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Exercise for Depression (EXDEP)

Primary Purpose

Depression, Unipolar, Bipolar Disorder

Status
Completed
Phase
Not Applicable
Locations
Germany
Study Type
Interventional
Intervention
Exercise
Sponsored by
Johannes Gutenberg University Mainz
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Depression, Unipolar focused on measuring Depression, Unipolar depression, Bipolar affective disorder, Exercise, Internet-based intervention

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Ability to understand the purpose and risks of the study and provide signed and dated informed consent and authorization to use confidential health information in accordance with national and local subject privacy regulations.
  2. Aged 18 to 65 years old, inclusive, at the time of informed consent.
  3. Montral Cognitive Assessment (MoCA) > 26 to exclude cognitive impairment.
  4. Apart from a clinical diagnosis of major depression or bipolar affective disorder, the subject must be in good health as determined by the Investigator, based on medical history and physical examination.
  5. QIDS scores > 5

Exclusion Criteria:

  1. Use of antidepressive medications or benzodiazepines at doses that have not been stable for at least 6 weeks prior to Screening
  2. Psychotherapy that started less than 8 weeks prior to Screening
  3. Any clinically significant psychiatric illness other than major depression or bipolar affective disorder
  4. Transient ischemic attack or stroke or any unexplained loss of consciousness within 1 year prior to Screening
  5. Any uncontrolled medical or neurological/neurodegenerative condition that, in the opinion of the Investigator, might impair treatment compliance and adherence
  6. History of unstable angina, myocardial infarction, chronic heart failure (New York Heart Association Class III or IV), or clinically significant conduction abnormalities (e.g., unstable atrial fibrillation) within 1 year prior to Screening
  7. Clinically significant 12-lead ECG abnormalities, as determined by the Investigator
  8. Uncontrolled hypertension defined as: average of 3 systolic blood pressure [SBP]/diastolic blood pressure [DBP] readings > 165/100 mmHg at Screening
  9. History of malignancy or carcinoma, with the following exceptions:

    i) Subjects with cancers in remission more than 5 years prior to Screening. ii) Subjects with a history of excised or treated basal cell or squamous carcinoma. iii) Subjects with prostate cancer in situ.

  10. History of seizure within 2 years prior to Screening.
  11. Recent history (within 1 year of Screening) of alcohol or substance abuse as determined by the Investigator, a positive urine drug (due to non-prescription drug) or alcohol test at Screening
  12. Clinically significant systemic illness or serious infection (e.g., pneumonia, septicemia) within 30 days prior to or during Screening
  13. History of human immunodeficiency virus (HIV), hepatitis C virus (HCV) or hepatitis B virus (HBV)
  14. Any other medical conditions (e.g., renal disease) that are not stable or controlled, or, which in the opinion of the Investigator, could affect the subject's safety or interfere with the study assessments
  15. Female subjects who are pregnant or currently breastfeeding
  16. Participation in another study
  17. Other unspecified reasons that, in the opinion of the Investigator or Biogen, make the subject unsuitable for enrollment

Sites / Locations

  • Department of Psychiatry and Psychotherapy, University Medical Center, Mainz
  • Department of Sports Medicine, Johannes Gutenberg University, Mainz

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

No Intervention

Arm Label

Exercise Group

Treatment as usual group

Arm Description

Experimental arm type will assess whether a newly developed, supervised 8-week individualized, internet-based exercise therapy is effective in reducing depressive symptoms.

Treatment as usual. Other form of therapy (e.g. antidepressive medication) will not be affected.

Outcomes

Primary Outcome Measures

Severity of depressive symptoms - Quick Inventory of Depressive Symptomatology - clinical rating-16 (QIDS C-16)
Change of Score on the QIDS C-16 after 8 weeks compared to baseline.
Severity of depressive symptoms - Quick Inventory of Depressive Symptomatology - self-report-16 (QIDS SR-16)
Change of Score on the QIDS SR-16 after 8 weeks compared to baseline.

Secondary Outcome Measures

Adherence of internet-based concept
Adherence of internet-based concept using an own questionnaire. Participants respond at the end of every week how they managed their individualized exercise schedule in terms of number of realised training sessions, average heart rate and subjective perceived exertion.
Placebo effect of exercise (QIDS-SR16)
Change of Score on the QIDS-SR16 after one week of training to determine placebo effect of exercise.
Placebo effect of exercise (QIDS-C16)
Change of Score on the QIDS-C16 after one week of training to determine placebo effect of exercise.
Peak oxygen uptake (VO2peak)
Change of VO2peak after 8 weeks compared to baseline. Participants will be subjected to a step-wise treadmill test at baseline and after 8 weeks.
Lactate threshold
Change of lactate threshold using the baseline +1.5 mmol model after 8 weeks compared to baseline.
Short form 36 (SF36) health survey questionnaire
Change of score on the SF-36 after 8 weeks compared to baseline.
General self efficacy questionnaire (GSE)
Change of score on the GSE after 8 weeks compared to baseline.
Global Clinical Issues (GCI)
Change of score on GCI after 8 weeks compared to baseline.
Circulating, cell-free DNA (cfDNA)
Change of cfDNA concentrations after 8 weeks compared to baseline.

