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Physical activity following discharge from inpatient adult mental health settings 成人精神健康住院病人出院后的体育活动
IF 4.7 3区 医学 Q2 PSYCHIATRY Pub Date : 2023-12-18 DOI: 10.1016/j.mhpa.2023.100574
Philip Hodgson , Jack Haywood , Alex Benham

Background

People with severe mental illness are considerably less physically active than the general population and experience a premature mortality of 10–20 years, often attributed to modifiable behaviours, including physical activity. Inpatient environments provide opportunities for people with SMI to become more physically active, however evidence is limited on its sustainability following discharge to community settings.

Objective

This review aimed to summarise the published evidence relating to physical activity interventions following discharge from inpatient adult mental health settings.

Design

MEDLINE, CINAHL, PsycINFO and AMED databases were searched to identify articles considering physical activity interventions taking place following discharge from an adult (>18) inpatient mental health setting, published after 2007.

Results

Of 3412 unique results, 5 studies were eligible for inclusion. Despite all included studies involving some transition between inpatient and community mental health settings, to-date no study has focused exclusively on physical activity interventions delivered following discharge from inpatient mental health settings.

Conclusions

This review has found insufficient evidence to guide the delivery of physical activity following discharge from inpatient mental health services. Future research is required to improve our knowledge of the optimal forms and delivery of physical activity interventions during this time, alongside quantifying the impact on readmission rates and clinical presentation.

背景严重精神疾病患者的体育活动量远低于普通人群,他们的过早死亡率高达 10-20 年,这通常归咎于可改变的行为,包括体育活动。本综述旨在总结已发表的与成人精神疾病住院患者出院后体育锻炼干预措施相关的证据。设计检索了MEDLINE、CINAHL、PsycINFO和AMED数据库,以确定2007年后发表的、考虑成人(18岁)精神疾病住院患者出院后体育锻炼干预措施的文章。尽管所有纳入的研究都涉及到住院病人与社区精神健康环境之间的过渡,但迄今为止,还没有一项研究专门针对从住院精神健康环境出院后开展的体育活动干预。我们需要在未来开展研究,进一步了解在此期间体育锻炼干预的最佳形式和实施方法,同时量化其对再入院率和临床表现的影响。
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引用次数: 0
“Goldilocks days” for adolescent mental health: Movement behaviour combinations for well-being, anxiety and depression by gender 青少年心理健康的 "黄金日":按性别分列的促进幸福感、焦虑和抑郁的运动行为组合
IF 4.7 3区 医学 Q2 PSYCHIATRY Pub Date : 2023-12-13 DOI: 10.1016/j.mhpa.2023.100572
Markus J. Duncan , Nicholas Kuzik , Diego Augusto Santos Silva , Richard E. Bélanger , Valerie Carson , Jean-Philippe Chaput , Guy Faulkner , Mark A. Ferro , Anne-Marie Turcotte-Tremblay , Scott T. Leatherdale , Karen A. Patte , Mark S. Tremblay
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引用次数: 0
Physical activity interventions to improve mental health and wellbeing in university students in the UK: A service mapping study 体育活动干预以改善英国大学生的心理健康和福祉:一项服务测绘研究
IF 4.7 3区 医学 Q2 PSYCHIATRY Pub Date : 2023-11-29 DOI: 10.1016/j.mhpa.2023.100563
Francesca Malagodi , Eleanor J. Dommett , James L. Findon , Benjamin Gardner

Background and aims

Student mental health is of increasing concern: over a quarter of UK students report a mental health issue, and reactive support services cannot cope with increasing demand. Physical activity (PA) is associated with improved mental health in higher education settings. Universities are well placed to offer PA to promote students’ mental health and wellbeing. This study represents the first attempt to establish how many UK universities offer PA-based interventions to improve mental health and wellbeing of students, and what these interventions entail. We sought to identify, and code the characteristics of, interventions regarding how to encourage regular PA.

