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  • Addiction, Drugs
  • Information from Lay-Language Summaries is Embargoed Until the Conclusion of the Scientific Presentation

    013—Mood Disorders: Human Biomarkers, Treatment, and Post Mortem Studies

    Saturday, November 09, 2013, 1:00 pm - 3:15 pm

    13.01: Effects of exercise on anxiety and depression disorders: Review of meta-analyses and neurobiological mechanisms

    Location: 30B

    ">*H. BUDDE1, I. HELMICH2, M. WEGNER3;
    1Med. Sch. Hamburg, 20457 Hamburg, Germany; 2Dept. of Neurology, Psychosomatic Medicine, and Psychiatry, Inst. of Hlth. Promotion and Clin. Movement Science, German Sports Univ. Cologne, Cologne, Germany; 3Inst. of Sport Science, Univ. of Bern, Bern, Switzerland

    Abstract Body: Anxiety and depression are the most frequently diagnosed psychological diseases showing a high co-morbidity. They have a severe impact on the lives of the persons concerned. Many meta-analytical studies suggested a positive anxiolytic and depression-reducing effect of exercise programs. The aim of this research was to synthesise meta-analyses on the effects of exercise on anxiety and depression and to describe average effect sizes. For this purpose 39 meta-analyses were included reporting 53 effect sizes for anxiety scores of 61,100 participants and depression scores of 81,141 persons. The average documented anxiolytic effect of exercise in these reviews was small, 0.33. In contrast, the effect of exercise on depression was significantly higher and at a moderate level, 0.55. Data of randomized controlled trials suggest higher sizes for the effect of exercise on anxiety and depression leading to increases up to moderate and large effects, respectively. Additionally, exercise seems to be more beneficial for patients compared to participants within a non-clinical, normal range of psychological disease. Especially for the effect of exercise on anxiety, more high quality meta-analyses of randomized controlled trials are needed. Both diseases have been associated with similar underlying neurobiological mechanisms. Among such mechanisms are changes in monoamine, growth factors, and cortisol levels, as well as neurogenesis in limbic structures. Beside exercise psychotherapy and treatment with antidepressants (e.g. selective serotonin reuptake inhibitors) are common interventions for anxiety disorders as well as depression. The observed behavioral and biological influence of exercise training on depressive and anxiety disorders suggests that it induces the same neurobiological alterations as antidepressant drug treatment by elevating the levels of serotonin, increasing central norepinephrine neurotransmission, altering the hypothalamic adrenocortical system. Furthermore exercise stimulates the growth of new nerve cells and the induction of the release of proteins and peptides that improve the health and survival of nerve cells like Brain-derived neurotrophic factor (BDNF), Vascular Endothelial Growth Factor (VEGF), Insulin-like growth factor 1 (IGF-1) and Vascular Growth Factor (VGF).

    Lay Language Summary: This synthesis of all available meta-analyses on the impact of exercise or physical activity on different measures of anxiety and depression indicates that exercise has a positive effect. We examined the existing literature involving over 140.000 participants forming a review of 39 meta-analysis including 1,578 single studies representing the largest evidence based research ever, allowing a wide-ranging conclusion over the effect of exercise on anxiety and depression. The selected 39 meta-analyses reported the effects of exercise on anxiety scores of 61,100 participants and on depression scores of 81,141 persons. Overall, exercise had a positive effect on both depression and anxiety. However, individuals with depression benefitted more from exercise than persons with anxiety disorders. Anxiety and depression are the most frequently diagnosed psychological diseases showing a high co-occurance. Every fourth person in North America and Europe experiences at least one episode of depression or anxiety disorder over their lifetime. In elderly people, both mental diseases are even more prevalent. Anxiety and depression have a severe impact on the lives of the persons concerned. Traditional treatment with antidepressants and psychotherapy commonly has side effects like weight gain, increases in blood pressure, and impairment of sexual functions. Exercise could be a less costly and less time-consuming alternative to these traditional treatments. By synthesizing the existing meta-analyses on the impact of exercise on depression and/or anxiety our aim was to estimate more powerfully the true effect size in comparison to a less precise effect size derived in a single meta analysis. Thus, our synthesis was conducted on several trials of exercise treatment, in an effort to obtain a better understanding of how well this treatment works. Exclusively articles were incorporated which reported effect sizes for the impact of exercise or physical activity on different measures of anxiety and depression. Additionally, to the positive anxiolytic and depression-reducing effect of exercise programs, a physically active lifestyle seems to be more beneficial for patients compared to participants within a non-clinical, normal range of psychological diseases. Studies comparing exercise with medication as a treatment for depression showed that the efficiency of antidepressant medication is comparable to the effects of elevated physical activity. The effect of exercise on anxiety is also comparable to pharmacological treatments or cognitive behavioral therapy. Both diseases have been associated with similar underlying neurobiological mechanisms.
    Exercise as well as psychotherapy and treatment with antidepressants (e.g. selective serotonin reuptake inhibitors) are common interventions for anxiety disorders and depression. The observed behavioral and biological influence of exercise training on depressive and anxiety disorders suggests that it induces the same neurobiological alterations as antidepressant drug treatment by elevating the levels of serotonin, increasing central noradrenaline neurotransmission and altering the stress hormones. Furthermore exercise stimulates the growth of new nerve cells (neurogenesis) and the induction of the release of growth factors which improve the health and survival of nerve cells. Regarding the type of exercise, findings for both anxiety and depression vary in program and session length or frequency of sessions per week. Hence, especially for the effect of exercise on anxiety, more high quality studies are needed to fill this gap. Our review of existing research on exercise effecting depression and anxiety suggests that exercise could be a probate means for the treatment of depression and anxiety that is less costly, less time-consuming, and has fewer side effects than medication or psychotherapy alone.

