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High-intensity interval training may reduce depressive symptoms in individuals with schizophrenia, putatively through improved VO(2)max: A randomized controlled trial

INTRODUCTION: High-intensity interval training (HIIT) may improve cardiorespiratory fitness (CRF) and mental health. The current observer-blinded RCT investigates the sparsely studied efficiency of HIIT in reducing psychotic and non-psychotic symptoms in schizophrenia and complements previous studie...

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Autores principales: Bang-Kittilsen, Gry, Engh, John Abel, Holst, René, Holmen, Tom Langerud, Bigseth, Therese Torgersen, Andersen, Eivind, Mordal, Jon, Egeland, Jens
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9394183/
https://www.ncbi.nlm.nih.gov/pubmed/36003983
http://dx.doi.org/10.3389/fpsyt.2022.921689
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author Bang-Kittilsen, Gry
Engh, John Abel
Holst, René
Holmen, Tom Langerud
Bigseth, Therese Torgersen
Andersen, Eivind
Mordal, Jon
Egeland, Jens
author_facet Bang-Kittilsen, Gry
Engh, John Abel
Holst, René
Holmen, Tom Langerud
Bigseth, Therese Torgersen
Andersen, Eivind
Mordal, Jon
Egeland, Jens
author_sort Bang-Kittilsen, Gry
collection PubMed
description INTRODUCTION: High-intensity interval training (HIIT) may improve cardiorespiratory fitness (CRF) and mental health. The current observer-blinded RCT investigates the sparsely studied efficiency of HIIT in reducing psychotic and non-psychotic symptoms in schizophrenia and complements previous studies by investigating whether symptom reduction following HIIT is associated with, putatively partly mediated by, increased VO(2)max. METHODS: Participants (outpatients meeting diagnostic criteria for schizophrenia) were randomized to HIIT (n = 43) or a comparison group performing low-intensity active video gaming (AVG) to control for social interaction (n = 39). Both interventions consisted of two supervised sessions/week for 12 weeks and a 4 months follow-up. Effects on overall symptoms and symptom domains [PANSS (0–6 scale), five-factor model] were estimated using mixed-effects models (intention-to-treat, n = 82). Underlying mechanisms were analyzed using moderated mediation analyses (n = 66). We anticipated that HIIT would reduce overall symptoms, particularly depressive symptoms, more than AVG, and symptom reduction would be associated with, putatively mediated through, improved VO(2)max. RESULTS: Depressive symptoms (baseline score 3.97, 95% CI: 3.41, 4.52), were −1.03 points more reduced in HIIT than AVG at post-intervention (95% CI: −1.71, −0.35, p = 0.003), corresponding to a small to moderate effect size (d = 0.37) and persisting at follow-up. There was a small reduction in overall symptoms, but no significant between-group differences were observed. Change in VO(2)max correlated negatively with the change in depressive symptoms. Mediation analysis showed a significant effect of change in VO(2)max on change in depressive symptoms within HIIT. The total effect was moderated by group, and depressive symptoms were more reduced in HIIT. Direct effects, not mediated through VO(2)max, were non-significant. Indirect effects, mediated through VO(2)max, were non-significant, but the moderated mediation test indicated a non-significant trend of 0.4 points (95% CI: −1.188, 0.087) and a larger reduction in depressive symptoms through VO(2)max in HIIT. CONCLUSION: HIIT reduced depressive symptoms more than AVG, which persisted at follow-up. HIIT may serve as a complementing treatment option targeting these symptoms in individuals with schizophrenia, even before they reach clinical depression. Depressive symptoms are important to prevent, stabilize, and treat due to their negative implications for psychological wellbeing and long-term functional outcome. Reduction in depressive symptoms was associated with improved VO(2)max, and non-significant trends in the data supported that improved VO(2)max may be part of the complex mechanisms underlying the anti-depressive effect of HIIT. CLINICAL TRIAL REGISTRATION: [www.ClinicalTrials.gov], identifier [NCT02205684].
