Buscar en
Revista Colombiana de Psiquiatría
Toda la web
Inicio Revista Colombiana de Psiquiatría Ejercicio y depresión
Información de la revista
Vol. 39. Núm. 4.
Páginas 732-748 (Diciembre 2010)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 39. Núm. 4.
Páginas 732-748 (Diciembre 2010)
Artículos de revisión/actualización
Acceso a texto completo
Ejercicio y depresión
Exercise and Depression
Visitas
1128
Felipe Villegas Salazar1,
Autor para correspondencia
felipevillegas15@hotmail.com

Correspondencia: Felipe Villegas Salazar, Departamento de Psiquiatría y Salud Mental, Hospital de San Ignacio, Carrera 7a N° 40-62, Bogotá, Colombia
1 Médico residente de tercer año de Psiquiatría, Pontificia Universidad Javeriana, Bogotá, Colombia
Este artículo ha recibido
Información del artículo
Resumen
Introducción

Cada vez más, el ejercicio se presenta como una elección terapéutica viable para el manejo de los trastornos depresivos.

Objetivo

Describir la evidencia existente con relación al ejercicio como tratamiento de los trastornos depresivos, la plausibilidad biológica de esta asociación, las diferencias entre los distintos tipos de ejercicio y divergencias de la efectividad en diferentes poblaciones.

Método

Se realizó una búsqueda sistemática de la literatura en Medline de los siguientes términos MeSH: exercise y depression utilizando el conector [and], limitado a los artículos por idioma (inglés y español). Posteriormente hubo una búsqueda secundaria de las bibliografías citadas.

Resultados

Algunos estudios indican una asociación bidireccional entre el sedentarismo y los trastornos depresivos, motivo por el cual el ejercicio puede ser benéfico como tratamiento para los trastornos depresivos. El ejercicio es un tratamiento seguro que puede ayudar al control sintomático de otras enfermedades asociadas.

Conclusiones

A pesar de que la evidencia no es conclusiva, el ejercicio debe ser tomado en cuenta como un tratamiento complementario en los trastornos depresivos. Se requiere continuar las investigaciones en esta área del conocimiento.

Palabras clave:
depresión
actividad física
ejercicio
Abstract
Introduction

In recent years, exercise has been increasingly prescribed as a therapeutic alternative in the treatment of depressive disorders. Nevertheless, its therapeutic efficacy has not been systematically evaluated.

Objective

To systematically review the evidence regarding the therapeutic efficacy of exercise in the treatment of depressive disorders in humans.

Methods

A search of the literature was performed in Medline using the following MeSH terms: exercise, depression, and the connector AND. Secondary sources of literature were included too. Search results were collected and reviewed independently and systematically by trained clines.

Results

There is sufficient evidence supporting a bidirectional association between sedentarism and depressive disorders. Thus it is biologically plausible that exercise may have antidepressive effects. However, the evidence regarding its therapeutic efficacy alone is inconclusive.

Conclusions

Exercise may improve specific symptoms in subjects with major depression. Although inconclusive, evidence suggests that exercise may be useful as a complementary therapy in the treatment of depressive disorders.

