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Abstract
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Unipolar depression is the world-wide leading cause of disability [1] with an estimated life-time prevalence of 17% [2]. Major depressive disorder (MDD) is commonly treated with antidepressant medication and/or psychotherapy. However, some patients with mild to moderate depressive symptoms prefer additional or alternative therapy approaches such as exercise [3, 4]. Regular exercise ideally results in a clinically relevant improvement of depressive symptoms [4, 5, 6] and an increase in endurance performance that reduces the risk of cardiovascular events, and type 2 diabetes, for which MDD patients are susceptible [7].
Due to extended waiting periods for MDD patients to receive treatment in some countries, e.g., Germany [8], therapeutic strategies that provide a fast, universal access and require limited resources are needed. Web-based therapeutic approaches fulfill these claims and may provide a similar outcome compared to face-to-face interventions [9]. Previous studies have highlighted the potential of web-based interventions to support patients regardless of their location [10, 11]. For example, computerized cognitive behavioral therapy (cCBT) has revealed similar effects compared to face-to-face interventions in psychiatric disorders with moderate effect sizes when provided individually tailored [9]. Of note, these conclusions are based on a comparably low sample size [12] and the success of a cCBT may depend on patient characteristics such as baseline depression [13]. In contrast to cCBT, exercise is cognitively less demanding and capable of promoting health-related effects in a patient cohort that is vulnerable for cardiovascular diseases [7]. In addition, exercise may be attractive to patients who do not respond to psychotropic drugs [14].
This commentary addresses web-based exercise, defined as exercise interventions delivered via email, mobile app or website [15] as a promising therapeutic approach for the treatment of depressive symptoms. I summarize the current research in this area and offer an innovative perspective from the field of sports science on how exercise can be managed in this patient collective. The manuscript concludes with key features for future web-based approaches to further improve the evidence for this approach.
Language: en |