Levin, Gregory, Greenwood, Kenneth, and Newton, Robert (2015) Modality of exercise influences rate of decrease in depression for cancer survivors with elevated depressive symptomatology. Psycho-Oncology, 24 (Supplement 2). J-4. pp. 63-64.

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Abstract

Background/purpose: This feasibility study aimed to identify whether different types of exercise provide similar reductions in depression symptoms to cancer survivors with elevated depression, compared to control.

Methods: 32 participants (58.9± 9.4 years) were allocated to a 12-week clinic-based, supervised exercise group (n =10), an unsupervised, home-based exercise group (n =8), or a usual care control group (n =14). The aerobic sessions weekly. Home-based participants were provided with printed material about benefits of exercise and were encouraged to complete 150 min of exercise weekly. Controls received no exercise or printed material and were encouraged tomaintain usual activity.

Results: Both home-based (6.4 ± 5.3 to 2.2 ± 2.9, p = .006) and supervised (6.9 ± 4.2 to 4.0 ± 2.4, p = .021) interventions effectively reduced HADS-D scores compared to control (7.2 ± 2.5 to 7.7 ± 3.6). Not only did the home-based group decrease depression to a greater extent but also more rapidly. HADS-D scores at week 6 were 3.4 ± 3.5 and 6.1 ± 4.2 for the home-based and supervised groups, respectively (d = 0.50).

Conclusions: The rate of exercise-related reductions in depression was influenced by the modality of exercise. Psychological mechanisms such as mastery and distraction may have accounted for initial rapid improvements in the home-based group. However, increasing the duration of the programme appeared to diminish the favourable short-term response to self-managed exercise. Research Implications: The findings of this research suggest that exercise for depression in cancer is beneficial. However, more information is required to understand the optimal prescriptive factors that influence mood. The shift in rate of response should be examined in more detail including adherence. As this was a feasibility study, a larger randomised trial should be conducted to confirm the findings. Practice Implications: Comorbid depression negatively impacts on the quality of life of cancer survivors. Rates of clinically disruptive depression are reportedly three times higher than the noncancer population. Therefore, there is a need to treat or manage depression. Exercise appears to be an effective alternative to pharmacotherapy or psychological counselling. This additional therapy may be more suitable for some patients.

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