Objective: Mental health problems continue to present a global challenge and contribute significantly to the global burden of human disease. Disease-related components such as physical fitness, daily energy expenditure, pulmonary functions, and quality of life are important parameters in physical rehabilitation of depressive patients. Therefore, the aim of this study is to compare physical fitness parameters (aerobic exercise capacity, muscle strength, trunk flexibility, and body composition), daily physical activity, pulmonary function, sleep, and life quality changes in patients with depression versus healthy controls as well as to investigate the associations among these parameters.
Methods: The patients were diagnosed with depression by trained psychiatrists using the Structured Clinical Interview for DSM-IV criteria. Eighty patients (40 male, 40 female) with depression and 80 healthy controls (40 male, 40 female) were included in this study. Handgrip strength and back-leg strength were measured with dynamometers; trunk flexibility was measured with a flexion meter; daily physical activity was monitored with a metabolic holter; pulmonary function tests were performed with a portable spirometer. Maximal aerobic capacity (VO2max) was estimated with Astrand submaximal exercise protocol. Body composition parameters were determined with a bioelectrical impedance analysis system. Waist, abdomen and hip circumference measurements were taken with a tape measure. Beck depression Inventory (BDI), Beck anxiety Inventory (BAI), Pittsburgh sleep quality index (PSQI), and SF-36 quality of life questionnaires were applied to all participants. The significance level was determined as P-value of 0.05 or less in statistical analysis.
Results: We found that handgrip and back-leg strengths and health-related quality of life were lower, waist/hip ratio, PSQI, BDI and BAI scores were higher in female patients with depression, compared to healthy controls; whereas, VO2max and health-related quality of life were lower, and daily sleep duration and PSQI, BDI and BAI scores were higher in male patients with depression, compared to healthy controls. Other parameters were not significantly different between the patients and the controls. In female patients, the BDI and BAI scores were negatively correlated with the strength measurements and SF-36 score, but positively correlated with the PSQI score. In male patients, the BDI and BAI scores were negatively correlated with the SF-36 score but positively correlated with the PSQI score. Also the BDI score showed positive correlation with the daily sleep duration in the male patients. In both male and female patients, the BAI score showed positive correlation with the VO2max.
Conclusion: This study revealed that handgrip and back-leg strengths, life and sleep qualities, and anxiety symptomatology were impaired in female depressive patients, as compared to healthy controls, whereas aerobic exercise capacity, daily sleep duration, life and sleep qualities were impaired in male depressive patients, as compared to healthy controls. We suggest that paying attention to the decline in muscle strength in female patients with depression and decreased aerobic exercise capacity in male patients with depression affecting exercise treatment planning might be helpful for the development of more beneficial strategies for illness management.