Key words:
Depression
motor activity
exercise
El Texto completo está disponible en PDF
Referencias
[1]
DP Goldberg, Y Lecrubier.
Form and frequency of mental disorders across centers.
Mental illness in general health care: an international study, pp. 323-334
[2]
CJ Murray, AD López.
Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Sudy.
Lancet, 349 (1997), pp. 1436-1442
[3]
G Andrews, K Sanderson, J Corry, HM Lapsley.
Using epidemiological data to model efficiency in reducing de burden of depression.
J Ment Health Policy Econ, 3 (2000), pp. 175-186
[4]
M Zerihun.
Depression drains workplace productivity [Internet]. 2001 [Citado 31 octubre 2001].
[5]
MH Trivedi, AJ Rush, SR Wisniewski, AA Nierenberg, D Warden, L Ritz, et al.
Evaluation of outcomes with citalopram for depression using measurement-based care in STAR*D: implications for clinical practice.
Am J Psychiatry, 163 (2000), pp. 28-40
[6]
J Moncrieff.
A comparison of antidepressant trials using active and inert placebos.
Int J Methods Psychiatr Res, 12 (2003), pp. 117-127
[7]
JA Astin.
Why patients use alternative medicine: results of a national study.
JAMA, 279 (1998), pp. 1548-1553
[8]
ME Farmer, BZ Locke, EK Mo□cicki, AL Dannenberg, DB Larson, LS Radloff.
Physical activity and depressive symptoms: the NHANES I Epidemiologic Follow-Up Study.
Am J Epidemiol, 128 (1988), pp. 1340-1351
[9]
D Kristz-Silverstein, E Barret-Connor, C Corbeau.
Cross-sectional and prospective study of exercise and depressed mood in the elderly: the Rancho Bernardo study.
Am J Epidemiol, 153 (2001), pp. 596-603
[10]
P Hassmén, N Koivula, A Uutela.
Physical exercise and psychological well-being: a population study in Finland.
Prev Med, 30 (2000), pp. 17-25
[11]
Australian Government, Department of Health and Ageing.
Exercise physiologists eligible to provide services under Medicare [Internet], Department of Health and Ageing, (2005),
[12]
Mental Health Foundation.
Up and running? Exercise therapy and the treatment of mild or moderate depression in primary care [Internet], Mental Health Foundation, (2005),
[13]
JC Fournier, RJ DeRubeis, SD Hollon, S Dimidjian, JD Amsterdam, RC Shelton, et al.
Antidepressant drug effects and depression severity: a patient-level meta-analysis.
[14]
LB Augestad, RP Slettemoen, WD Flanders.
Physical activity and depressive symptoms among Norwegian adults aged 20-50.
Public Health Nurs, 25 (2008), pp. 536-545
[15]
B Roshanaei-Moghaddam, WJ Katon, J Russo.
The longitudinal effects of depression on physical activity.
Gen Hosp Psychiatry, 31 (2009), pp. 306-315
[16]
AH Harris, R Cronkite, R Moos.
Physical activity, exercise coping, and depression in a 10-year cohort study of depressed patients.
J Affect Disord, 93 (2006), pp. 79-85
[17]
DI Galper, MH Trivedi, CE Barlow, AL Dunn, JB Kampert.
Inverse association between physical inactivity and mental health in men and women.
Med Sci Sports Exerc, 38 (2006), pp. 173-178
[18]
P Hassmén, N Koivula, A Uutela.
Physical exercise and psychological well-being: a population study in Finland.
Prev Med, 30 (2000), pp. 17-25
[19]
N Schmitz, J Kruse, J Kugler.
The association between physical exercises and health-related quality of life in subjects with mental disorders: results from a cross-sectional survey.
Prev Med, 39 (2004), pp. 1200-1207
[20]
JA Blumenthal, MA Babyak, PM Doraiswamy, L Watkins, BM Hoffman, KA Barbour, et al.
Exercise and pharmacotherapy in the treatment of major depressive disorder.
Psychosom Med, 69 (2007), pp. 587-596
[21]
GE Mead, W Morley, P Campbell, CA Greig, M McMurdo, DA Lawlor.
Exercise for depression.
Cochrane Database Syst Rev, (2009),
[22]
DA Lawlor, SW Hopker.
The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials.
BMJ, 322 (2001), pp. 763-767
[23]
JA Blumenthal, L Ong.
A commentary on ‘Exercise and Depression’ (Mead et al, 2009): And the verdict is …l.
Ment Health Phys Act, 2 (2009), pp. 97-99
[24]
CD Rethorst, BM Wipfli, DM Landers.
The antidepressive effects of exercise: a meta-analysis of randomized trials.
Sports Med, 39 (2009), pp. 491-511
[25]
AL Brosse, ES Sheets, HS Lett, JA Blumenthal.
Exercise and the treatment of clinical depression in adults: recent findings and future directions.
