title: 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.
abstract: 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.
  
  
  
  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.
  
  
  
  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]).
  
  
  
  Greater cardiorespiratory fitness but not domain-specific physical activity was associated with a lower incidence of MDD and clinical anxiety.
authors.affiliation: Department of Epidemiology and Preventive Medicine, University of Regensburg, Franz-Josef-Strauß-Allee 11, D-93053 Regensburg, Germany. sebastian.baumeister@ukr.de.|Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.|Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Sebastian E
authors.initials: SE
authors.lastname: Baumeister
authors.affiliation: Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.
authors.forename: Michael F
authors.initials: MF
authors.lastname: Leitzmann
authors.affiliation: Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.|German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Bahls
authors.affiliation: Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.|German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany.
authors.forename: Marcus
authors.initials: M
authors.lastname: Dörr
authors.affiliation: Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.
authors.forename: Daniela
authors.initials: D
authors.lastname: Schmid
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany.|Helios Hanseklinikum Stralsund, Stralsund, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Schomerus
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Katja
authors.initials: K
authors.lastname: Appel
authors.affiliation: Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.|German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany.
authors.forename: Marcello R P
authors.initials: MR
authors.lastname: Markus
authors.affiliation: Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.|German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany.
authors.forename: Henry
authors.initials: H
authors.lastname: Völzke
authors.affiliation: Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.|Department of Internal Medicine, District Hospital Demmin, Demmin, Germany.
authors.forename: Sven
authors.initials: S
authors.lastname: Gläser
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Hans-Jörgen
authors.initials: HJ
authors.lastname: Grabe
mesh_terms: D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000517:prevention & control / Q000523:psychology; D000072599:Cardiorespiratory Fitness; D015331:Cohort Studies; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology* / Q000517:prevention & control / Q000523:psychology; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology* / Q000517:prevention & control / Q000523:psychology; D015444:Exercise / Q000523:psychology*; D005260:Female; D005858:Germany; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D009790:Occupations; D011446:Prospective Studies; D012008:Recurrence; D013223:Statistics as Topic; D055815:Young Adult