1015–9PubMedCrossRefGoogle Scholar
  159. 159.
    Blumenthal JA, Fredrikson M, Matthews KA, et al. Stress reactivity and exercise training in premenopausal and postmenopausal women. Health Psychol 1991; 10 (6): 384–91PubMedCrossRefGoogle Scholar
  160. 160.
    Gold PW, Licinio J, Wong ML, et al. Corticotropin releasing hormone in the pathophysiology of melancholic and atypical depression and in the mechanism of action of antidepressant drugs. Ann N Y Acad Sci 1995; 771: 716–29PubMedCrossRefGoogle Scholar
  161. 161.
    Lanfumey L, Mannoury LC, Froger N, et al. 5-HT-HPA interactions in two models of transgenic mice relevant to major depression. Neurochem Res 2000; 25 (9–10): 1199–206PubMedCrossRefGoogle Scholar
  162. 162.
    Mokrani MC, Duval F, Crocq MA, et al. HPA axis dysfunction in depression: correlation with monoamine system abnormalities. Psychoneuroendocrinology 1997; 22 Suppl. 1: S63–8CrossRefGoogle Scholar
  163. 163.
    Pitchot W, Herrera C, Ansseau M. HPA axis dysfunction in major depression: relationship to 5-HT(1A) receptor activity. Neuropsychobiology 2001; 44 (2): 74–7PubMedCrossRefGoogle Scholar
  164. 164.
    Wildmann J, Kruger A, Schmole M, et al. Increase of circulating beta-endorphin-like immunoreactivity correlates with the change in feeling of pleasantness after running. Life Sci 1986; 38 (11): 997–1003PubMedCrossRefGoogle Scholar
  165. 165.
    Janal MN, Colt EW, Clark WC, et al. Pain sensitivity, mood and plasma endocrine levels in man following long-distance running: effects of naloxone. Pain 1984; 19 (1): 13–25PubMedCrossRefGoogle Scholar
  166. 166.
    Hoffmann P, Terenius L, Thoren P. Cerebrospinal fluid immunoreactive beta-endorphin concentration is increased by voluntary exercise in the spontaneously hypertensive rat. Regul Pept 1990; 28 (2): 233–9PubMedCrossRefGoogle Scholar
  167. 167.
    Lobstein DD, Rasmussen CL. Decreases in resting plasma betaendorphin and depression scores after endurance training. J Sports Med Phys Fitness 1991; 31 (4): 543–51PubMedGoogle Scholar
  168. 168.
    Darko DF, Risch SC, Gillin JC, et al. Association of betaendorphin with specific clinical symptoms of depression. Am J Psychiatry 1992; 149 (9): 1162–7PubMedGoogle Scholar
  169. 169.
    France RD, Urban BJ. Cerebrospinal fluid concentrations of beta-endorphin in chronic low back pain patients: influence of depression and treatment. Psychosomatics 1991; 32 (1): 72–7PubMedCrossRefGoogle Scholar
  170. 170.
    Krittayaphong R, Light KC, Golden RN, et al. Relationship among depression scores, beta-endorphin, and angina pectoris during exercise in patients with coronary artery disease. Clin J Pain 1996; 12 (2): 126–33PubMedCrossRefGoogle Scholar
  171. 171.
    Leary MR. The role of low self-esteem in emotional and behavioral problems: why is low self-esteem dysfunctional? J Soc Clin Psychol 1995; 14 (3): 297–314CrossRefGoogle Scholar
  172. 172.
    Roberts JE, Gotlib IH. Temporal variability in global self-esteem and specific self-evaluation as prospective predictors of emotional distress: specificity in predictors and outcome. J Abnorm Psychol 1997; 106 (4): 521–9PubMedCrossRefGoogle Scholar
  173. 173.
    Bandura A, Pastorelli C, Barbaranelli C, et al. Self-efficacy pathways to childhood depression. J Pers Soc Psychol 1999; 76 (2): 258–69PubMedCrossRefGoogle Scholar
  174. 174.
    Maciejewski PK. Self-efficacy as a mediator between stressful life events and depressive symptoms: differences based on history of prior depression. Br J Psychiatry 2000; 176: 373–8PubMedCrossRefGoogle Scholar
  175. 175.