Methods

All UK universities were contacted and asked to report PA provisions available to students. We extracted key information from intervention descriptions, including using the Behaviour Change Technique (BCT) Taxonomy v1, to characterise component behaviour change strategies.

Results

Of 143 public UK universities identified, 125 (87%) responded to our request. Of these, only 45 (36%) universities had PA provisions in place, with a total of 54 interventions available across the country, each delivered for between 6 and 12 weeks. Most interventions were tailored (82%) and used BCTs focused on instructing students on how to perform physical activity (61%), restructuring the environment to facilitate activity (54%), and behavioural goal setting (46%).

Conclusions

Only a minority of UK universities offer PA interventions to students. These offerings focus on enhancing students' capabilities and giving greater opportunities for PA. Universities should consider offering greater PA provision to students, and address students’ motivation to engage in PA.

背景和目的学生的心理健康越来越受到关注:超过四分之一的英国学生报告有心理健康问题,而被动的支持服务无法应对日益增长的需求。在高等教育环境中,体育活动(PA)与改善心理健康有关。大学有能力提供PA来促进学生的心理健康和幸福。这项研究首次尝试确定有多少英国大学提供基于pa的干预措施来改善学生的心理健康和福祉,以及这些干预措施需要什么。我们试图识别和编码有关如何鼓励定期PA的干预措施的特征。方法联系所有英国大学,并要求其报告学生可获得的PA规定。我们从干预描述中提取关键信息,包括使用行为改变技术(BCT)分类法v1来描述组件的行为改变策略。结果在确定的143所英国公立大学中,125所(87%)回应了我们的要求。在这些大学中,只有45所(36%)大学有PA规定,全国共有54种干预措施,每种干预措施为期6至12周。大多数干预措施都是量身定制的(82%),使用的btc侧重于指导学生如何进行体育活动(61%),重组环境以促进活动(54%),以及设定行为目标(46%)。只有少数英国大学为学生提供心理干预。这些课程的重点是提高学生的能力,并为PA提供更多的机会。大学应该考虑为学生提供更多的PA,并解决学生参与PA的动机。
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引用次数: 0
Cross-cultural adaptation and validation of the Spanish version of the Exercise and Eating Disorders Questionnaire 西班牙语版运动与饮食失调问卷的跨文化适应与验证
IF 4.7 3区 医学 Q2 PSYCHIATRY Pub Date : 2023-11-26 DOI: 10.1016/j.mhpa.2023.100564
María Fernandez-del-Valle , Margarita Pérez Ruiz , Danika A. Quesnel , Alejandro F. San Juan , Andrea Barrios-Hernández , Montserrat Graell-Berna , Fernando Martínez-Abad

Purpose

This study aimed to adapt and assess the validity and reliability of the Spanish version of the Exercise in Eating Disorders Questionnaire (EED-Q) in order to diversify and offer a more comprehensive, effective, and standardized assessment of maladaptive exercise (ME) in ED.

Methods

The EED-Q is a self-reported questionnaire that assesses eating disorders (ED) patients' attitudes towards exercise. Based on the four-factor model of the original version, the EED-Q was adapted through forward and back-translation and inconsistencies were addressed through a committee of experts. Then, the EED-Q Spanish version (S-EED-Q) was administered to 172 patients with eating disorders (age = 15.28 ± 1.64 years). An exploratory factor analysis was computed to assess the construct validity. Inter-item correlations, item-factor correlations, McDonald's Omega, and Cronbach's Alpha were estimated to test the internal consistency (reliability). In addition, convergent validity was tested by relating EED-Q and the Eating Disorders Inventory 2 (EDI-2) scores, discriminant validity was assessed comparing EED-Q item-factor correlations, and divergent validity was conducted by analyzing EED-Q factor correlations.