Sports Med, 32 (2002), pp. 741-760
[26]
G Stathopoulou, MB Powers, AC Berry, JAJ Smits, MW Otto.
Exercise interventions for mental health: a quantitative and qualitative review.
Clin Psychol Sci Prac, 13 (2006), pp. 179-193
[27]
AL Dunn, TG Reigle, SD Youngstedt, RB Armstrong, RK Dishman.
Brain norepinephrine and metabolites after treadmill training and wheel running in rats.
Med Sci Sport Exerc, 28 (1996), pp. 204-209
[28]
RK Dishman.
Brain monoamines, exercise, and behavioral stress: animal models.
Med Sci Sports Exerc, 29 (1997), pp. 63-74
[29]
JM Glass, AK Lyden, F Petzke, P Stein, G Whalen, K Ambrose, et al.
The effect of brief exercise cessation on pain, fatigue, and mood symptom development in healthy, fit individuals.
J Psychosom Res, 57 (2004), pp. 391-398
[30]
BN Greenwood, TE Foley, HE Day, D Burhans, L Brooks, S Campeau, et al.
Wheel running alters serotonin (5-HT) transporter, 5-HT1A, 5-HT1B, and alpha 1b-adrenergic receptor mRNA in the rat raphe nuclei.
Biol Psychiatry, 57 (2005), pp. 559-568
[31]
N Schneiderman, G Ironson, SG Siegel.
Stress and health: psychological, behavioral, and biological determinants.
Annu Rev Clin Psychol, 1 (2005), pp. 607-628
[32]
VB Risbrough, MB Stein.
Role of corticotropin releasing factor in anxiety disorders: a translational research perspective.
Horm Behav, 50 (2006), pp. 550-561
[33]
U Ehlert, J Gaab, M Heinrichs.
Psychoneuroendocrinological contributions to the etiology of depression, posttraumatic stress disorder, and stress-related bodily disorders: the role of the hypothalamus-pituitary-adrenal axis.
Biol Psicol, 57 (2001), pp. 141-152
[34]
RA Dienstbier.
Behavioral correlates of sympathoadrenal reactivity: the toughness model.
Med Sci Sports Exerc, 23 (1991), pp. 846-852
[35]
SK Droste, A Gesing, S Ulbricht, MB Müller, AC Linthorst, JM Reul.
Effects of long-term voluntary exercise on the mouse hypothalamic-pituitary-adrenocortical axis.
Endocrinology, 144 (2003), pp. 3012-3023
[36]
JA Blumenthal, M Fredrikson, KA Matthews, CM Kuhn, S Schniebolk, German, et al.
Stress reactivity and exercise training in premenopausal and post-menopausal women.
Health Psychol, 10 (1991), pp. 384-391
[37]
P Hoffmann, L Terenius, P Thorén.
Cerebrospinal fluid immunoreactive beta-endorphin concentration is increased by voluntary exercise in the spontaneously hypertensive rat.
Regul Pept, 28 (1990), pp. 233-239
[38]
H Boecker, T Sprenger, ME Spilker, G Henriksen, M Koppenhoefer, KJ Wagner, et al.
The runner's high: opioidergic mechanisms in the human brain.
Cereb Cortex, 18 (2008), pp. 2523-2531
[39]
AC Pereira, DE Huddleston, AM Brickman, SS Sosunov, R Hen, GM McKhann, et al.
An in vivo correlate of exercise-induced neurogenesis in the adult dentate gyrus.
Proc Natl Acad Sci U S A, 104 (2007), pp. 5638-5643
[40]
BJ Nicklas, T You, M Pahor.
Behavioural treatments for chronic systemic inflammation: effects of dietary weight loss and exercise training.
CMAJ, 172 (2005), pp. 1199-1209
[41]
R Mössner, O Mikova, E Koutsilieri, M Saoud, AC Ehlis, N Müller, et al.
Consensus paper of the WFSBP Task Force on Biological Markers: biological markers in depression.
World J Biol Psychiatry, 8 (2007), pp. 141-174
[42]
MP Ryan.
The antidepressant effects of physical activity: mediating self-esteem and self-efficacy mechanisms.
Psychol Health, 23 (2008), pp. 279-307
[43]
A Bandura, C Pastorelli, C Barbaranelli, GV Caprara.
Self-efficacy pathways to childhood depression.
J Pers Soc Psychol, 76 (1999), pp. 258-269
[44]
PK Maciejewski, HG Prigerson, CM Mazure.
Self-efficacy as a mediator between stressful life events and depressive symptoms: differences based on history of prior depression.
Br J Psychiatry, 176 (2000), pp. 373-378
[45]
A Bandura.
Self-efficacy: toward a unifying theory of behavioral change.
Psychol Rev, 84 (1977), pp. 191-215
[46]
L Gauvin, JC Spence.
Physical activity and psychological well-being: knowledge base, current issues, and caveats.
Nutr Rev, 54 (1996), pp. S53-S65
[47]
A Bandura.
Self-efficacy: the exercise of control, W.H. Freeman and Company, (1997),
[48]
LL Craft.
Exercise and clinical depression: examining two psychological mechanisms.
Psychol Sport Exerc, 6 (2005), pp. 151-171
[49]
N Just, LB Alloy.
