title: Effects of structured exercise and pharmacotherapy vs. pharmacotherapy for adults with depressive symptoms: A randomized clinical trial.
abstract: OBJECTIVE
  Physical exercise has been consistently documented as a complementary therapy in the treatment of depressive disorders. However, despite a higher prevalence among women compared to men, the trials developed in women are scarce. In addition, the optimal dosage of exercise capable of producing benefits that reduce depressive symptoms remains unclear. This clinical trial is designed to measure the effect of a structured physical exercise program as a complement to antidepressant medication in the treatment of women with depression.
  
  
  METHODS
  From July 2013 to May 2014, we implemented a randomized controlled trial (HAPPY BRAIN study). A total of 26 women (aged 50.16 ± 12.08) diagnosed with clinical depression were randomized either to a supervised aerobic exercise group (45-50 min/week three times a week for four months) plus pharmacotherapy (intervention group), or only antidepressant medication (control group).
  
  
  RESULTS
  The exercise group presented a decrease in BDI-II and DASS-21 total score scales. Relatively to DASS-21, it showed a significant decrease in anxiety and stress. The exercise group when compared to a control group showed improvement in relation to physical functioning parameters between baseline and post-intervention. Moreover, anthropometric parameters presented only significant differences between groups in fat mass percentage. Nonetheless, no differences were found between groups in weight, body mass index, waist circumference, and self-esteem.
  
  
  CONCLUSIONS
  Our results showed that supervised structured aerobic exercise training could be an effective adjuvant therapy for treating women with depression, reducing depressive symptomatology and improving physical fitness. A key factor of this improvement included strict control of exercise workload parameters and adjustment to each subject's capacity. In our study, due to the sample size there is an increase in the probability of type II errors.
authors.affiliation: Centre of Research, Sports Sciences, Health and Human Development, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal. Electronic address: larafcarneiro@gmail.com.
authors.forename: Lara S F
authors.initials: LS
authors.lastname: Carneiro
authors.affiliation: Centre of Research, Education, Innovation and Intervention in Sport, Faculty of Sport, University of Porto, Porto, Portugal.
authors.forename: António Manuel
authors.initials: AM
authors.lastname: Fonseca
authors.affiliation: Psychiatry and Mental Health Clinic, Centro Hospitalar São João, Porto, Portugal; Department of Pharmacology and Therapeutics, Faculty of Medicine, University of Porto, Porto, Portugal.
authors.forename: Maria Augusta
authors.initials: MA
authors.lastname: Vieira-Coelho
authors.affiliation: Centre of Research, Sports Sciences, Health and Human Development, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.
authors.forename: Maria Paula
authors.initials: MP
authors.lastname: Mota
authors.affiliation: Department of Education and Psychology, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.
authors.forename: José
authors.initials: J
authors.lastname: Vasconcelos-Raposo
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use*; D015992:Body Mass Index; D003131:Combined Modality Therapy / Q000379:methods; D003866:Depressive Disorder / Q000628:therapy*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010348:Patient Care Team; D012649:Self Concept; D016896:Treatment Outcome; D055105:Waist Circumference
chemical_list: D000928:Antidepressive Agents
keywords: Aerobic exercise; Depression; Major depressive disorder; Women