The Exercise Effect on Mental Health

Neurobiological Mechanisms

Henning Budde, Mirko Wegner, Henning Budde, Mirko Wegner

• Publisher: CRC Press
• Year: 2018
• ISBN:
  9781498739535
• Edition: 1
• Topic: Medicina
• Subtopic: Psiquiatría y salud mental

The Exercise Effect on Mental Health contains the most recent and thorough overview of the links between exercise and mental health, and the underlying mechanisms of the brain. The text will enhance interested clinicians' and researchers' understanding of the neurobiological effect of exercise on mental health. Editors Budde and Wegner have compiled a comprehensive review of the ways in which physical activity impacts the neurobiological mechanisms of the most common psychological and psychiatric disorders, including depression, anxiety, bipolar disorder, and schizophrenia. This text presents a rigorously evidence-based case for exercise as an inexpensive, time-saving, and highly effective treatment for those suffering from mental illness and distress.

Section 1

The Benefits of Exercise – a Theoretical Introduction (Mechanisms)

1Epidemiology of Common Mental Disorders

Robert Kohn

Prevalence and Incidence

Sociodemographic Risk Factors

Gender

Age

Marital Status

Social Economic Status

Life Events

Stigma and Discrimination

Comorbidity

Psychiatric Comorbidity

Physical Comorbidity

Physical Activity

Course of Major Depression

Child and Adolescent Studies

Societal Cost

Global Burden of Disease

Treatment Gap

Conclusion

References

Prevalence and Incidence

In DSM-5 (American Psychiatric Association 2013) major depressive disorder is defined as having five or more symptoms during the same two-week period, which cause clinically significant distress or impairment, and at least one should be a depressed mood or loss of interest or pleasure. The other symptoms include: change in weight; sleep disturbance; psychomotor agitation or retardation; fatigue or loss of energy; worthlessness or guilt; impaired concentration; and thoughts of death. The current DSM-5 criteria are similar to the DSM-IV (American Psychiatric Association 2000) diagnostic criteria used in most of the psychiatric epidemiological surveys conducted since the 1990s.

The anxiety disorders have been redefined from DSM-IV to DSM-5. In DSM-IV the anxiety disorders included panic disorder, agoraphobia without a history of panic disorder, specific phobia, social phobia, post-traumatic stress disorder, acute stress disorder, generalized anxiety disorder, and obsessive-compulsive disorder. The anxiety disorders in DSM-5 have been narrowed with post-traumatic stress disorder and acute stress disorder being moved into a category entitled Trauma – and Stressor- Related Disorders and obsessive-compulsive disorder being placed in a category entitled Obsessive-Compulsive and Related Disorders. Current psychiatric epidemiological studies are primarily based on the DSM-IV definition of anxiety disorders. Acute stress disorder is not usually included among general population psychiatric epidemiological surveys and the inclusion of obsessive-compulsive disorder may be variable.

Prevalence and incidence studies are based on representative community household surveys that utilize a structured diagnostic instrument, such as the Composite International Diagnostic Interview (CIDI) (Robins et al. 1988). The prevalence of major depressive disorder varies widely cross nationally. For example, the 12-month prevalence ranges from 0.3% in Vietnam to 10.2% in Iran. Across studies based on DSM-IV using the CIDI the estimated median 12-month prevalence is 4.7% (n = 42 studies) (see Table 1.1). Similarly, there is a broad range of lifetime prevalence rates from 3.2% in Nigeria to 20.4% in France. The median lifetime prevalence is estimated at 9.9% (n = 39 studies). Major depressive disorder has an early age of onset; the median age in epidemiological studies is approximately 27.6 years of age (n = 23 studies).

Table 1.1Twelve-month and lifetime DSM-III-R and DSM-IV prevalence rates and age of onset of major depressive episodes and anxiety disorders from selected Composite International Diagnostic Interview studies

