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From the Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC.
Address reprint requests to: James A. Blumenthal, PhD, Department of Psychiatry and Behavioral Sciences, Box 3119, Duke University Medical Center, Durham, NC 27710. Email: blume003{at}mc.duke.edu
OBJECTIVE: The purpose of this study was to assess the status of 156 adult volunteers with major depressive disorder (MDD) 6 months after completion of a study in which they were randomly assigned to a 4-month course of aerobic exercise, sertraline therapy, or a combination of exercise and sertraline.
METHODS: The presence and severity of depression were assessed by clinical interview using the Diagnostic Interview Schedule and the Hamilton Rating Scale for Depression (HRSD) and by self-report using the Beck Depression Inventory. Assessments were performed at baseline, after 4 months of treatment, and 6 months after treatment was concluded (ie, after 10 months).
RESULTS: After 4 months patients in all three groups exhibited significant improvement; the proportion of remitted participants (ie, those who no longer met diagnostic criteria for MDD and had an HRSD score <8) was comparable across the three treatment conditions. After 10 months, however, remitted subjects in the exercise group had significantly lower relapse rates (p = .01) than subjects in the medication group. Exercising on one’s own during the follow-up period was associated with a reduced probability of depression diagnosis at the end of that period (odds ratio = 0.49, p = .0009).
CONCLUSIONS: Among individuals with MDD, exercise therapy is feasible and is associated with significant therapeutic benefit, especially if exercise is continued over time.
Key Words: depression, • exercise, • aging.
Abbreviations: BDI = Beck Depression Inventory;; DIS = Diagnostic Interview Schedule;; DSM-IV = Diagnostic and Statistical Manual of Mental Disorders, fourth edition;; HRSD = Hamilton Rating Scale for Depression;; MDD = major depressive disorder;; OR = odds ratio;; SMILE = Standard Medical Intervention and Long-Term Exercise (study).
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