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Associations of Leisure-Time and Occupational Physical Activity and Cardiorespiratory Fitness With Incident and Recurrent Major Depressive Disorder, Depressive Symptoms, and Incident Anxiety in a General Population

J Clin Psychiatry 2017;78(1):e41–e47

Objective: Physical activity and cardiorespiratory fitness may help prevent depression and anxiety. Previous studies have been limited by error-prone measurements. We examined whether self-reported physical activity domains and peak exercise capacity (peakVO2) are associated with incident and recurrent major depressive disorder (MDD), depressive symptoms, and anxiety disorders.

Methods: This was a prospective population-based study of 1,080 adult men and women (25–83 years) with a median follow-up of 4.5 years and measures of physical activity during leisure time, sports, and work (Baecke questionnaire); a measure of depressive symptoms (Beck Depression Inventory II); symptom-limited cycle ergometer testing (peakVO2, oxygen uptake at anaerobic threshold [VO2@AT], maximum power output at peak exertion); and a structured psychiatric interview (Munich Composite International Diagnostic Interview). Baseline data were collected between 2002 and 2006, and follow-up data, between 2007 and 2010.

Results: After adjustment for age, sex, education, smoking, alcohol consumption, and waist circumference, the relative risks for incident MDD per standard deviation (SD) increase in leisure-time physical activity, physical activity during sport, physical activity at work, peakVO2, VO2@AT, and maximum power output were 1.002 (95% confidence interval, 0.90 to 1.12), 1.02 (0.90 to 1.15), 0.94 (0.80 to 1.10), 0.71 (0.52 to 0.98), 0.83 (0.66 to 1.04), and 0.71 (0.52 to 0.96), respectively. PeakVO2, VO2@AT, and maximum power output were associated with recurrent MDD, depressive symptoms, and anxiety. PeakVO2 was more strongly related to the co-occurrence of MDD and anxiety (adjusted odds ratio [OR] = 0.45 [0.24 to 0.84]) than depression or anxiety alone (OR = 0.71 [0.53 to 0.94]).

Conclusions: Greater cardiorespiratory fitness but not domain-specific physical activity was associated with a lower incidence of MDD and clinical anxiety.