Results

The S-EED-Q revealed significant generalized correlations among the scale items and showed good reliability scores (McDonald's Omega and Cronbach's alpha >0.7) except for Factor 2 (McDonald's Omega = 0.63 and Cronbach's alpha = 0.58). After eliminating items 8 and 15 due to their low factor loadings, the EFA revealed a robust empirical factor structure, adequate to the theoretical model, with good levels of total explained variance (65%). Convergent, discriminant and divergent validity showed good performance: results showed expected correlations between EED-Q and EDI-2, all items achieved higher item-factor correlations in their theoretical factor than in the others, and all factor-factor correlations were as expected.

Conclusion

This study is the first to adapt and validate the S-EED-Q. The psychometric properties of the S-EED-Q compared to the original version were supported with some limitations. Although the psychometric properties of the scale are adequate and the construct, convergent, discriminant and divergent validity are endorsed, some of the original items are questionable. Likewise, the items of the positive and healthy exercise factor require an in-depth revision.

目的对西班牙语版《饮食失调运动问卷》(ED - q)的效度和信度进行调整和评估,以期对饮食失调(ED)患者的适应性不良运动(ME)进行更全面、有效和标准化的评估。方法ED- q是一份评估饮食失调(ED)患者对运动态度的自填问卷。在原版本的四因素模型的基础上,通过前后翻译对ed - q进行了调整,并通过专家委员会解决了不一致之处。然后,对172例饮食失调患者(年龄= 15.28±1.64岁)实施ed - q西班牙版(s - ed - q)。采用探索性因子分析评估构念效度。评估项目间相关、项目-因素相关、麦当劳ω和Cronbach's Alpha来检验内部一致性(信度)。此外,通过将ed - q与饮食失调量表2 (edi2)的得分相关联来检验收敛效度,通过比较ed - q项目因子的相关性来评估判别效度,通过分析ed - q因素的相关性来评估发散效度。结果s - ed - q量表项间具有显著的广义相关性,除因子2 (McDonald's Omega = 0.63, Cronbach's alpha = 0.58)外,其他量表项均具有较好的信度得分(McDonald's Omega和Cronbach's alpha >0.7)。由于项目8和15的低因子负荷,在消除项目8和15后,EFA显示了一个强大的经验因素结构,足以满足理论模型,具有良好的总解释方差水平(65%)。收敛效度、判别效度和发散效度表现良好:结果显示ed - q和ed -2之间存在预期的相关,所有项目在其理论因子上的项目-因子相关均高于其他项目,所有因素-因子相关均符合预期。结论本研究首次采用并验证了s - ed - q。与原始版本相比,s - ed - q的心理测量特性得到了支持,但存在一些局限性。虽然该量表的心理测量特性是充分的,并且其结构效度、收敛效度、判别效度和发散效度都是被认可的,但一些原始项目是值得怀疑的。同样,积极和健康运动因素的项目也需要深入修订。
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引用次数: 0
Physical activity and mental health: Comparing between-person and within-person associations in longitudinal analysis 体育活动与心理健康:纵向分析中人与人之间关联的比较
IF 4.7 3区 医学 Q2 PSYCHIATRY Pub Date : 2023-10-01 DOI: 10.1016/j.mhpa.2023.100546
Chloe Sher , Cary Wu

Background

Extensive research has consistently highlighted the strong association between physical activity and mental health. But few have examined how this association may differ at the between-person and the within-person level. This longitudinal study compares how within-person and between-person changes in physical activity are associated mental health during the COVID-19 pandemic among the American population.

Methods

We analyzed data from the Understanding Coronavirus in America (UCA) survey, a probability-based online panel of American adults. An average of more than 6000 panel members repeatedly participated across 33 waves from the start of the pandemic in March 2020 to January 2023. Measures of physical activity include 1) number of days exercised in the past week (0–7), and 2) whether gone outside to walk, hike, and exercise in the past week (0 = no, 1 = yes), capturing both the frequency and the context (e.g., outdoor) of physical activity. Mental health is indicated using the four-item Patient Health Questionnaire (PHQ-4). We used multilevel Within-Between Random Effects models (REWB) that provide coefficients for both between-individual as well as within-individual associations.