The response styles theory of depression: tests and an extension of the theory.
J Abnorm Psychol, 106 (1997), pp. 221-229
[50]
J Morrow, S Nolen-Hoeksema.
Effects of responses to depression on the remediation of depressive affect.
J Pers Soc Psychol, 58 (1990), pp. 519-527
[51]
S Nolen-Hoeksema, J Morrow, BL Fredrickson.
Response styles and the duration of episodes of depressed mood.
J Abnorm Psychol, 102 (1993), pp. 20-28
[52]
SA Paluska, FJ D'Amico.
The comfort of family practice residents with health care of patients of the opposite gender.
Fam Med, 32 (2000), pp. 612-617
[53]
M aan het Rot, KA Collins, HL Fitterling.
Physical exercise and depression.
Mt Sinai J Med, 76 (2009), pp. 204-214
[54]
AL Dunn, MH Trivedi, JB Kempert, CG Clark, OH Chambliss.
Exercise treatment for depression: efficacy and dose response.
Am J Prev Med, 28 (2005), pp. 1-8
[55]
C Donaldson, D Lam.
Rumination, mood and social problem-solving in major depression.
Psychol Med, 34 (2004), pp. 1309-1318
[56]
American Psychiatric Association.
Manual diagnóstico y estadístico de los trastornos mentales, 4a ed., Masson, (2001),
[57]
AL Dunn, MH Trivedi, JB Kampert, CG Clark, OH Chambliss, AL Dunn, MH Trivedi, JB Kampert, CG Clark, HO Chambliss.
The DOSE study: a clinical trial to efficacy and dose response of exercise as treatment for depression. Design paper.
Controlled Clinical Trials, 23 (2002), pp. 584-603
[58]
PH Fentem.
ABC of sports medicine. Benefits of exercise in health and disease.
BMJ, 308 (1994), pp. 1291-1295
[59]
HN Williford, BR Barfield, RB Lazenby, MS Olson.
A survey of physicians’ attitudes and practices related to exercise promotion.
Prev Med, 21 (1992), pp. 630-636
[60]
JO Prochaska, CC DiClemente.
Stages and processes of self-change of smoking: toward an integrative model of change.
J Consult Clin Psychol, 51 (1983), pp. 390-395
[61]
KM Pollock.
Exercise in treating depression: broadening the psychotherapist's role.
J Clin Psychol, 57 (2001), pp. 1289-1300
[62]
RR Wing, S Phelan, D Tate.
The role of adherence in mediating the relationship between depression and health outcomes.
J Psychosom Res, 53 (2002), pp. 877-881
[63]
RJ Seime, KS Vickers.
The Challenges of treating depression with exercise: from evidence to practice.
Clin Pyschol Sci Prac, 13 (2006), pp. 194-197
[64]
D Azar, K Ball, J Salmon, VJ Cleland.
Physical activity correlates in young women with depressive symptoms: a qualitative study.
Int J Behav Nutr Phys Act, 7 (2010), pp. 3
[65]
FG Leon, AK Ashton, DA D'Mello, B Dantz, J Hefner, GA Matson, et al.
Depression and comorbid medical illness: therapeutic and diagnostic challenges.
J Fam Pract, Suppl (2003), pp. S19-S33
[66]
NA Singh, KM Clements, MA Fiatarone.
A randomized controlled trial of progressive resistance training in depressed elders.
J Gerontol A Biol Sci Med Sci, 52 (1997), pp. M27-M35
[67]
C Palmer.
Exercise as a treatment for depression in elders.
J Am Acad Nurse Pract, 17 (2005), pp. 60-66
[68]
N Sjösten, SL Kivelä.
The effects of physical exercise on depressive symptoms among the aged: a systematic review.
Int J Geriatr Psychiatry, 21 (2006), pp. 410-418
[69]
VS Conn, MA Minor, KJ Burks, MJ Rantz, SH Pomeroy.
Integrative review of physical activity research with aging adults.
J Am Geriatr Soc, 51 (2003), pp. 1159-1168
[70]
KE Joynt, DJ Whellan, CM O'Connor.
Depression and cardiovascular disease: mechanisms of interaction.
Biol Psychiatry, 54 (2003), pp. 248-261
[71]
SM Lai, S Studenski, L Richards, S Perera, D Reker, S Rigler, et al.
Therapeutic exercise and depressive symptoms after stroke.
J Am Geriatr Soc, 54 (2006), pp. 240-247
[72]
DJ Buysse.
Insomnia, depression and aging: assessing sleep and mood interactions in older adults.
Geriatrics, 59 (2004), pp. 47-51
[73]
JM Heath, MR Stuart.
Prescribing exercise for frail elders.
J Am Board Fam Pract, 15 (2002), pp. 218-228
[74]
CK Martin, TS Church, AM Thompson, CP Earnest, SN Blair.
Exercise dose and quality of life: a randomized controlled trial.
Arch Intern Med, 169 (2009), pp. 269-278

Conflictos de interés: el autor manifiesta que no existe ningún conflicto de interés en este artículo.

Copyright © 2010. Asociación Colombiana de Psiquiatría
Opciones de artículo
Herramientas