Full Information

First Posted
August 8, 2016
Last Updated
February 28, 2018
Sponsor
Johannes Gutenberg University Mainz
Collaborators
Department of Psychiatry and Psychotherapy, University Medical Center, Mainz
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1. Study Identification

Unique Protocol Identification Number
NCT02874833
Brief Title
Exercise for Depression
Acronym
EXDEP
Official Title
The Efficacy of Exercise in Depressive Episodes of Unipolar Depression and Bipolar Affective Disorders
Study Type
Interventional

2. Study Status

Record Verification Date
February 2018
Overall Recruitment Status
Completed
Study Start Date
July 2016 (Actual)
Primary Completion Date
October 2017 (Actual)
Study Completion Date
February 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Johannes Gutenberg University Mainz
Collaborators
Department of Psychiatry and Psychotherapy, University Medical Center, Mainz

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
A randomized single-blinded prospective study to evaluate the efficacy of an individualized supervised 8-week exercise program in subjects with moderate to severe depressive episodes compared to treatment-as-usual
Detailed Description
The purpose of this study is to assess the efficacy of a supervised and indvidualized 8-week exercise program compared to treatment-as-usual in subjects with a moderate or severe depressive episode in the context of unipolar depression or bipolar affective disorders. Numerous previous studies suggest that exercise may help to improve the symptoms of depression. Moreover, exercise was shown to enhance neuroplasticity in adults whereas depression results in decreased neuroplasticity. Here, we aim at elucidating whether a newly developed supervised, Internet-based, individualized exercise program of the Institute of Sports Science and the Department of Psychiatry and Psychotherapy at the University Mainz is more effective in reducing depressive symptoms than treatment-as-usual. Furthermore, this study will clarify if severely depressed subjects are able to adhere to an internet-based exercise therapy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Depression, Unipolar, Bipolar Disorder
Keywords
Depression, Unipolar depression, Bipolar affective disorder, Exercise, Internet-based intervention

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
20 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Exercise Group
Arm Type
Experimental
Arm Description
Experimental arm type will assess whether a newly developed, supervised 8-week individualized, internet-based exercise therapy is effective in reducing depressive symptoms.
Arm Title
Treatment as usual group
Arm Type
No Intervention
Arm Description
Treatment as usual. Other form of therapy (e.g. antidepressive medication) will not be affected.
Intervention Type
Other
Intervention Name(s)
Exercise
Intervention Description
After performance diagnostics, participants will complete an 8-week supervised, individualized exercise program. Training will include up to 3 aerobic training sessions and up to two resistance training units per week.
Primary Outcome Measure Information:
Title
Severity of depressive symptoms - Quick Inventory of Depressive Symptomatology - clinical rating-16 (QIDS C-16)
Description
Change of Score on the QIDS C-16 after 8 weeks compared to baseline.
Time Frame
8 weeks
Title
Severity of depressive symptoms - Quick Inventory of Depressive Symptomatology - self-report-16 (QIDS SR-16)
Description
Change of Score on the QIDS SR-16 after 8 weeks compared to baseline.
Time Frame
8 weeks
Secondary Outcome Measure Information:
Title
Adherence of internet-based concept
Description
Adherence of internet-based concept using an own questionnaire. Participants respond at the end of every week how they managed their individualized exercise schedule in terms of number of realised training sessions, average heart rate and subjective perceived exertion.
Time Frame
8 weeks
Title
Placebo effect of exercise (QIDS-SR16)
Description
Change of Score on the QIDS-SR16 after one week of training to determine placebo effect of exercise.
Time Frame
8-10 days
Title
Placebo effect of exercise (QIDS-C16)
Description
Change of Score on the QIDS-C16 after one week of training to determine placebo effect of exercise.
Time Frame
8-10 days
Title
Peak oxygen uptake (VO2peak)
Description
Change of VO2peak after 8 weeks compared to baseline. Participants will be subjected to a step-wise treadmill test at baseline and after 8 weeks.
Time Frame
8 weeks
Title
Lactate threshold
Description
Change of lactate threshold using the baseline +1.5 mmol model after 8 weeks compared to baseline.
Time Frame
8 weeks
Title
Short form 36 (SF36) health survey questionnaire
Description
Change of score on the SF-36 after 8 weeks compared to baseline.
Time Frame
8 weeks
Title
General self efficacy questionnaire (GSE)
Description
Change of score on the GSE after 8 weeks compared to baseline.
Time Frame
8 weeks
Title
Global Clinical Issues (GCI)
Description
Change of score on GCI after 8 weeks compared to baseline.
Time Frame
8 weeks
Title
Circulating, cell-free DNA (cfDNA)
Description
Change of cfDNA concentrations after 8 weeks compared to baseline.
Time Frame
8 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Ability to understand the purpose and risks of the study and provide signed and dated informed consent and authorization to use confidential health information in accordance with national and local subject privacy regulations. Aged 18 to 65 years old, inclusive, at the time of informed consent. Montral Cognitive Assessment (MoCA) > 26 to exclude cognitive impairment. Apart from a clinical diagnosis of major depression or bipolar affective disorder, the subject must be in good health as determined by the Investigator, based on medical history and physical examination. QIDS scores > 5 Exclusion Criteria: Use of antidepressive medications or benzodiazepines at doses that have not been stable for at least 6 weeks prior to Screening Psychotherapy that started less than 8 weeks prior to Screening Any clinically significant psychiatric illness other than major depression or bipolar affective disorder Transient ischemic attack or stroke or any unexplained loss of consciousness within 1 year prior to Screening Any uncontrolled medical or neurological/neurodegenerative condition that, in the opinion of the Investigator, might impair treatment compliance and adherence History of unstable angina, myocardial infarction, chronic heart failure (New York Heart Association Class III or IV), or clinically significant conduction abnormalities (e.g., unstable atrial fibrillation) within 1 year prior to Screening Clinically significant 12-lead ECG abnormalities, as determined by the Investigator Uncontrolled hypertension defined as: average of 3 systolic blood pressure [SBP]/diastolic blood pressure [DBP] readings > 165/100 mmHg at Screening History of malignancy or carcinoma, with the following exceptions: i) Subjects with cancers in remission more than 5 years prior to Screening. ii) Subjects with a history of excised or treated basal cell or squamous carcinoma. iii) Subjects with prostate cancer in situ. History of seizure within 2 years prior to Screening. Recent history (within 1 year of Screening) of alcohol or substance abuse as determined by the Investigator, a positive urine drug (due to non-prescription drug) or alcohol test at Screening Clinically significant systemic illness or serious infection (e.g., pneumonia, septicemia) within 30 days prior to or during Screening History of human immunodeficiency virus (HIV), hepatitis C virus (HCV) or hepatitis B virus (HBV) Any other medical conditions (e.g., renal disease) that are not stable or controlled, or, which in the opinion of the Investigator, could affect the subject's safety or interfere with the study assessments Female subjects who are pregnant or currently breastfeeding Participation in another study Other unspecified reasons that, in the opinion of the Investigator or Biogen, make the subject unsuitable for enrollment
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Patrick Jung, PD Dr. habil.
Organizational Affiliation
Department of Psychiatry and Psychotherapy, University Medical Center, Mainz
Official's Role
Principal Investigator
Facility Information:
Facility Name
Department of Psychiatry and Psychotherapy, University Medical Center, Mainz
City
Mainz
State/Province
Rhineland-Palatinate
ZIP/Postal Code
55099
Country
Germany
Facility Name
Department of Sports Medicine, Johannes Gutenberg University, Mainz
City
Mainz
State/Province
Rhineland-Palatinate
ZIP/Postal Code
55099
Country
Germany

