Differential treatment effects of an integrated motivational interviewing and exercise intervention on depressive symptom profiles and associated factors: A randomised controlled cross-over trial among youth with major depression

Yasmina Nasstasia; Amanda L Baker; Terry J Lewin; Sean A Halpin; Leanne Hides; Brian J Kelly; Robin Callister

doi:10.1016/j.jad.2019.08.035

Differential treatment effects of an integrated motivational interviewing and exercise intervention on depressive symptom profiles and associated factors: A randomised controlled cross-over trial among youth with major depression

J Affect Disord. 2019 Dec 1:259:413-423. doi: 10.1016/j.jad.2019.08.035. Epub 2019 Aug 19.

Authors

Yasmina Nasstasia¹, Amanda L Baker², Terry J Lewin², Sean A Halpin³, Leanne Hides⁴, Brian J Kelly², Robin Callister⁵

Affiliations

¹ School of Psychology, University of Newcastle, Callaghan, NSW 2308, Australia. Electronic address: yasmina.nasstasia@newcastle.edu.au.
² School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia.
³ School of Psychology, University of Newcastle, Callaghan, NSW 2308, Australia.
⁴ School of Psychology, University of Queensland, St Lucia, QLD 4072, Australia.
⁵ Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia.

PMID: 31610998
DOI: 10.1016/j.jad.2019.08.035

Abstract

Background: Exercise is increasingly recognised as an efficacious intervention for major depressive disorder (MDD) but to our knowledge differential treatment effects on depressive symptom profiles (cognitive, somatic and affective) and associated changes in psychological, physiological and behavioural factors have not been examined among youth with MDD.

Methods: Sixty-eight participants (mean age 20.8) meeting DSM-IV diagnostic criteria for MDD were randomised to an Immediate intervention or Control/delayed condition (n = 34 per group). The integrated intervention comprised an initial session of motivational interviewing (MI) followed by a 12-week, multi-modal exercise program. Changes in depressive symptom profiles were assessed with the Beck Depression Inventory-II (BDI-II) total score and factorial symptom subscales.

Results: There were significant differential improvements in BDI-II total scores post-treatment among intervention participants, which were also observed across the cognitive and affective subscales. Individual BDI-II items from the cognitive subscale showing significant differential improvement related to negative self-concept, while those from the affective subscale related to interest/activation; the energy item within the somatic subscale also revealed significant differential improvement. Significant differential improvements were also observed in exercise participation, negative automatic thoughts, behavioural activation and bench press repetitions among intervention participants, which correlated significantly with depression improvements.

Limitations: The exercise intervention was delivered in a supervised, group format and potential social meditators of change cannot be excluded.

Conclusions: Exercise differentially effects depressive symptom profiles with similar antidepressant effects as would be expected from psychological therapies improving negative cognition and emotional health.

Keywords: Affective; Cognitive; Depression; Exercise; Somatic; Youth.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Cognition
Combined Modality Therapy
Cross-Over Studies
Delivery of Health Care, Integrated
Depressive Disorder, Major / psychology
Depressive Disorder, Major / therapy*
Exercise / psychology
Exercise Therapy / methods*
Female
Humans
Male
Motivational Interviewing / methods*
Treatment Outcome
Young Adult