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spelling pubmed-93941832022-08-23 High-intensity interval training may reduce depressive symptoms in individuals with schizophrenia, putatively through improved VO(2)max: A randomized controlled trial Bang-Kittilsen, Gry Engh, John Abel Holst, René Holmen, Tom Langerud Bigseth, Therese Torgersen Andersen, Eivind Mordal, Jon Egeland, Jens Front Psychiatry Psychiatry INTRODUCTION: High-intensity interval training (HIIT) may improve cardiorespiratory fitness (CRF) and mental health. The current observer-blinded RCT investigates the sparsely studied efficiency of HIIT in reducing psychotic and non-psychotic symptoms in schizophrenia and complements previous studies by investigating whether symptom reduction following HIIT is associated with, putatively partly mediated by, increased VO(2)max. METHODS: Participants (outpatients meeting diagnostic criteria for schizophrenia) were randomized to HIIT (n = 43) or a comparison group performing low-intensity active video gaming (AVG) to control for social interaction (n = 39). Both interventions consisted of two supervised sessions/week for 12 weeks and a 4 months follow-up. Effects on overall symptoms and symptom domains [PANSS (0–6 scale), five-factor model] were estimated using mixed-effects models (intention-to-treat, n = 82). Underlying mechanisms were analyzed using moderated mediation analyses (n = 66). We anticipated that HIIT would reduce overall symptoms, particularly depressive symptoms, more than AVG, and symptom reduction would be associated with, putatively mediated through, improved VO(2)max. RESULTS: Depressive symptoms (baseline score 3.97, 95% CI: 3.41, 4.52), were −1.03 points more reduced in HIIT than AVG at post-intervention (95% CI: −1.71, −0.35, p = 0.003), corresponding to a small to moderate effect size (d = 0.37) and persisting at follow-up. There was a small reduction in overall symptoms, but no significant between-group differences were observed. Change in VO(2)max correlated negatively with the change in depressive symptoms. Mediation analysis showed a significant effect of change in VO(2)max on change in depressive symptoms within HIIT. The total effect was moderated by group, and depressive symptoms were more reduced in HIIT. Direct effects, not mediated through VO(2)max, were non-significant. Indirect effects, mediated through VO(2)max, were non-significant, but the moderated mediation test indicated a non-significant trend of 0.4 points (95% CI: −1.188, 0.087) and a larger reduction in depressive symptoms through VO(2)max in HIIT. CONCLUSION: HIIT reduced depressive symptoms more than AVG, which persisted at follow-up. HIIT may serve as a complementing treatment option targeting these symptoms in individuals with schizophrenia, even before they reach clinical depression. Depressive symptoms are important to prevent, stabilize, and treat due to their negative implications for psychological wellbeing and long-term functional outcome. Reduction in depressive symptoms was associated with improved VO(2)max, and non-significant trends in the data supported that improved VO(2)max may be part of the complex mechanisms underlying the anti-depressive effect of HIIT. CLINICAL TRIAL REGISTRATION: [www.ClinicalTrials.gov], identifier [NCT02205684]. Frontiers Media S.A. 2022-08-04 /pmc/articles/PMC9394183/ /pubmed/36003983 http://dx.doi.org/10.3389/fpsyt.2022.921689 Text en Copyright © 2022 Bang-Kittilsen, Engh, Holst, Holmen, Bigseth, Andersen, Mordal and Egeland. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Bang-Kittilsen, Gry
Engh, John Abel
Holst, René
Holmen, Tom Langerud
Bigseth, Therese Torgersen
Andersen, Eivind
Mordal, Jon
Egeland, Jens
High-intensity interval training may reduce depressive symptoms in individuals with schizophrenia, putatively through improved VO(2)max: A randomized controlled trial
title High-intensity interval training may reduce depressive symptoms in individuals with schizophrenia, putatively through improved VO(2)max: A randomized controlled trial
title_full High-intensity interval training may reduce depressive symptoms in individuals with schizophrenia, putatively through improved VO(2)max: A randomized controlled trial
title_fullStr High-intensity interval training may reduce depressive symptoms in individuals with schizophrenia, putatively through improved VO(2)max: A randomized controlled trial
title_full_unstemmed High-intensity interval training may reduce depressive symptoms in individuals with schizophrenia, putatively through improved VO(2)max: A randomized controlled trial
title_short High-intensity interval training may reduce depressive symptoms in individuals with schizophrenia, putatively through improved VO(2)max: A randomized controlled trial
title_sort high-intensity interval training may reduce depressive symptoms in individuals with schizophrenia, putatively through improved vo(2)max: a randomized controlled trial
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9394183/
https://www.ncbi.nlm.nih.gov/pubmed/36003983
http://dx.doi.org/10.3389/fpsyt.2022.921689
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