Results

We reported three main findings. First, both within-person and between-person increases in physical activity are significantly associated with lower levels of anxiety and depression regardless of the measure. Second, between-person changes in physical activity are more strongly associated with mental health than within-person changes. Third, a large share of the between-person association (about 32%) can be attributed to structural inequalities captured by status markers such as gender, race, and SES.

Conclusions

Our findings indicate the value of physical activity as a mental health intervention and highlight that both between-individual inequality in physical activity, as well as within-individual changes in physical activity, should be considered. The finding of a stronger between-person association that is largely related to status markers such as gender, race, and SES can be used to develop targeted intervention and prevention strategies to improve mental health through physical activity among the most vulnerable populations.

背景广泛的研究一直强调体育活动与心理健康之间的密切联系。但很少有人研究过这种联系在人与人之间和人与人内部的差异。这项纵向研究比较了在新冠肺炎大流行期间,美国人口中身体活动的人内和人间变化与心理健康的关系。方法我们分析了美国了解冠状病毒(UCA)调查的数据,这是一个基于概率的美国成年人在线小组。从2020年3月疫情开始到2023年1月,平均有6000多名小组成员在33波疫情中反复参与。体育活动的衡量标准包括1)过去一周锻炼的天数(0-7),以及2)过去一周有无外出散步、徒步旅行和锻炼(0=否,1=是),记录体育活动的频率和背景(如户外)。心理健康使用四项患者健康问卷(PHQ-4)来表示。我们使用了多级随机效应内部模型(REWB),该模型提供了个体之间以及个体内部关联的系数。结果我们报告了三个主要发现。首先,无论采取何种措施,人内和人与人之间体育活动的增加都与焦虑和抑郁水平的降低显著相关。其次,人与人之间身体活动的变化比人与人内部的变化与心理健康的关系更为密切。第三,人与人之间的联系有很大一部分(约32%)可归因于性别、种族和SES等身份标记所捕捉到的结构性不平等。结论我们的研究结果表明了体育活动作为心理健康干预的价值,并强调了个人体育活动中的不平等,应予以考虑。发现人与人之间的联系更强,这在很大程度上与性别、种族和社会经济地位等地位标志有关,可以用来制定有针对性的干预和预防策略,通过体育活动改善最脆弱人群的心理健康。
{"title":"Physical activity and mental health: Comparing between-person and within-person associations in longitudinal analysis","authors":"Chloe Sher ,&nbsp;Cary Wu","doi":"10.1016/j.mhpa.2023.100546","DOIUrl":"https://doi.org/10.1016/j.mhpa.2023.100546","url":null,"abstract":"<div><h3>Background</h3><p>Extensive research has consistently highlighted the strong association between physical activity and mental health. But few have examined how this association may differ at the between-person and the within-person level. This longitudinal study compares how within-person and between-person changes in physical activity are associated mental health during the COVID-19 pandemic among the American population.</p></div><div><h3>Methods</h3><p>We analyzed data from the Understanding Coronavirus in America (UCA) survey, a probability-based online panel of American adults. An average of more than 6000 panel members repeatedly participated across 33 waves from the start of the pandemic in March 2020 to January 2023. Measures of physical activity include 1) number of days exercised in the past week (0–7), and 2) whether gone outside to walk, hike, and exercise in the past week (0 = no, 1 = yes), capturing both the frequency and the context (e.g., outdoor) of physical activity. Mental health is indicated using the four-item Patient Health Questionnaire (PHQ-4). We used multilevel Within-Between Random Effects models (REWB) that provide coefficients for both between-individual as well as within-individual associations.</p></div><div><h3>Results</h3><p>We reported three main findings. First, both within-person and between-person increases in physical activity are significantly associated with lower levels of anxiety and depression regardless of the measure. Second, between-person changes in physical activity are more strongly associated with mental health than within-person changes. Third, a large share of the between-person association (about 32%) can be attributed to structural inequalities captured by status markers such as gender, race, and SES.</p></div><div><h3>Conclusions</h3><p>Our findings indicate the value of physical activity as a mental health intervention and highlight that both between-individual inequality in physical activity, as well as within-individual changes in physical activity, should be considered. The finding of a stronger between-person association that is largely related to status markers such as gender, race, and SES can be used to develop targeted intervention and prevention strategies to improve mental health through physical activity among the most vulnerable populations.</p></div>","PeriodicalId":51589,"journal":{"name":"Mental Health and Physical Activity","volume":"25 ","pages":"Article 100546"},"PeriodicalIF":4.7,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50187486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Physical activity interventions for young people with increased risk of problematic substance use: A systematic review including different intervention formats 针对问题药物使用风险增加的年轻人的体育活动干预:包括不同干预形式的系统综述
IF 4.7 3区 医学 Q2 PSYCHIATRY Pub Date : 2023-10-01 DOI: 10.1016/j.mhpa.2023.100551
Lisa Klamert , Gillinder Bedi , Melinda Craike , Susan Kidd , Michaela C. Pascoe , Alexandra G. Parker

