Improvements in Psychosocial Functioning and Health-Related Quality of Life Following Exercise Augmentation in Patients With Treatment Response but Nonremitted Major Depressive Disorder: Results From the Tread Study

Abstract

BACKGROUND Functional impairments often remain despite symptomatic improvement with antidepressant treatment, supporting the need for novel treatment approaches. The present study examined the extent to which exercise augmentation improved several domains of psychosocial functioning and quality of life among depressed participants. METHODS Data were collected from 122 partial responders to antidepressant medication. Participants were randomized to either high (16 kilocalories per kilogram of weight per week [KKW]) or low dose (4KKW) exercise. Participants completed a combination of supervised and home-based exercise for 12 weeks. The Short-Form Health Survey, Work and Social Adjustment Scale, Social Adjustment Scale, the Quality of Life Enjoyment and Satisfaction Questionnaire, and the Satisfaction with Life Scale were collected at 6 and 12 weeks. Participants with data for at least one of the two follow-up time points (n=106) were analyzed using a linear mixed model to assess change from baseline within groups and the difference between groups for each psychosocial outcome measure. All analyses controlled for covariates, including baseline depressive symptomatology. RESULTS Participants experienced significant improvements in functioning across tested domains, and generally fell within a healthy range of functioning on all measures at Weeks 6 and 12. While no differences were found between exercise groups, improvements were observed across a variety of psychosocial and quality-of-life domains, even in the low exercise dose group. CONCLUSIONS These findings support exercise augmentation of antidepressant treatment as a viable intervention for treatment-resistant depression to improve function in addition to symptoms.

Early Improvement in Psychosocial Function Predicts Longer-Term Symptomatic Remission in Depressed Patients

“…These findings extend previous studies reporting substantial improvement in psychosocial function with a variety of treatments [7–13, 48]. They also add to an emerging literature that suggests that at least a subgroup of depressed individuals realize functional improvements early in the course of antidepressant treatment, and these early changes in work productivity and psychosocial function predict future clinical course [27].…”

Prediction of treatment outcomes to exercise in patients with nonremitted major depressive disorder

“…Full description of these measures have been published previously (Greer et al, 2016; Rethorst et al, 2013a; Rethorst et al, 2013b; Suterwala et al, 2016; Toups et al, 2011; Trivedi et al, 2011; Trivedi et al, 2006a). These variables were selected based on the results of these previously published findings and other factors that have been associated with treatment outcomes in depression (Sotsky et al, 1991; Trivedi et al, 2006b; Warden et al, 2007).…”

Impact of a structured, group-based running programme on clinical, cognitive and social function in youth and adults with complex mood disorders: a 12-week pilot study

“…Critically, however, there is scant information concerning the effects of exercise on non-mood outcomes, including social and cognitive functioning and quality of life, in patients who do not respond to first-line therapies,20 or who experience recurrent episodes and ongoing functional impairment,12 14 21 even after mood symptoms have improved 22 23. Here, only a handful of studies reported improvements in depressive symptoms24–26 and psychosocial functioning and quality of life27 in treatment-resistant clinical populations. Finally, there is a paucity of research examining the impact of exercise on outcomes in patients with BD 28.…”