ASSOCIATION BETWEEN LEVELS OF PHYSICAL ACTIVITY AND ANXIETY, STRESS, AND DEPRESSION IN PATIENTS WITH OBSESSIVE-COMPULSIVE DISORDER
DOI:
https://doi.org/10.18554/acbiobras.v8i2.8756Keywords:
Stress Psychological , anxiety disorders, mental disordersAbstract
Obsessive-compulsive disorder (OCD) is a chronic and severe psychiatric disorder that can lead to anxiety attacks, stress, and depressive behaviors. Therapeutic approaches generally involve pharmacotherapy and cognitive-behavioral therapy. Alternative treatment methods, however, may include physical exercise. This study sought to analyze possible associations between levels of physical activity, anxiety, stress, and depression in adults with OCD. Data collection was performed at the Oswaldo Cruz University Hospital by applying the International Physical Activity Questionnaire (IPAQ) and the Depression, Anxiety, and Stress Scale (DASS-21) to 18 patients. Seven individuals (38.9%) had extremely severe levels of anxiety, four (22.2%) had extremely severe levels of stress, and nine (50%) had extremely severe levels of depression. Eight individuals (44.4%) were considered active, while four (22.2%) were considered sedentary. Sedentary patients with extremely severe anxiety, depression, and stress were 3 (42.9%), 3 (33.3%), and 2 (50%), respectively. The Spearman test identified significant relationships between the DASS-21 variables, but no associations with physical activity levels. The lack of significant differences between the DASS-21 and IPAQ scale values, as determined by the Chi-square, Fisher's exact, and Mann-Whitney tests, may have been influenced by the small sample size. Therefore, the exploratory and descriptive nature of this study should be emphasized, and no cause-and-effect inferences should be proposed. New prospective and longitudinal studies may more reliably estimate the potential of physical activity on OCD symptoms.
References
1. Rapinesi C, Kotzalidis GD, Ferracuti S, Sani G, Girardi P, Del Casale A. Brain Stimulation in Obsessive-Compulsive Disorder (OCD): A Systematic Review. Current Neuropharmacology. 2019; 17(8): 787–807. http://doi.org/10.2174/1570159X17666190409142555.
2. American Psychiatry Association. Diagnostic and Statistical Manual of Mental disorders - DSM-5. 5th.ed. Washington: American Psychiatric Publishing, 2014.
3. Pampaloni I, Marriott S, Pessina E, Fisher C, Govender A, Mohamed H, Chandler A, Tyagi H, Morris L, Pallanti S. The global assessment of OCD. Comprehensive Psychiatry. 2022; 118. https://doi.org/10.1016/j.comppsych.2022.152342.
4. Rickelt J, Viechtbauer W, Marcelis M, van den Heuvel OA, van Oppen P, Eikelenboom M, Schruers K. Anxiety during the long-term course of obsessive-compulsive disorder. Journal of Affective Disorders. 2024; 15(345): 311-319. https://doi.org/10.1016/j.jad.2023.10.078.
5. Pittenger C, Bloch MH. Pharmacological treatment of obsessive-compulsive disorder. The Psychiatric clinics of North America. 2014; 37(3): 375-391. https://doi.org/10.1016/j.psc.2014.05.006.
6. Kaczkurkin AN, Foa EB. Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence. Dialogues in Clinical Neuroscience. 2015; 17(3): 337-346. https://doi.org/10.31887/DCNS.2015.17.3/akaczkurkin.
7. Del Casale A, Sorice S, Padovano A, Simmaco M, Ferracuti S, Lamis DA, Rapinesi C, Sani G, Girardi P, Kotzalidis GD, Pompili M. Psychopharmacological Treatment of Obsessive-Compulsive Disorder (OCD). Current Neuropharmacology. 2019; 17(8): 710-736. http://doi.org/10.2174/1570159X16666180813155017.
8. Burchi E, Hollander E, Pallanti S. From Treatment Response to Recovery: A Realistic Goal in OCD. International Journal of Neuropsychopharmacology. 2018; 21(11): 1007-1013. https://doi.org/10.1093/ijnp/pyy079.
9. Leite CT, Saada NA, Sousa FGAS, Cavalcante AV, Cardoso RT, Pereira MFL, Costa AJH, Vieira LR, Parreira A, Rodrigues NS, Silveira FCAR, Cardoso MO, Melo RMR, Martins AVB, Dias RB, Silva IA, Vieira JFQ, Silva VCB. Impacto da Terapia Cognitivo-Comportamental no Tratamento de Transtornos de Ansiedade Generalizada: Revisão de Evidências Recentes. Brazilian Journal of Implantology and Health Sciences. 2024; 6: 1908-1921. https://doi.org/10.36557/2674-8169.2024v6n9p1908-1921.
10. Bottoms L, Prat Pons M, Fineberg NA, Pellegrini L, Fox O, Wellsted D, Drummond LM, Reid J, Baldwin DS, Hou R, Chamberlain S, Sireau N, Grohmann D, Laws KR. Effects of exercise on obsessive-compulsive disorder symptoms: a systematic review and meta-analysis. International Journal of Psychiatry in Clinical Practice. 2023; 27(3): 232-242. https://doi.org/10.1080/13651501.2022.2151474.
