Assessment of Bidirectional Relationships Between Physical Activity and Depression Among Adults: A 2-Sample Mendelian Randomization Study
Karmel W. Choi,Chia-Yen Chen,Chia-Yen Chen,Murray B. Stein,Murray B. Stein,Yann C. Klimentidis,Min-Jung Wang,Karestan C. Koenen,Jordan W. Smoller +8 more
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TLDR
Robust evidence supports a protective relationship between objectively assessed—but not self-reported—physical activity and the risk for MDD and points to the importance of objective measurement of physical activity in epidemiologic studies of mental health.Abstract:
IMPORTANCE Increasing evidence shows that physical activity is associated with reduced risk for depression, pointing to a potential modifiable target for prevention. However, the causality and direction of this association are not clear; physical activity may protect against depression, and/or depression may result in decreased physical activity.OBJECTIVE To examine bidirectional relationships between physical activity and depression using a genetically informed method for assessing potential causal inference.DESIGN, SETTING, AND PARTICIPANTS This 2-sample mendelian randomization (MR) used independent top genetic variants associated with 2 physical activity phenotypes-self- reported (n = 377 234) and objective accelerometer-based (n = 91 084)-and with major depressive disorder (MDD) (n = 143 265) as genetic instruments from the largest available, nonoverlapping genome-wide association studies (GWAS). GWAS were previously conducted in diverse observational cohorts, including the UK Biobank (for physical activity) and participating studies in the Psychiatric Genomics Consortium (for MDD) among adults of European ancestry. Mendelian randomization estimates from each genetic instrument were combined using inverse variance weighted meta-analysis, with alternate methods (eg, weighted median, MR Egger, MR-Pleiotropy Residual Sum and Outlier [PRESSO]) and multiple sensitivity analyses to assess horizontal pleiotropy and remove outliers. Data were analyzed from May 10 through July 31, 2018.MAIN OUTCOMES AND MEASURES MDD and physical activity.RESULTS GWAS summary data were available for a combined sample size of 611 583 adult participants. Mendelian randomization evidence suggested a protective relationship between accelerometer-based activity and MDD (odds ratio [ OR], 0.74 for MDD per 1-SD increase in mean acceleration; 95% CI, 0.59-0.92; P = .006). In contrast, there was no statistically significant relationship between MDD and accelerometer-based activity (beta = -0.08 in mean acceleration per MDD vs control status; 95% CI, -0.47 to 0.32; P = .70). Furthermore, there was no significant relationship between self-reported activity and MDD (OR, 1.28 for MDD per 1-SD increase in metabolic-equivalent minutes of reported moderate-to-vigorous activity; 95% CI, 0.57-3.37; P = .48), or between MDD and self-reported activity (beta = 0.02 per MDD in standardized metabolic-equivalent minutes of reported moderate-to-vigorous activity per MDD vs control status; 95% CI, -0.008 to 0.05; P = .15).CONCLUSIONS AND RELEVANCE Using genetic instruments identified from large-scale GWAS, robust evidence supports a protective relationship between objectively assessed-but not self-reported-physical activity and the risk for MDD. Findings point to the importance of objective measurement of physical activity in epidemiologic studies of mental health and support the hypothesis that enhancing physical activity may be an effective prevention strategy for depression.read more
Citations
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The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness
Joseph Firth,Joseph Firth,Joseph Firth,Najma Siddiqi,Ai Koyanagi,Ai Koyanagi,Ai Koyanagi,Dan Siskind,Simon Rosenbaum,Cherrie Galletly,Stephanie Allan,Constanza Caneo,Rebekah Carney,André F. Carvalho,André F. Carvalho,Mary Lou Chatterton,Christoph U. Correll,Christoph U. Correll,Jackie Curtis,Fiona Gaughran,Fiona Gaughran,Adrian H. Heald,Adrian H. Heald,Adrian H. Heald,Erin Hoare,Sarah E Jackson,Steve Kisely,Steve Kisely,Karina Lovell,Mario Maj,Patrick D. McGorry,Cathrine Mihalopoulos,Hannah Myles,Brian O'Donoghue,Toby Pillinger,Jerome Sarris,Jerome Sarris,Felipe Barreto Schuch,David Shiers,Lee Smith,Marco Solmi,Shuichi Suetani,Shuichi Suetani,Johanna Taylor,Scott B Teasdale,Graham Thornicroft,John Torous,Tim Usherwood,Tim Usherwood,Davy Vancampfort,Nicola Veronese,Philip B. Ward,Alison R. Yung,Alison R. Yung,Eoin Killackey,Brendon Stubbs,Brendon Stubbs +56 more
TL;DR: This Commission summarises advances in understanding on the topic of physical health in people with mental illness, and presents clear directions for health promotion, clinical care, and future research.
Physical activity and incident depression: a meta-analysis of prospective cohort studies
TL;DR: In this paper, the prospective relationship between physical activity and incident depression was examined and potential moderators were explored, which supported the notion that physical activity can confer protection against the emergence of depression regardless of age and geographical region.
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A meta-review of "lifestyle psychiatry": the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders.
Joseph Firth,Joseph Firth,Marco Solmi,Robyn E Wootton,Davy Vancampfort,Felipe Barreto Schuch,Erin Hoare,Simon Gilbody,John Torous,Scott B Teasdale,Sarah E Jackson,Lee Smith,M. Eaton,Felice N. Jacka,Nicola Veronese,Wolfgang Marx,Garcia Ashdown-Franks,Garcia Ashdown-Franks,Garcia Ashdown-Franks,Dan Siskind,Jerome Sarris,Jerome Sarris,Simon Rosenbaum,André F. Carvalho,André F. Carvalho,Brendon Stubbs,Brendon Stubbs +26 more
TL;DR: A systematic meta‐review of the top‐tier evidence examining how physical activity, sleep, dietary patterns and tobacco smoking impact on the risk and treatment outcomes across a range of mental disorders concludes that poor sleep is a risk factor for mental illness.
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Predicting Polygenic Risk of Psychiatric Disorders.
Alicia R. Martin,Alicia R. Martin,Mark J. Daly,Elise B. Robinson,Steven E. Hyman,Benjamin M. Neale +5 more
TL;DR: Fundamental concepts involved in computing genetic risk with current methods, strengths and weaknesses of various approaches, assessments of utility, and applications to various psychiatric disorders and related traits are discussed.
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Comorbid depression in medical diseases.
Stefan M. Gold,Ole Köhler-Forsberg,Rona Moss-Morris,Anja Mehnert,J. Jaime Miranda,Monika Bullinger,Andrew Steptoe,Mary A. Whooley,Christian Otte +8 more
TL;DR: The epidemiology, mechanisms, diagnosis and treatment of comorbid depression in patients with medical diseases, including major depressive disorder, are discussed.
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