Preferred Intensity Exercise Does Not Improve Mood More than Prescribed Intensity in Major Depressive Disorder

Optimal exercise parameters (e.g. intensity) for decreasing symptoms of depression are unknown. Recent data suggest that patients performing an exercise training program at intensities they preferred yielded a greater benefit than training at prescribed levels. Allowing patients to select their exercise intensity may increase the affective benefit. PURPOSE: To determine if an acute bout of exercise at a preferred intensity results in greater decreases in depressed mood compared to a bout of exercise at a prescribed intensity. METHODS: Eighteen females with major depressive disorder completed four 30-minute bouts of cycling exercise at different intensities: prescribed sessions at light (RPE = 11), moderate (RPE = 13) and hard (RPE = 15) intensities or a session at a preferred intensity. Profile of mood states (POMS) and depression visual analog scales (VAS) were filled out before and 30 minutes after each bout of exercise. Patients filled out the Exercise Benefits and Barriers Scale prior to exercise. RESULTS: Compared to baseline, POMS Depression scores decreased for both the preferred (3.8 ± 3.1) and prescribed (Average = 7.1 ± 7.4) sessions (Effect size d=0.63). Similarly, depression VAS scores decreased for both the preferred (16.4 ± 14.4) and prescribed (16.6 ± 17.5) bouts. POMS total mood disturbance (TMD) decreased 25.3 points following the prescribed sessions compared to 14.9 points following the preferred session (d=.51). When compared to the prescribed session that was closest in RPE and METs of the preferred session, similar decreases in depression were observed. An individual’s perception of the benefits of exercise was moderately related (r=.69) to their POMS TMD after the preferred session. CONCLUSIONS: Depressed patients did not benefit more from a preferred intensity exercise session than a prescribed intensity bout and may even have a smaller mood response following preferred intensity bouts. This suggests that programs that leave selection of exercise parameters up to the individual may be less effective in reducing depression than training programs with explicit intensity instructions. Increasing patients’ perceptions of the benefits of exercise may elicit greater effects. The results highlight the need for systematic research optimizing prescribed exercise parameters for depression.