TY - JOUR
A1 - Heinzel, Stephan
A1 - Lawrence, Jimmy B.
A1 - Kallies, Gunnar
A1 - Rapp, Michael Armin
A1 - Heissel, Andreas
T1 - Using Exercise to Fight Depression in Older Adults
BT - A Systematic Review and Meta-Analysis
JF - GeroPsych : the journal of gerontopsychology and geriatric psychiatry
N2 - Depression is the most prevalent psychiatric disorder in the general population. Despite a large demand for efficient treatment options, the majority of older depressed adults does not receive adequate treatment: Additional low-threshold treatments are needed for this age group. Over the past two decades, a growing number of randomized controlled trials (RCT) have been conducted, testing the efficacy of physical exercise in the alleviation of depression in older adults. This meta-analysis systematically reviews and evaluates these studies; some subanalyses testing specific effects of different types of exercise and settings are also performed. In order to be included, exercise programs of the RCTs had to fulfill the criteria of exercise according to the American College of Sports Medicine, including a sample mean age of 60 or above and an increased level of depressive symptoms. Eighteen trials with 1,063 participants fulfilled our inclusion criteria. A comparison of the posttreatment depression scores between the exercise and control groups revealed a moderate effect size in favor of the exercise groups (standardized mean difference (SMD) of –0.68, p < .001). The effect was comparable to the results achieved when only the eleven trials with low risk of bias were included (SMD = –0.63, p < .001). The subanalyses showed significant effects for all types of exercise and for supervised interventions. The results of this meta-analysis suggest that physical exercise may serve as a feasible, additional intervention to fight depression in older adults. However, because of small sample sizes of the majority of individual trials and high statistical heterogeneity, results must be interpreted carefully.
KW - depression
KW - exercise
KW - older adults
KW - meta-analysis
KW - review
Y1 - 2015
U6 - https://doi.org/10.1024/1662-9647/a000133
SN - 1662-9647
SN - 1662-971X
VL - 28
SP - 149
EP - 162
PB - Hogrefe
CY - Cambridge, Mass. ; Göttingen [u.a.]
ER -
TY - GEN
A1 - Chaparro, Camilo G. A. Perez
A1 - Zech, Philipp A.
A1 - Heinzel, Stephan
A1 - Mayer, Frank
A1 - Wolfarth, Bernd
A1 - Rapp, Michael Armin
A1 - Heissel, Andreas
T1 - Effects Of Aerobic & Resistance Training On Cardiorespiratory Fitness In People Living with HIV. A Meta-analysis
T2 - Medicine and science in sports and exercise : official journal of the American College of Sports Medicine
Y1 - 2017
U6 - https://doi.org/10.1249/01.mss.0000519265.28705.86
SN - 0195-9131
SN - 1530-0315
VL - 49
SP - 842
EP - 842
PB - Lippincott Williams & Wilkins
CY - Philadelphia
ER -
TY - GEN
A1 - Zech, Philipp A.
A1 - Rapp, Michael Armin
A1 - Heinzel, Stephan
A1 - Wolfarth, Bernd
A1 - Lawrence, Jimmy B.
A1 - Heissel, Andreas
T1 - Does Exercise Help People Living with HIV Improve Their Quality of Life? A meta-analysis.
T2 - Medicine and science in sports and exercise : official journal of the American College of Sports Medicine
Y1 - 2017
U6 - https://doi.org/10.1249/01.mss.0000518177.22369.2f
SN - 0195-9131
SN - 1530-0315
VL - 49
SP - 470
EP - 470
PB - Lippincott Williams & Wilkins
CY - Philadelphia
ER -
TY - JOUR
A1 - Heinzel, Stephan
A1 - Rapp, Michael Armin
A1 - Fydrich, Thomas
A1 - Ströhle, Andreas
A1 - Teran, Christina
A1 - Kallies, Gunnar
A1 - Schwefel, Melanie
A1 - Heissel, Andreas
T1 - Neurobiological mechanisms of exercise and psychotherapy in depression
BT - the SPeED studyRationale, design, and methodological issues
JF - Clinical Trials
N2 - Background/Aims: Even though cognitive behavioral therapy has become a relatively effective treatment for major depressive disorder and cognitive behavioral therapy-related changes of dysfunctional neural activations were shown in recent studies, remission rates still remain at an insufficient level. Therefore, the implementation of effective augmentation strategies is needed. In recent meta-analyses, exercise therapy (especially endurance exercise) was reported to be an effective intervention in major depressive disorder. Despite these findings, underlying mechanisms of the antidepressant effect of exercise especially in combination with cognitive behavioral therapy have rarely been studied to date and an investigation of its neural underpinnings is