Biomedical subjects

Tracy L Greer

Publications and source records attributed to Tracy L Greer.

4 recordsLinked to original sources

PubMed2006

Exercise as an augmentation strategy for treatment of major depression.

The use of augmentation strategies among patients with major depression is increasing because rates of complete remission with standard antidepressant monotherapy are quite low. Clinical and neurobiological data suggest that exercise may be a good candidate for use as an augmentation treatment for depression. This pilot study examined the use of exercise to augment antidepressant medication in patients with major depression. Seventeen patients with incomplete remission of depressive symptoms began a 12-week exercise program while continuing their antidepressant medication (unchanged in type or dose). Individual exercise prescriptions were calculated based on an exercise dose consistent with currently recommended public health guidelines. The exercise consisted of both supervised and home-based sessions. The 17-item Hamilton Rating Scale for Depression (HRSD17) and the Inventory of Depressive Symptomatology-Self-Report (IDS-SR30) were used to assess symptoms of depression on a weekly basis. Intent-to-treat analyses yielded significant decreases on both the HRSD17 (5.8 points, p < 0.008) and IDS-SR30 (13.9 points, p < 0.002). For patients who completed the study (n = 8), HRSD17 scores decreased by 10.4 points and IDS-SR30 scores decreased by 18.8 points. This study provides preliminary evidence for exercise as an effective augmentation treatment for antidepressant medication. This is a lower-cost augmentation strategy that has numerous health benefits and may further reduce depressive symptoms in partial responders to antidepressant treatment. Practical tips on how practitioners can use exercise to enhance antidepressant treatment are discussed. Longer-term use of exercise is also likely to confer additional health benefits for this population.

Adult↗

PubMed2006

TREAD: TReatment with Exercise Augmentation for Depression: study rationale and design.

BACKGROUND: Despite recent advancements in the pharmacological treatment of major depressive disorder (MDD), over half of patients who receive treatment with antidepressant medication do not achieve full remission of symptoms. There is evidence that exercise can reduce depressive symptomatology when used as a treatment for MDD. However, no randomized controlled trials have evaluated exercise as an augmentation strategy for patients with carefully diagnosed MDD who remain symptomatic following an adequate acute phase trial of antidepressant therapy. PURPOSE: TReatment with Exercise Augmentation for Depression (TREAD) is an NIMH-funded, randomized, controlled trial designed to assess the relative efficacy of two doses of aerobic exercise to augment selective serotonin reuptake inhibitor (SSRI) treatment of MDD. METHODS: The TREAD study includes 12 weeks of acute phase treatment with a 12-week post-treatment follow-up. In addition to looking at change in depressive symptoms as a primary outcome, it also includes comprehensive assessment of psychosocial function and treatment adherence. RESULTS: This paper reviews the rationale and design of TREAD and illustrates how we address several key issues in contemporary patient-oriented research on MDD: 1) the use of augmentation strategies in the treatment of depressive disorders in general, 2) the use of non-pharmacological strategies in the treatment of depressive disorders, 3) the considerations of designing a well-controlled trial using two active treatment groups, and 4) the implementation of an adherence program for the use of exercise as a treatment strategy. CONCLUSIONS: The TREAD study is uniquely designed to overcome sources of potential bias and threats to internal and external validity that have limited prior research on the mental health effects of exercise. The study is facilitated by the development of a multidisciplinary research team that includes experts in both depression treatment and exercise physiology, as well as other related fields.

Adolescent↗

PubMed2005

Impaired delay and trace eyeblink conditioning performance in major depressive disorder.

BACKGROUND: Preliminary evidence obtained in our lab has revealed that depressive symptoms impair associative learning, as measured by acquisition of eyeblink classical conditioning (EBCC) tasks. The current study assesses EBCC acquisition in individuals with major depressive disorder (MDD). METHODS: The 17-item Hamilton Rating Scale for Depression (HAM-D(17)) and the 30-item Inventory for Depressive Symptomatology, Self-Report (IDS-SR(30)) were used to quantify severity of depressive symptoms. Participants received 60 trials each in delay 500, trace 500, and trace 1000 conditioning paradigms. A 150-ms, 5-7 psi air puff served as the unconditioned stimulus (US), and an 80-dB, 1-kHz tone as the conditioned stimulus (CS). Mean percent conditioned responses (CRs) served as the primary measure of task acquisition. RESULTS: The MDD group generated significantly fewer CRs on delay 500 and trace 500 tasks, and approached significance on the trace 1000 task compared to healthy controls. Furthermore, presentation of successive trials did not increase CR production in the depressed group, in contrast to progressive increases observed in the control group. LIMITATIONS: The presentation of multiple EBCC tasks precludes some detailed analyses of task-specific performance. Future studies may also benefit from including sufficient numbers of subjects to assess differential characteristics of depression (e.g., length of episode, depressive subtype) and treatment effects. CONCLUSIONS: These data suggest that MDD impairs acquisition of EBCC, providing behavioral support for cerebellar and hippocampal dysfunction in depression. Delineating the neural substrates involved in MDD may aid in future treatment approaches for this pervasive disorder.

Air↗

PubMed2004

Reductions in stress and depressive symptoms in mothers of substance-exposed infants, participating in a psychosocial program.

OBJECTIVE: Depression profoundly impairs psychosocial functioning. Depression can have disruptive effects on a person's family, with significant impact on the psychosocial development of the children. Recent research suggests that a mother's depressive symptoms may increase parenting stress and that parenting stress may, in turn, increase depressive symptoms, with a possible negative cycle to this process. Little is known about how these two factors interact in drug-involved mothers. This study examines how the NEW CONNECTIONS intervention (a parental education and support program for drug-involved parents) acts on parental stress and symptoms of depression. METHODS: The study site was the NEW CONNECTIONS Infant Intervention Program. The Beck Depression Inventory-II (BDI-II) and the Parenting Stress Index (PSI) were administered to drug- and alcohol-involved mothers (N = 120) at baseline and after the intervention (Week 12). RESULTS: Four of the seven PSI domains of parenting stress showed a significant reduction (Demandingness, Competence, Isolation, and Role Restriction). Changes in four domains were significantly correlated with reductions in depressive symptoms (Competence, Isolation, Attachment, and Role Restriction). There was a significant reduction in depressive symptoms as measured by the BDI-II. CONCLUSION: Reduction in some aspects of parenting stress is associated with reduction in depressive symptoms in mothers of substance-exposed infants who participated in the NEW CONNECTIONS psychosocial intervention targeting the parent-child relationship.

Adult↗