Objective

This systematic review investigates physical activity (PA) interventions for (1) reducing substance use and associated outcomes, (2) increasing physical activity, and (3) improving mental health in young people aged 12–25 years at increased risk for problematic substance use.

Method

Four databases (PsycINFO, CINAHL, SPORTDiscus, and Medline) and grey literature, including hand searches, were searched (2021–2022). Non-randomized controlled or randomized controlled trials of a) multimodal or unimodal, short or long-term physical activity interventions in young people at increased risk of problematic substance use that b) investigated substance use outcomes were included. PA and mental health outcomes were explored where possible.

Results

Sixty-one percent of the studies (k = 17/28) reported a significant improvement in outcomes related to tobacco (e.g., abstinence, cravings, withdrawal symptoms, smoking pattern), alcohol (e.g., quantity, frequency), or other substance use (e.g., frequency, quantity, recent use). Eight studies reported an increase in PA participation; two reported a beneficial effect on depression symptoms. The certainty of the evidence, i.e., the confidence in the reported effect estimates, was downgraded based on the risk of bias assessment. Findings should therefore be interpreted cautiously.

Conclusions

A range of physical activity intervention formats and modalities may decrease substance use and associated outcomes and increase physical activity participation among people at risk for problematic substance use. Future research is warranted to better establish efficacy and investigate the effectiveness of implementing physical activity as part of treatment for substance use in young people.

目的本系统综述调查了体育活动(PA)干预措施,以(1)减少物质使用和相关结果,(2)增加体育活动,以及(3)改善12-25岁年轻人的心理健康,这些年轻人的问题物质使用风险增加。方法检索四个数据库(PsycINFO、CINAHL、SPORTDiscus和Medline)和灰色文献,包括手搜索(2021–2022)。包括a)对问题药物使用风险增加的年轻人进行多模式或单一模式、短期或长期体育活动干预的非随机对照或随机对照试验,b)调查药物使用结果。在可能的情况下,对PA和心理健康结果进行了探讨。结果61%的研究(k=17/28)报告称,与烟草(如禁欲、食欲、戒断症状、吸烟模式)、酒精(如数量、频率)或其他物质使用(如频率、数量、最近使用)有关的结果有显著改善。八项研究报告了巴勒斯坦权力机构参与度的增加;两人报告了对抑郁症症状的有益效果。证据的确定性,即对报告效果估计的置信度,根据偏差评估的风险进行了降级。因此,应当谨慎地解释调查结果。结论一系列体育活动干预形式和模式可以减少药物使用和相关结果,并增加有问题药物使用风险人群的体育活动参与度。未来的研究有必要更好地确定疗效,并调查将体育活动作为年轻人药物使用治疗的一部分的有效性。
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引用次数: 1
Interventions to increase physical activity and reduce sedentary behaviour in severe mental ill health: How effective are they?’- A systematic review 在严重精神疾病中增加体育活动和减少久坐行为的干预措施:效果如何?”-系统综述
IF 4.7 3区 医学 Q2 PSYCHIATRY Pub Date : 2023-10-01 DOI: 10.1016/j.mhpa.2023.100547
Emily Peckham , Garry Tew , Ben Lorimer , Laura Bailey , Rebecca Beeken , Cindy Cooper , Samantha Gascoyne , Simon Gilbody , Gareth Jones , Katarzyna Machaczek , Katie Pickering , Gemma Traviss-Turner , Brendon Stubbs