    Muris P, Schmidt H, Lambrichs R, et al. Protective and vulnerability factors of depression in normal adolescents. Behav Res Ther 2001; 39 (5): 555–65PubMedCrossRefGoogle Scholar
  176. 176.
    Tillema JL. Negative mood, perceived self-efficacy, and personal standards in dysphoria: the effects of contextual cues on self-defeating patterns of cognition. Cognit Ther Res 2001; 25 (5): 535–49CrossRefGoogle Scholar
  177. 177.
    Bosscher RJ. Running and mixed physical exercises with depressed psychiatric patients. Int J Sport Psychol 1999; 24 (2): 170–84Google Scholar
  178. 178.
    Ossip-Klein DJ, Doyne EJ, Bowman ED, et al. Effects of running or weight lifting on self-concept in clinically depressed women. J Consult Clin Psychol 1989; 57 (1): 158–61PubMedCrossRefGoogle Scholar
  179. 179.
    McAuley E, Blissmer B, Katula J, et al. Physical activity, selfesteem, and self-efficacy relationships in older adults: a randomized controlled trial. Ann Behav Med 2000; 22 (2): 131–9PubMedCrossRefGoogle Scholar
  180. 180.
    Stice E, Hayward C, Cameron R, et al. Body-image and eating disturbances predict onset of depression among female adolescents: a longitudinal study. J Abnorm Psychol 2000; 109 (3): 438–44PubMedCrossRefGoogle Scholar
  181. 181.
    McAuley E, Mihalko SL, Bane SM. Exercise and self-esteem in middle-aged adults: multidimensional relationships and physical fitness and self-efficacy influences. J Behav Med 1997; 20 (1): 67–83PubMedCrossRefGoogle Scholar
  182. 182.
    Just N. The response styles theory of depression: tests and an extension of the theory. J Abnorm Psychol 1997; 106 (2): 221–9PubMedCrossRefGoogle Scholar
  183. 183.
    Nolen-Hoeksema S, Morrow J. Effects of rumination and distraction on naturally occurring depressed mood. Cogn Emot 1993; 7 (6): 561–70CrossRefGoogle Scholar
  184. 184.
    Hollon SD. Behavioral activation treatment for depression: a commentary. Clin Psychol Sci Pract 2001; 8 (3): 271–4CrossRefGoogle Scholar
  185. 185.
    Hughes JR. Psychological effects of habitual aerobic exercise: a critical review. Prev Med 1984; 13 (1): 66–78PubMedCrossRefGoogle Scholar
  186. 186.
    Dishman RK, Buckworth J. Adherence to physical activity. In: Morgan WP, editor. Physical activity and mental health. Washington (DC): Taylor & Francis, 1997: 63–80Google Scholar
  187. 187.
    Rhodes RE, Martin AD, Taunton JE, et al. Factors associated with exercise adherence among older adults: an individual perspective. Sports Med 1999; 28 (6): 397–411PubMedCrossRefGoogle Scholar
  188. 188.
    Prochaska JO, DiClemente CC. Stages and processes of selfchange of smoking: toward an integrative model of change. J Consult Clin Psychol 1983; 51 (3): 390–5PubMedCrossRefGoogle Scholar
  189. 189.
    Prochaska JO, Velicer WF, Rossi JS, et al. Stages of change and decisional balance for 12 problem behaviors. Health Psychol 1994; 13 (1): 39–46PubMedCrossRefGoogle Scholar
  190. 190.
    Martinsen EW. Benefits of exercise for the treatment of depression. Sports Med 1990; 9: 380–9PubMedCrossRefGoogle Scholar
  191. 191.
    Herman S, Blumenthal JA, Babyak M, et al. Exercise therapy for depression in middle-aged and older adults: predictors of early dropout and treatment failure. Health Psychol. In pressGoogle Scholar

Copyright information

© Adis International Limited 2002

Authors and Affiliations

  • Alisha L. Brosse
    • 1
  • Erin S. Sheets
    • 1
  • Heather S. Lett
    • 2
  • James A. Blumenthal
    • 2
  1. 1.Department of PsychologyUniversity of ColoradoBolderUSA
  2. 2.Department of Psychiatry and Behavioral SciencesDuke University Medical CenterDurhamUSA

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