lacking. A better understanding of the psychological and neural mechanisms of exercise and cognitive behavioral therapy would be important for developing optimal treatment strategies in depression. The SPeED study (Sport/Exercise Therapy and Psychotherapyevaluating treatment Effects in Depressive patients) is a randomized controlled trial to investigate underlying physiological, neurobiological, and psychological mechanisms of the augmentation of cognitive behavioral therapy with endurance exercise. It is investigated if a preceding endurance exercise program will enhance the effect of a subsequent cognitive behavioral therapy. Methods: This study will include 105 patients diagnosed with a mild or moderate depressive episode according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed.). The participants are randomized into one of three groups: a high-intensive or a low-intensive endurance exercise group or a waiting list control group. After the exercise program/waiting period, all patients receive an outpatient cognitive behavioral therapy treatment according to a standardized therapy manual. At four measurement points, major depressive disorder symptoms (Beck Depression Inventory, Hamilton Rating Scale for Depression), (neuro)biological measures (neural activations during working memory, monetary incentive delay task, and emotion regulation, as well as cortisol levels and brain-derived neurotrophic factor), neuropsychological test performance, and questionnaires (psychological needs, self-efficacy, and quality of life) are assessed. Results: In this article, we report the design of the SPeED study and refer to important methodological issues such as including both high- and low-intensity endurance exercise groups to allow the investigation of dose-response effects and physiological components of the therapy effects. Conclusion: The main aims of this research project are to study effects of endurance exercise and cognitive behavioral therapy on depressive symptoms and to investigate underlying physiological and neurobiological mechanisms of these effects. Results may provide important implications for the development of effective treatment strategies in major depressive disorder, specifically concerning the augmentation of cognitive behavioral therapy by endurance exercise.
KW - Major depressive disorder
KW - depression
KW - psychotherapy
KW - cognitive behavioral therapy
KW - endurance exercise
KW - training
KW - functional magnetic resonance imaging
KW - brain-derived neurotrophic factor
KW - basic psychological needs
KW - cortisol
Y1 - 2017
U6 - https://doi.org/10.1177/1740774517729161
SN - 1740-7745
SN - 1740-7753
VL - 15
IS - 1
SP - 53
EP - 64
PB - Sage Publ.
CY - London
ER -
TY - JOUR
A1 - Heissel, Andreas
A1 - Pietrek, Anou F.
A1 - Flunger, Barbara
A1 - Fydrich, Thomas
A1 - Rapp, Michael Armin
A1 - Heinzel, Stephan
A1 - Vansteenkiste, Maarten
T1 - The Validation of the German Basic Psychological Need Satisfaction and Frustration Scale in the Context of Mental Health
JF - European Journal of Health Psychology
N2 - The primary aim of the current study was to examine the unique contribution of psychological need frustration and need satisfaction in the prediction of adults’ mental well-being and ill-being in a heterogeneous sample of adults (N = 334; Mage = 43.33, SD = 32.26; 53% females). Prior to this, validity evidence was provided for the German version of the Basic Psychological Need Satisfaction and Frustration Scale (BPNSFS) based on Self-Determination Theory (SDT). The results of the validation analyses found the German BPNSFS to be a valid and reliable measurement. Further, structural equation modeling (SEM) showed that both need satisfaction and frustration yielded unique and opposing associations with well-being. Specifically, the dimension of psychological need frustration predicted adults’ ill-being. Future research should examine whether frustration of psychological needs is involved in the onset and maintenance of psychopathology (e.g., major depressive disorder).
KW - basic psychological need frustration
KW - need satisfaction
KW - mental health
KW - well-being
KW - depression
Y1 - 2018
U6 - https://doi.org/10.1027/2512-8442/a000017
SN - 2512-8442
SN - 2512-8450
VL - 25
IS - 4
SP - 119
EP - 132
PB - Hogrefe
CY - Göttingen
ER -
TY - JOUR
A1 - Kallies, Gunnar
A1 - Rapp, Michael Armin
A1 - Fydrich, Thomas
A1 - Fehm, Lydia
A1 - Tschorn, Mira
A1 - Teran, Christina
A1 - Schwefel, Melanie
A1 - Pietrek, Anou F.