Background

People with severe mental ill health experience a mortality gap of 15–20 years and one of the main reasons for this is due to preventable physical health conditions. Physical activity can reduce the risk of developing physical health conditions such as diabetes and cardiovascular disease yet people with severe mental ill health are less physically active and more sedentary than the general population.

Methods

A systematic review was conducted to investigate the effectiveness of interventions aimed at increasing physical activity and reducing sedentary behaviour in people with severe mental ill health. The protocol was published with PROSPERO (CRD42021277579). Randomised controlled trials conducted in any country in any setting and published in English with an aim of increasing physical activity or reducing sedentary behaviour were included.

Results

Eleven unique studies were identified for inclusion. Due to the variability between interventions, outcome measures, and time points, it was not possible to conduct a meta-analysis. Effect estimates suggested that three of the interventions were effective at increasing physical activity. However, the certainty of the evidence was rated as low using the GRADE approach.

Conclusions

The evidence on interventions to increase activity shows promise but is insufficiently robust for an intervention to be recommended in clinical guidelines. More high-quality and statistically powered trials are needed to guide best practice and policy.

背景患有严重精神疾病的人的死亡率差距为15-20年,其中一个主要原因是可预防的身体健康状况。体育活动可以降低患糖尿病和心血管疾病等身体健康状况的风险,但与普通人群相比,患有严重精神疾病的人身体活动较少,久坐不动。方法对严重精神疾病患者增加体力活动和减少久坐行为的干预措施的有效性进行系统综述。该方案由PROSPERO发布(CRD42021277579)。随机对照试验在任何国家、任何环境中进行,并以英语发表,目的是增加体力活动或减少久坐行为。结果确定了11项独特的纳入研究。由于干预措施、结果测量和时间点之间的可变性,不可能进行荟萃分析。效果估计表明,其中三项干预措施在增加体力活动方面是有效的。然而,使用GRADE方法,证据的确定性被评为低。结论关于增加活动的干预措施的证据显示出了希望,但对于临床指南中推荐的干预措施来说不够有力。需要进行更多高质量和有统计依据的试验,以指导最佳做法和政策。
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引用次数: 1
Effects of different exercise patterns on drug craving in female methamphetamine-dependent patients: Evidence from behavior and fNIRS 不同运动方式对女性甲基苯丙胺依赖患者药物渴求的影响:来自行为学和fNIRS的证据
IF 4.7 3区 医学 Q2 PSYCHIATRY Pub Date : 2023-10-01 DOI: 10.1016/j.mhpa.2023.100534
Yifan Chen , Xuru Wang , Chenglin Zhou

Objective

To explore the effects of short-term moderate-intensity cycle ergometer and aerobic calisthenics training on drug craving and brain activity.

Methods

Forty female methamphetamine (MA)-dependent patients were randomly assigned to receive 30 min of either moderate-intensity cycle ergometer or aerobic calisthenics training. Before and after exercise, drug-cue exposure task was used to assess changes in subjective drug craving, and functional near-infrared spectroscopy (fNIRS) was used to assess activation of prefrontal cortex.

Results

After the intervention, drug craving was significantly decreased in both groups, and activation of frontal polar area (FPA) was significantly decreased in the cycle ergometer group. Functional connectivity between right dorsolateral prefrontal cortex (DLPFC) and FPA in the aerobic calisthenics group was significantly reduced. Pre-exercise levels of drug craving correlated positively with FPA activation.

