Depressed Patients Less Likely to Maintain Physical Activity after Surgery

Patients who are depressed are less likely to adhere to a physician’s orders about physical activity and less likely to be physically active on a regular basis, the results of a new study show.

Researchers at the University of Washington found that depression in patients after a coronary event such as a heart attack was “a significant risk factor for developing a sedentary lifestyle or a poor adherence to an exercise regimen recommended by the patients’ doctor.” In their analysis of the correlation between depression and physical activity, the researchers found “a great difference in how they compared factors such as the patients’ health, physical activity and depression.”

Babak Roshanaei-Moghaddam, MD, Department of Psychiatry and Behavioral Science, lead author of the study, and fellow researchers evaluated 11 different studies that included some 20,000 patients, eight of which showed patients with symptoms of depression after a coronary event. One study that evaluated depression and anxiety in 224 heart attack survivors at three and 12 months after hospitalization showed that those who had suffered from anxiety and depression while hospitalized had a 59% drop in their exercise level, compared with 31% who had not been depressed. One year later, the gap had increased, “with 51 percent of depressed patients exercising less compared with 26 percent of non-depressed patients.”

“We have hypothesized that there are both behavioral habits associated with depression, such as smoking and obesity, which may then limit exercise motivation and enjoyment, as well as biologic factors that can cause obesity and decrease energy level, exercise tolerance and pain threshold,” said Roshanaei-Moghaddam.

In another possible explanation for the study’s findings, Evette Joy Ludman, PhD, Group Health Cooperative, Seattle, WA, said, “Depression can indeed make people have less motivation and energy to exercise. The sad part about this is that physical activity is not only important for preventing and managing many chronic conditions; it can be very helpful for improving mood and other symptoms of depression.”

Results of the study were also published in the July/August issue of General Hospital Psychiatry.