    Information from Lay-Language Summaries is Embargoed Until the Conclusion of the Scientific Presentation

    013—Mood Disorders: Human Biomarkers, Treatment, and Post Mortem Studies

    Saturday, November 09, 2013, 1:00 pm - 3:15 pm

    13.01: Effects of exercise on anxiety and depression disorders: Review of meta-analyses and neurobiological mechanisms

    Location: 30B

    ">*H. BUDDE1, I. HELMICH2, M. WEGNER3;
    1Med. Sch. Hamburg, 20457 Hamburg, Germany; 2Dept. of Neurology, Psychosomatic Medicine, and Psychiatry, Inst. of Hlth. Promotion and Clin. Movement Science, German Sports Univ. Cologne, Cologne, Germany; 3Inst. of Sport Science, Univ. of Bern, Bern, Switzerland

    Abstract Body: Anxiety and depression are the most frequently diagnosed psychological diseases showing a high co-morbidity. They have a severe impact on the lives of the persons concerned. Many meta-analytical studies suggested a positive anxiolytic and depression-reducing effect of exercise programs. The aim of this research was to synthesise meta-analyses on the effects of exercise on anxiety and depression and to describe average effect sizes. For this purpose 39 meta-analyses were included reporting 53 effect sizes for anxiety scores of 61,100 participants and depression scores of 81,141 persons. The average documented anxiolytic effect of exercise in these reviews was small, 0.33. In contrast, the effect of exercise on depression was significantly higher and at a moderate level, 0.55. Data of randomized controlled trials suggest higher sizes for the effect of exercise on anxiety and depression leading to increases up to moderate and large effects, respectively. Additionally, exercise seems to be more beneficial for patients compared to participants within a non-clinical, normal range of psychological disease. Especially for the effect of exercise on anxiety, more high quality meta-analyses of randomized controlled trials are needed. Both diseases have been associated with similar underlying neurobiological mechanisms. Among such mechanisms are changes in monoamine, growth factors, and cortisol levels, as well as neurogenesis in limbic structures. Beside exercise psychotherapy and treatment with antidepressants (e.g. selective serotonin reuptake inhibitors) are common interventions for anxiety disorders as well as depression. The observed behavioral and biological influence of exercise training on depressive and anxiety disorders suggests that it induces the same neurobiological alterations as antidepressant drug treatment by elevating the levels of serotonin, increasing central norepinephrine neurotransmission, altering the hypothalamic adrenocortical system. Furthermore exercise stimulates the growth of new nerve cells and the induction of the release of proteins and peptides that improve the health and survival of nerve cells like Brain-derived neurotrophic factor (BDNF), Vascular Endothelial Growth Factor (VEGF), Insulin-like growth factor 1 (IGF-1) and Vascular Growth Factor (VGF).

    Lay Language Summary: This synthesis of all available meta-analyses on the impact of exercise or physical activity on different measures of anxiety and depression indicates that exercise has a positive effect. We examined the existing literature involving over 140.000 participants forming a review of 39 meta-analysis including 1,578 single studies representing the largest evidence based research ever, allowing a wide-ranging conclusion over the effect of exercise on anxiety and depression. The selected 39 meta-analyses reported the effects of exercise on anxiety scores of 61,100 participants and on depression scores of 81,141 persons. Overall, exercise had a positive effect on both depression and anxiety. However, individuals with depression benefitted more from exercise than persons with anxiety disorders. Anxiety and depression are the most frequently diagnosed psychological diseases showing a high co-occurance. Every fourth person in North America and Europe experiences at least one episode of depression or anxiety disorder over their lifetime. In elderly people, both mental diseases are even more prevalent. Anxiety and depression have a severe impact on the lives of the persons concerned. Traditional treatment with antidepressants and psychotherapy commonly has side effects like weight gain, increases in blood pressure, and impairment of sexual functions. Exercise could be a less costly and less time-consuming alternative to these traditional treatments. By synthesizing the existing meta-analyses on the impact of exercise on depression and/or anxiety our aim was to estimate more powerfully the true effect size in comparison to a less precise effect size derived in a single meta analysis. Thus, our synthesis was conducted on several trials of exercise treatment, in an effort to obtain a better understanding of how well this treatment works. Exclusively articles were incorporated which reported effect sizes for the impact of exercise or physical activity on different measures of anxiety and depression. Additionally, to the positive anxiolytic and depression-reducing effect of exercise programs, a physically active lifestyle seems to be more beneficial for patients compared to participants within a non-clinical, normal range of psychological diseases. Studies comparing exercise with medication as a treatment for depression showed that the efficiency of antidepressant medication is comparable to the effects of elevated physical activity. The effect of exercise on anxiety is also comparable to pharmacological treatments or cognitive behavioral therapy. Both diseases have been associated with similar underlying neurobiological mechanisms.
    Exercise as well as psychotherapy and treatment with antidepressants (e.g. selective serotonin reuptake inhibitors) are common interventions for anxiety disorders and depression. The observed behavioral and biological influence of exercise training on depressive and anxiety disorders suggests that it induces the same neurobiological alterations as antidepressant drug treatment by elevating the levels of serotonin, increasing central noradrenaline neurotransmission and altering the stress hormones. Furthermore exercise stimulates the growth of new nerve cells (neurogenesis) and the induction of the release of growth factors which improve the health and survival of nerve cells. Regarding the type of exercise, findings for both anxiety and depression vary in program and session length or frequency of sessions per week. Hence, especially for the effect of exercise on anxiety, more high quality studies are needed to fill this gap. Our review of existing research on exercise effecting depression and anxiety suggests that exercise could be a probate means for the treatment of depression and anxiety that is less costly, less time-consuming, and has fewer side effects than medication or psychotherapy alone.