Psychosocial Determinants of Physical Activity Vary by Depression Severity

Greater depression severity is indicative of less favorable psychosocial determinants for physical activity compared with individuals with mild and moderate depressive symptoms, according to findings published in Psychology of Sport and Exercise.

Researchers conducted a randomized controlled trial that included physically inactive adults (N=215) diagnosed with major depressive disorder. Study patients were recruited between January 2019 and October 2021 from 4 psychiatric clinics in Switzerland. The study patients were assessed for psychosocial determinants of physical activity using 7 questionnaires concerning volitional and motivational physical activity aspects. A computer-based Single Target Implicit Association Test measured implicit attitudes towards physical activity.

Among the study patients (mean, 41±13 years of age; 53% women) with major depressive disorder, the group reporting more severe depression symptomology (n=52) showed less favorable psychosocial determinants for negative outcome expectancies, action planning, self-efficacy, perceived barriers, intention, coping planning, external motivation, introjected motivation, and intrinsic motivation compared with the groups reporting mild (n=89) and moderate (n=74) depression symptomology. The researchers did not note any significant differences in social and demographic background variables between patients with severe, moderate, and mild depression.

The group reporting more severe depression also perceived more barriers for regular physical activity. It was observed that depression severity did not lead to variation in social support, positive outcome expectancies, identified and implicit attitudes towards physical activity. The most frequently used antidepressant medications among the study patients were trazadone (24%), escitalopram (19%), and vortioxetine (17%), and 27% received antipsychotic medication.

Patients with severe symptom severity reported higher negative outcome expectancies, lower physical activity-related self-efficacy, less motivation, weaker intention to engage in additional physical activity, lower levels of physical activity and coping planning, and more perceived barriers compared with those who had mild and moderate severity.

No significant differences between positive outcome expectancies and social support according to severity of depression could be found.

Study authors concluded, “Psychosocial determinants of physical activity do vary according to depression severity,” and that depression severity is a potential moderator of intervention effects. They continue, “[T]aking depression severity into account seems particularly meaningful when tailoring behavioral interventions to explicit psychosocial determinants of physical activity.”