A1 - Henze, Romy
A1 - Hellweg, Rainer
A1 - Ströhle, Andreas
A1 - Heinzel, Stephan
A1 - Heissel, Andreas
T1 - Serum brain-derived neurotrophic factor (BDNF) at rest and after acute aerobic exercise in major depressive disorder
JF - Psychoneuroendocrinology
N2 - Physiological mechanisms of an anti-depressive effect of physical exercise in major depressive disorder (MDD) seem to involve alterations in brain-derived neurotrophic factor (BDNF) level. However, previous studies which investigated this effect in a single bout of exercise, did not control for confounding peripheral factors that contribute to BDNF-alterations. Therefore, the underlying cause of exercise-induced BDNF-changes remains unclear. The current study aims to investigate serum BDNF (sBDNF)-changes due to a single-bout of graded aerobic exercise in a group of 30 outpatients with MDD, suggesting a more precise analysis method by taking plasma volume shift and number of platelets into account. Results show that exercise-induced increases in sBDNF remain significant (p<.001) when adjusting for plasma volume shift and controlling for number of platelets. The interaction of sBDNF change and number of platelets was also significant (p=.001) indicating larger sBDNF-increase in participants with smaller number of platelets. Thus, findings of this study suggest an involvement of peripheral as well as additional possibly brain-derived mechanisms explaining exercise-related BDNF release in MDD. For future studies in the field of exercise-related BDNF research, the importance of controlling for peripheral parameters is emphasized.
KW - Brain-derived neurotrophic factor (BDNF)
KW - Platelets
KW - Major depressive disorder
KW - Physical exercise
Y1 - 2018
U6 - https://doi.org/10.1016/j.psyneuen.2018.12.015
SN - 0306-4530
VL - 102
SP - 212
EP - 215
PB - Elsevier
CY - Oxford
ER -
TY - JOUR
A1 - Heissel, Andreas
A1 - Zech, Philipp
A1 - Rapp, Michael Armin
A1 - Schuch, Felipe B.
A1 - Lawrence, Jimmy B.
A1 - Kangas, Maria
A1 - Heinzel, Stephan
T1 - Effects of exercise on depression and anxiety in persons living with HIV: A meta-analysis
JF - Journal of psychosomatic research
N2 - Objective: The purpose of this systematic review and meta-analysis was to examine the effects of exercise on depression and anxiety in people living with HIV (PLWH), and to evaluate, through subgroup analysis, the effects of exercise type, frequency, supervision by exercise professionals, study quality, and control group conditions on these outcomes. Method: A literature search was conducted through four electronic databases from inception to February 2019. Considered for inclusion were randomized controlled trials (RCTs) investigating exercise interventions and depression or anxiety as outcomes in people living with HIV (>= 18 years of age). Ten studies were included (n = 479 participants, 49.67% females at baseline), and the standardized mean difference (SMD) and heterogeneity were calculated using random-effect models. An additional pre-post meta-analysis was also conducted. Results: A large effect in favor of exercise when compared to controls was found for depression (SMD = -0.84, 95%CI = [-1.57, -0.11], p = 0.02) and anxiety (SMD = -1.23, 95%CI = [-2.42, 0.04], p = -0.04). Subgroup analyses for depression revealed large effects on depression for aerobic exercise only (SMD = -0.96, 95%CI = [-1.63, -0.30], p = 0.004), a frequency of >= 3 exercise sessions per week (SMD = -1.39, 95%CI = [-2.24, -0.54], p < 0.001), professionally supervised exercise (SMD = -1.40, 95%CI = [-2.46, -0.17], p = 0.03]), and high-quality studies (SMD = -1.31, 95%CI = [-2.46, -0.17], p = 0.02). Conclusion: Exercise seems to decrease depressive symptoms and anxiety in PLWH, but other larger and high-quality studies are needed to verify these effects.
KW - HIV
KW - Exercise
KW - Depression
KW - Anxiety
KW - Meta-analysis
KW - Supervision
Y1 - 2019
U6 - https://doi.org/10.1016/j.jpsychores.2019.109823
SN - 0022-3999
SN - 1879-1360
VL - 126
PB - Elsevier
CY - Oxford
ER -
TY - JOUR
A1 - Heissel, Andreas
A1 - Pietrek, Anou F.
A1 - Rapp, Michael Armin
A1 - Heinzel, Stephan
A1 - Williams, Geoffrey
T1 - Perceived health care climate of older people attending an exercise program
BT - validation of the german short version of the health care climate questionnaire
JF - Journal of aging and physical activity : JAPA ; the official journal of the International Society for Aging and Physical Activity
N2 - The role of perceived need support from exercise professionals in improving mental health was examined in a sample of older adults, thereby validating the short Health Care Climate Questionnaire. A total of 491 older people (M = 72.68 years; SD = 5.47) attending a health exercise program participated in this study. Cronbach's alpha was found to be high (alpha = .90). Satisfaction with the exercise professional correlated moderately with the short Health Care Climate Questionnaire mean value (r = .38; p < .01). The mediator analyses yielded support for the self-determination theory process model in older adults by showing both basic need satisfaction and frustration as mediating variables between perceived autonomy support and depressive symptoms. The short Health Care Climate Questionnaire is an economical instrument for assessing basic need satisfaction provided by the exercise therapist from the participant's perspective. Furthermore, this cross-sectional study supported the link from coaching style to the satisfaction/frustration of basic psychological needs, which in turn, predicted mental health. Analyses of criterion validity suggest a revision of the construct by integrating need frustration.