12. IPD Sharing Statement

Citations:
PubMed Identifier
24026850
Citation
Cooney GM, Dwan K, Greig CA, Lawlor DA, Rimer J, Waugh FR, McMurdo M, Mead GE. Exercise for depression. Cochrane Database Syst Rev. 2013 Sep 12;2013(9):CD004366. doi: 10.1002/14651858.CD004366.pub6.
Results Reference
background
PubMed Identifier
25934030
Citation
Malykhin NV, Coupland NJ. Hippocampal neuroplasticity in major depressive disorder. Neuroscience. 2015 Nov 19;309:200-13. doi: 10.1016/j.neuroscience.2015.04.047. Epub 2015 Apr 28.
Results Reference
background
PubMed Identifier
16177036
Citation
van Praag H, Shubert T, Zhao C, Gage FH. Exercise enhances learning and hippocampal neurogenesis in aged mice. J Neurosci. 2005 Sep 21;25(38):8680-5. doi: 10.1523/JNEUROSCI.1731-05.2005.
Results Reference
background
PubMed Identifier
26167504
Citation
Yau GS, Lee JW, Woo TT, Wong RL, Wong IY. Central Macular Thickness in Children with Myopia, Emmetropia, and Hyperopia: An Optical Coherence Tomography Study. Biomed Res Int. 2015;2015:847694. doi: 10.1155/2015/847694. Epub 2015 Jun 8.
Results Reference
background
PubMed Identifier
30314962
Citation
Haller N, Lorenz S, Pfirrmann D, Koch C, Lieb K, Dettweiler U, Simon P, Jung P. Individualized Web-Based Exercise for the Treatment of Depression: Randomized Controlled Trial. JMIR Ment Health. 2018 Oct 12;5(4):e10698. doi: 10.2196/10698.
Results Reference
derived
PubMed Identifier
29789277
Citation
Pfirrmann D, Haller N, Huber Y, Jung P, Lieb K, Gockel I, Poplawska K, Schattenberg JM, Simon P. Applicability of a Web-Based, Individualized Exercise Intervention in Patients With Liver Disease, Cystic Fibrosis, Esophageal Cancer, and Psychiatric Disorders: Process Evaluation of 4 Ongoing Clinical Trials. JMIR Res Protoc. 2018 May 22;7(5):e106. doi: 10.2196/resprot.8607.
Results Reference
derived

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Exercise for Depression

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