Conclusion

Both short-term moderate-intensity cycle ergometer and aerobic calisthenics training effectively reduced subjective drug craving in female MA-dependent patients. Cycle ergometer training mainly decreased neural activity in FPA, and likely suppressed drug craving by reducing the episodic memory and pleasure experience of drug-related cues. Aerobic calisthenics training reduced functional connectivity between FPA and right DLPFC, and likely helped subjects reduce the motivation for drug-related behavior and inhibit drug craving.

目的探讨短期中等强度循环测功和有氧健美操训练对药物渴求和大脑活动的影响。方法将40例女性甲基苯丙胺(MA)依赖患者随机分为两组,一组接受30分钟的中等强度循环测功训练,另一组接受有氧健美操训练。运动前后,药物线索暴露任务用于评估主观药物渴求的变化,功能性近红外光谱(fNIRS)用于评估前额叶皮层的激活。结果干预后,两组患者对药物的渴求程度均显著降低,自行车测力计组的额极区(FPA)激活程度显著降低。有氧健美操组右背外侧前额叶皮层(DLPFC)和FPA之间的功能连接显著降低。运动前的药物渴求水平与FPA的激活呈正相关。结论短期中等强度循环测力计和有氧健美操训练均能有效降低女性MA依赖患者的主观药物渴求。周期测力计训练主要降低FPA的神经活动,并可能通过减少与毒品有关的线索的情景记忆和愉悦体验来抑制药物渴求。有氧健美操训练降低了FPA和右侧DLPFC之间的功能连接,可能有助于受试者减少与毒品有关的行为动机并抑制药物渴求。
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引用次数: 0
Adding web-based support to exercise referral schemes improves symptoms of depression in people with elevated depressive symptoms: A secondary analysis of the e-coachER randomised controlled trial 在运动转诊计划中添加基于网络的支持可以改善抑郁症状加重者的抑郁症状:e-oachER随机对照试验的二次分析
IF 4.7 3区 医学 Q2 PSYCHIATRY Pub Date : 2023-10-01 DOI: 10.1016/j.mhpa.2023.100535
Jeffrey Lambert , Adrian Taylor , Adam Streeter , Colin Greaves , Wendy M. Ingram , Sarah Dean , Kate Jolly , Nanette Mutrie , Lisa Price , John Campbell
<div><h3>Background</h3><p>Exercise referral schemes (ERS) reduce depression but the additional effect on mental health from web-based behavioural support is unknown. The e-coachER trial reported no effect of augmenting usual ERS with theory-driven web-based behavioural support on moderate to vigorous physical activity (MVPA) at 12 months for patients with chronic physical and mental health conditions. The present study reports the effects of the e-coachER intervention on depression, anxiety and MVPA only among participants with elevated depressive symptoms and investigates whether these were mediated by changes in MVPA and hypothesised cognitive and behavioural processes.</p></div><div><h3>Methods</h3><p>Of the original 450 adults recruited into the e-coachER trial, 205 had at least mild depression, based on the Hospital Anxiety and Depression Scale (HADS), and were included in the present analysis. Data collected included the HADS, accelerometer measured and self-reported MVPA and survey process measures on physical activity action planning, self-monitoring and goal reviewing, and perceived importance, confidence, competence, autonomy and support. Linear mixed models were used to compare groups for change in depression and anxiety at 4 and 12 months using intention-to-treat complete case analysis, controlling for baseline. We also examined whether changes in physical activity and process variables at 4 months mediated changes in depression and anxiety at 12 months.