KW - autonomy support
KW - basic psychological need satisfaction and frustration
KW - depression
KW - need support
KW - physical activity
Y1 - 2019
U6 - https://doi.org/10.1123/japa.2018-0350
SN - 1063-8652
SN - 1543-267X
VL - 28
IS - 2
SP - 276
EP - 286
PB - Human Kinetics Publ.
CY - Champaign
ER -
TY - JOUR
A1 - Heissel, Andreas
A1 - Pietrek, Anou F.
A1 - Schwefel, Melanie
A1 - Abula, Kahar
A1 - Wilbertz, Gregor
A1 - Heinzel, Stephan
A1 - Rapp, Michael Armin
T1 - STEP.De study
BT - a multicentre cluster-randomised effectiveness trial of exercise therapy for patients with depressive symptoms in healthcare services : study protocol
JF - BMJ open
N2 - Introduction Although exercise therapy has widely been shown to be an efficacious treatment modality for depression, evidence for its effectiveness and cost efficiency is lacking. The Sport/Exercise Therapy for Depression study is a multicentre cluster-randomised effectiveness trial that aims to compare the effectiveness and cost efficiency of exercise therapy and psychotherapy as antidepressant treatment.
Methods and analysis 480 patients (aged 18-65) with an International Classification of Diseases diagnosis associated with depressive symptoms are recruited. Up to 30 clusters (psychotherapists) are randomly assigned to allocate patients to either an exercise or a psychotherapy treatment as usual in a 2: 1 ratio. The primary outcome (depressive symptoms) and the secondary outcomes (work and social adjustment, quality of life) will be assessed at six measurement time points (t0: baseline, t1: 8 weeks after treatment initiation, t2: 16 weeks after treatment initiation, t3/ 4/5: 2, 6, 12 months after treatment). Linear regression analyses will be used for the primary endpoint data analysis. For the secondary endpoints, mixed linear and logistic regression models with fixed and random factors will be added. For the cost efficiency analysis, expenditures in the 12 months before and after the intervention and the outcome difference will be compared between groups in a multilevel model. Recruitment start date was 1 July 2018 and the planned recruitment end date is 31 December 2020.
Ethics and dissemination The study protocol was approved by the ethics committee of the University of Potsdam (No. 17/2018) and the Freie Universitat Berlin (No. 206/2018) and registered in the ISRCTN registry. Informed written consent will be obtained from all participants. The study will be reported in accordance with the Consolidated Standards of Reporting Trials and the Recommendations for Interventional Trials statements. The results will be published in peer-reviewed academic journals and disseminated to the public.
Y1 - 2020
U6 - https://doi.org/10.1136/bmjopen-2019-036287
SN - 2044-6055
VL - 10
IS - 4
PB - BMJ Publishing Group
CY - London
ER -
TY - GEN
A1 - Pietrek, Anou F.
A1 - Kangas, Maria
A1 - Kliegl, Reinhold
A1 - Rapp, Michael Armin
A1 - Heinzel, Stephan
A1 - Van der Kaap-Deeder, Jolene
A1 - Heissel, Andreas
T1 - Basic psychological need satisfaction and frustration in major depressive disorder
T2 - Zweitveröffentlichungen der Universität Potsdam : Gesundheitswissenschaftliche Reihe
N2 - Basic psychological needs theory postulates that a social environment that satisfies individuals’ three basic psychological needs of autonomy, competence, and relatedness leads to optimal growth and well-being. On the other hand, the frustration of these needs is associated with ill-being and depressive symptoms foremost investigated in non-clinical samples; yet, there is a paucity of research on need frustration in clinical samples. Survey data were compared between adult individuals with major depressive disorder (MDD; n = 115; 48.69% female; 38.46 years, SD = 10.46) with those of a non-depressed comparison sample (n = 201; 53.23% female; 30.16 years, SD = 12.81). Need profiles were examined with a linear mixed model (LMM). Individuals with depression reported higher levels of frustration and lower levels of satisfaction in relation to the three basic psychological needs when compared to non-depressed adults. The difference between depressed and non-depressed groups was significantly larger for frustration than satisfaction regarding the needs for relatedness and competence. LMM correlation parameters confirmed the expected positive correlation between the three needs. This is the first study showing substantial differences in need-based experiences between depressed and non-depressed adults. The results confirm basic assumptions of the self-determination theory and have preliminary implications in tailoring therapy for depression.
T3 - Zweitveröffentlichungen der Universität Potsdam : Gesundheitswissenschaftliche Reihe - 8
KW - basic need satisfaction and frustration
KW - depressive symptoms
KW - clinical sample
KW - need profiles
KW - social environment
Y1 - 2023
U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-582269
IS - 8
ER -