11. LeBouthillier DM, Asmundson GJG. The efficacy of aerobic exercise and resistance training as transdiagnostic interventions for anxiety-related disorders and constructs: A randomized controlled trial. Journal of Anxiety Disorder. 2017; 52: 43-52. https://doi.org/10.1016/j.janxdis.2017.09.005.
12. Abrantes AM, Farris SG, Brown RA, Greenberg BD, Strong DR, McLaughlin NC, Riebe D. Acute effects of aerobic exercise on negative affect and obsessions and compulsions in individuals with obsessive-compulsive disorder. Journal of Affective Disorders. 2019; 245: 991–7. https://doi.org/10.1016/j.jad.2018.11.074.
13. Bidzan-Bluma I, Lipowska M. Physical Activity and Cognitive Functioning of Children: A Systematic Review. Int. J. Environ. International Journal of Environmental Research and Public Health. 2018; 15(4): 800. https://doi.org/10.3390/ijerph15040800.
14. Freedman DE, Richter MA. A narrative review of exercise and obsessive-compulsive disorder. General Hospital Psychiatry. 2021; 71: 1-10. https://doi.org/10.1016/j.genhosppsych.2021.03.014.
15. Zangirolami-Raimundo J, Echeimberg JO, Leone C. Tópicos de metodologia de pesquisa: Estudos de corte transversal. Journal of Human Growth and Development. São Paulo. 2018; 28(3): 356-360. https://doi.org/10.7322/jhgd.152198.
16. Matsudo S, Araújo T, Matsudo V, Andrade D, Andrade E, Oliveira LC, Braggion G. Questionário Internacional de Atividade Física (IPAQ): Estudo de Validade e Reprodutibilidade no Brasil. Revista Brasileira de Atividade Física & Saúde, [S. l.]. 2001; 6(2): 5–18. https://doi.org/10.12820/rbafs.v.6n2p5-18.
17. Vignola RC, Tucci AM. Adaptation and validation of the depression, anxiety and stress scale (DASS) to Brazilian Portuguese. Journal of Affective Disorders. 2014; 155: 104-109. https://doi.org/10.1016/j.jad.2013.10.031.
18. Chung Y, Hsiao YT, Huang WC. Physiological and Psychological Effects of Treadmill Overtraining Implementation. Biology (Basel). 2021; 10(6): 515. https://doi.org/10.3390/biology10060515.
19. Rector NA, Man V, Lerman B. The expanding cognitive-behavioural therapy treatment umbrella for the anxiety disorders: disorder-specific and transdiagnostic approaches. The Canadian Journal of Psychiatry. 2014; 59(6): 301-309. https://doi.org/10.1177/070674371405900603.
20. Abrantes AM., Brown RA, Strong DR, McLaughlin N, Garnaat SL, Mancebo M, Riebe D, Desaulniers J, Yip AG, Rasmussen S, Greenberg BD. A pilot randomized controlled trial of aerobic exercise as an adjunct to OCD treatment. General Hospital Psychiatry. 2017; 49: 51-55. https://doi.org/10.1016/j.genhosppsych.2017.06.010.
21. Szuhany KL, Steinberg MH, McLaughlin NCR, Mancebo MC, Brown RA, Greenberg BD, Simon NM, Abrantes AM. Predictors of long-term exercise engagement in patients with obsessive-compulsive disorder: the role of physical activity enjoyment. Behavior Therapy. 2023; 54(4): 610-622. https://doi.org/10.1016/j.beth.2022.12.010.
22. Gleeson M, Bishop NC, Stensel DJ, Lindley MR, Mastana SS, Nimmo MA. The anti-inflammatory effects of exercise: mechanisms and implications. Nature Reviews Immunology. 2011; 11(9): 607-615. https://doi.org/10.1038/nri3041.
23. Szuhany KL, Bugatti M, Otto MW. A meta-analytic review of the effects of exercise on brain-derived neurotrophic factor. Journal of psychiatric research. 2015; 60:56–64. https://doi.org/10.1016/j.jpsychires.2014.10.003.
24. Gruner P, Pittenger C. Cognitive inflexibility in obsessive-compulsive disorder. Neuroscience. 2017; 345: 243-255. https://doi.org/10.1016/j.neuroscience.2016.07.030.
25. Kandola A, Ashdown-Franks G, Hendrikse J, Sabiston CM, Stubbs B. Physical activity and depression: towards understanding the antidepressant mechanisms. Neuroscience and Biobehavioral Reviews. 2019; 107: 525-539. https://doi.org/10.1016/j.neubiorev.2019.09.040.
26. Larun L, Nordheim LV, Ekeland E, Hagen KB, Heian F. Exercise in prevention and treatment of anxiety and depression among children and young people. Cochrane Database of Systematic Reviews. 2006; 3: CD004691. https://doi.org/10.1002/14651858.CD004691.pub2.
27. Ramos-Sanchez CP, Schuch FB, Seedat S, Louw QA, Stubbs B, Rosenbaum S, Firth J, van Winkel R, Vancampfort D. The anxiolytic effects of exercise for people with anxiety and related disorders: An update of the available meta-analytic evidence. Psychiatry Research. 2021; 302. https://doi.org/10.1016/j.psychres.2020.113604.
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