</p></div><div><h3>Results</h3><p>Of the 205 participants, 138 (67%) provided follow-up data at four months and 126 (61%) at 12 months. For those that provided follow-up data, those randomised to e-coachER reported improved levels of depression (−1.36, 95% CI: −2.55 to −0.18) but not anxiety, or MVPA, compared with controls at four months. No differences were observed at 12 months for depression, anxiety or MVPA. Intervention effects on accelerometer-measured or self-reported MVPA did not mediate improvements in depression or anxiety. However, intervention effects on confidence, competence and self-monitoring at four months significantly mediated the reduction in depression scores at four months. Intervention effects on competence and self-monitoring at four months also significantly mediated improvements in anxiety scores at four months.</p></div><div><h3>Interpretation</h3><p>Adding web-based support to usual <span>ERS</span> leads to reductions in depression but not anxiety at four months. Changes in depression and anxiety were influenced by changing people's motivational regulations toward physical activity. The benefit of adding web-based support to usual <span>ERS</span> on mental health appears to be from increasing a sense of confidence, competence and self-monitoring rather than from increasing physical activity in people with elevated depression. ERS should focus more on strengthening motivational regulations than just doing more exercise.</p></div><div><h3>Trial registratio
背景运动推荐计划(ERS)可以减少抑郁,但网络行为支持对心理健康的额外影响尚不清楚。e-oachER试验报告称,对于患有慢性身心健康状况的患者,在12个月时,通过理论驱动的基于网络的行为支持来增强常规ERS对中等至剧烈体力活动(MVPA)没有影响。本研究仅在抑郁症状加重的参与者中报告了电子乙酰胆碱酯酶干预对抑郁、焦虑和MVPA的影响,并调查了这些影响是否由MVPA的变化以及假设的认知和行为过程介导。方法根据医院焦虑和抑郁量表(HADS),在最初招募的450名参与e-oachER试验的成年人中,205人至少患有轻度抑郁症,并被纳入本分析。收集的数据包括HADS、加速度计测量和自我报告的MVPA以及关于体育活动行动计划、自我监测和目标审查以及感知重要性、信心、能力、自主性和支持的调查过程测量。线性混合模型用于比较各组在4个月和12个月时抑郁和焦虑的变化,使用意向治疗完整病例分析,控制基线。我们还研究了4个月时身体活动和过程变量的变化是否介导了12个月时抑郁和焦虑的变化。结果205名参与者中,138人(67%)在4个月时提供了随访数据,126人(61%)在12个月时获得了随访数据。对于那些提供随访数据的人,那些被随机分配到e-oachER的人在四个月时报告说,与对照组相比,抑郁水平有所改善(−1.36,95%CI:−2.55至−0.18),但焦虑或MVPA没有改善。在12个月时,没有观察到抑郁、焦虑或MVPA的差异。对加速度计测量或自我报告的MVPA的干预效果并没有介导抑郁或焦虑的改善。然而,在四个月时,对信心、能力和自我监控的干预效果显著介导了四个月抑郁评分的降低。干预对四个月时能力和自我监控的影响也显著介导了四个月后焦虑评分的改善。解释在通常的ERS中添加基于网络的支持可以在四个月时减少抑郁,但不会减少焦虑。抑郁和焦虑的变化受到人们对体育活动动机规则变化的影响。在通常的心理健康ERS中增加基于网络的支持的好处似乎是增加了自信、能力和自我监控感,而不是增加了抑郁症患者的体育活动。ERS应该更多地关注加强激励条例,而不仅仅是做更多的锻炼。试验注册ISRCTN15644451。
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引用次数: 0
Investigating psychosocial and behavioural mediators of the relationship between physical activity and depressive symptoms in women from socioeconomically disadvantaged neighbourhoods 调查社会经济弱势社区妇女身体活动与抑郁症状之间关系的社会心理和行为中介因素
IF 4.7 3区 医学 Q2 PSYCHIATRY Pub Date : 2023-10-01 DOI: 10.1016/j.mhpa.2023.100560
Thea Baker , Rhiannon White , Gavin Abbott , Eloise Litterbach , Megan Teychenne
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引用次数: 0
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Mental Health and Physical Activity
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