Country	Major Depression			Anxiety Disorders
	12M	LT	Onset	12M	LT	DX
Australia	4.8	12.8		11.8	20.0	1–5,7
Belgium	5.2	14.1	29.4	8.4	13.1	1,2,4,5,7,8
São Paulo, Brazil	10.1	18.0	24.3	19.9	28.1	1–8
Bulgaria	3.0	6.7		5.6		1,2,4,7,8
Beijing and Shanghai, China	2.0	3.8	30.3	3.0	4.8	1,2,4,5,7,8
Shenzhen, China	3.6	6.8	18.8
Canada	4.8	12.2		4.7		1,4,7
Chile*	5.7	9.2		9.9	16.2	1,2,4,5,7,8
Colombia	5.3	11.8	23.5	14.4	25.3	1,2,4,5,7,8
Medellin, Colombia	3.8	9.9
Czech Republic*	2.0	7.8
Finland	7.4
France	5.6	20.4	28.4	13.7	22.3	1,2,4,5,7,8
Germany	3.1	10.3	27.6	8.3	14.6	1,2,4,5,7,8
Guatemala	0.8	3.2		2.3	5.2	1–5,7
Pondicherry, India	4.5	9.0	31.9
Iran	10.2			15.6		1–5,7
Iraq	3.9	7.2	46.0	10.4	13.8	1,2,4,5,7,8
Israel	5.9	9.8	25.5	3.6	5.2	1,2,4,5,7,8
Italy	2.9	9.7	27.7	6.5	11.0	1,2,4,5,7,8
Japan	2.4	6.8	30.1	4.2	6.9	1,2,4,5,7,8
Lebanon	4.9	10.3	23.8	12.2	16.7	1,2,4,5,7,8
Mexico	3.7	7.6	23.5	8.4	14.3	1,2,4,5,7,8
Netherlands	4.9	18.0	27.2	8.9	15.93	1,2,4,5,7,8
New Zealand	5.7	15.8	24.2	15.0	24.6	1,2,4,5,7,8
Nigeria	1.1	3.2	29.2	4.2	6.5	1,2,4,5,7,8
Northern Ireland	8.8	17.7		12.3		1,2,4,7,8
Norway*	7.3	17.8
Peru	2.7	6.4	38.0	7.9	14.9	1,2,4,5,7,8
Poland	1.6	3.8
Portugal	7.0	17.4		13.7		1,2,4,7,8
Romania	1.5	2.9		4.2		1,2,4,7,8
Singapore	2.2	5.8	26.0	0.4	0.9	2
South Africa	4.9	10.4	22.3	8.2	15.8	1,2,4,5,7,8
South Korea	3.1	6.7		6.8	8.7	1,2,4,5,7,8
Spain	3.8	10.6	30.0	6.6	9.9	1,2,4,5,7,8
Murcia, Spain	6.0	13.8		9.7	15.0	1–8
Bangkok, Thailand		19.9			10.2	9
Turkey*	3.5	6.3		5.8	7.4	1,2,4,7,8
Izmir, Turkey	8.2
United States	8.3	19.2	22.7	19.0	31.0	1,2,4,5,7,8
Ukraine	8.4	14.6	27.8	6.8	10.9	1,2,4,5,7,8
Mekong Delta, Vietnam	0.3			0.4		1–5,7

*DSM-III-R diagnoses others are DSM-IV

12M = 12-month prevalence; LT = lifetime prevalence; Onset = median age of onset for depressive disorder; DX = Type of anxiety disorder included in study: agoraphobia without panic disorder = 1, generalized anxiety disorder = 2, obsessive-compulsive disorder = 3, panic disorder = 4, post-traumatic stress disorder = 5, separation anxiety disorder = 6, social phobia = 7, specific phobia = 8, not specified = 9

Alhasnawi et al. 2009; Andrade et al. 2003; Andrade et al. 2012; Bromet et al. 2011; Cho et al. 2015; Chong et al. 2012; Chong, Vaingankar, Abdin, and Subramaniam 2012; Fiestas and Piazza 2014; Gureje, Uwakwe, Oladeji, Makanjuola, and Esan 2010; Kessler et al. 2009; Kessler et al. 2015; Kohn 2013; Kringlen, Torgersen, and Cramer 2001; Lee et al. 2009; Markkula et al. 2015; McDowell et al. 2014; McEvoy, Grove, and Slade 2011; Navaro-Mateu et al. 2015; Patten et al. 2015; Piazza and Fiestas 2014; Sharifi et al. 2015; Steel et al. 2009; Thavichachart et al. 2001; Topuzoğlu et al. 2015; Vaingankar et al. 2013; Viana and Andrade 2012; Vicente et al. 2006

Data on the one-year incidence of major depression is based on a small number of prospective studies. The Epidemiological Catchment Area (ECA) survey reported an incidence rate of 1.6 per 100 person years at risk, 2.0 females and 1.1 males (Eaton et al. 1989). The Baltimore site of the ECA, 1981–1993, had an incidence rate of 0.3 (Eaton, Kalaydjian, Scharfstein, Mezuk, & Ding 2007). During the 1993–2004 period the incidence rate was 0.2. However, the difference between the two time periods, and incidence rates also found in shorter follow-up studies, may be due to attrition in the sample and not that the incidence of major depression is declining. For both periods, female gender and age of 30–44 had the highest incidence rates. A study based in Edmonton, Canada had an incidence rate of 2.8, with a rate for females of 3.7 and males 2.0 (Newman & Bland 1998). The incidence rate in the Canadian study was highest for age 45–64. The Netherlands Mental Health Survey and Incidence Study (NEMESIS) reported an incidence rate of 2.7 for major depression, 3.9 females and 1.7 males. The incidence rate was highest for males for ages 25–34 and for females for age 35–44 (Bijl, de Graaf, Ravelli, Smit, & Vollebergh 2002). The NEMISIS study examined risk factors associated with the incidence of a mood disorder; female gender, having a negative life event in the past 12 months, ongoing difficulties in the past 12 months, high neuroticism and sleep problems were all associated in an adjusted logistic regression model (de Graaf, Bijl, Ravelli, Smit, & Vollebergh 2002). In the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) risk factors for incidence of major depression included female gender, age 18–55, low income and being unmarried. The incidence rate for the NESARC study was 1.5, similar to the ECA study (Grant et al. 2009)....