Associations between physical activity, mental and somatic morbidity, and health care utilization in depressed patients

Abstract

The aim of this thesis was to examine the relationships between physical activity (PA) and depression, more precisely leisure-time physical activity (LTPA) in relation to psychiatric and somatic comorbidity, subsequent health care utilization (HCU), future depressive symptoms, and total PA among depressed patients, as well as the association between PA and coping with home chores. This thesis is based on data of population-based cross-sectional and longitudinal cohort study, the Finnish Depression and Metabolic Syndrome in Adults (FDMSA) and its five-year follow-up which were conducted within municipalities in the Central Finland Hospital District between 2008–2016. The study population was enrolled from patients ≥35 years old with depressive symptoms who scored ≥10 on the Beck Depression Inventory (BDI). Of the 760 patients, 447 received a depression diagnosis and from these 258 took part in the follow-up study. Participants’ psychiatric diagnoses were confimed by structured interview (M.I.N.I.). All participants completed a standard self-administered questionnaire on their socioeconomic background, factors related to health, morbidity, depressive symptoms, and PA. Participants’ LTPA were assessed with the questions categorized into three levels (low, moderate, and high) and their total PA was assessed via a short version of the International Physical Activity Questionnaire (IPAQ). All participants also underwent a health examination at baseline. The study nurses captured HCU from participants’ health records. LTPA level was not associated with psychiatric comorbidities or HCU among depressed patients. Higher PA levels were associated with lower cardiovascular disease, obesity, and depressive symptoms among depressed patients. Baseline LTPA did not predict the future improvement of depression, but it predicted the future total PA among depressed patients. Higher PA levels were related to lower home presenteeism among depressed patients. To conclude, PA can mitigate the risk factors associated with mental and somatic morbidity and promote health in depressed patients. However, the role of PA in depressed patients’ HCU is not clear. Therefore, PA should be considered and recommended in clinical practices and guidelines as an adjunctive treatment for depression.

Keywords: physical activity, depression, health care utilization, presenteeism