

Does exercise really help with depression? - CrazedGeek
http://www.bbc.com/future/story/20120822-does-exercise-help-depression

======
dkarl
tl;dr A feeble attempt to cover (cash in on) a story that was a misreported
load of bull from the beginning.

The article justifies itself by referencing "recent reports in the popular
media," i.e., we're too classy to report on fake fluffy science stories, we
just do the public service of helping people understand them. But this article
doesn't really help. If it wanted to help clear up the story, instead of
nosing its way to the trough, it would have explained that the study was not
designed to measure the effects of exercise on depression. In fact, exercise
was one of the effects studied. To know that you don't even have to get past
the abstract (<http://www.bmj.com/content/344/bmj.e2758>):

 _Main outcome measures: The primary outcome was self reported symptoms of
depression, assessed with the Beck depression inventory at four months post-
randomisation. Secondary outcomes included use of antidepressants and physical
activity at the four, eight, and 12 month follow-up points, and symptoms of
depression at eight and 12 month follow-up._

Whaaaa? What's going on here? The authors of the study helpfully explained it
to the journalist, who opted to write the kind of article that would attract a
lot of readers instead of an accurate one. But the journalist made a small
concession to the truth by quoting the authors' explanation: "the new study
simply recommended exercise of any kind – the authors explained that they
'asked a pragmatic question concerning a feasible intervention that could be
used in primary care.'"

Sure enough, if you read the abstract, the study was designed to test the
effectiveness of advice and education about exercise, not exercise itself:

 _Interventions: In addition to usual care, intervention participants were
offered up to three face to face sessions and 10 telephone calls with a
trained physical activity facilitator over eight months._

The key word in the authors' description of the study is "pragmatic." When it
comes to lifestyle changes, non-doctors like us want to know, "What happens if
I do X? Will it make a difference to my health?" Doctors are curious about
that just like the rest of us, but professionally, the question they ask is,
"What happens if I tell my patient to do X? Will it improve my patient's
health?"

The answer is almost always "no," because patients almost never make lasting
lifestyle changes. Knowledge about the effects of lifestyle changes is
interesting and provocative, and worth passing on to patients, but a lifestyle
change isn't a treatment that a doctor can administer. As the study says:
"Numerous studies have reported the positive effects of physical activity but
most of the current evidence originates from small non-clinical samples using
interventions that are not practicable in healthcare settings." That's why
studies like this exist: to test the treatments and services that health care
professionals _can_ provide to patients.

Unsurprisingly, the study yielded conclusions relating to the intervention it
was designed to study:

 _The TREAD intervention was a pragmatic and acceptable intervention that
could be implemented in the National Health Service and increase physical
activity levels but had no impact on symptoms of depression._

 _The main implication of our results is that advice and encouragement to
increase physical activity is not an effective strategy for reducing symptoms
of depression._

 _Clinicians and policy makers should alert people with depression that advice
to increase physical activity will not increase their chances of recovery from
depression._ (This is a hilarious recommendation. I am pretty sure that
depressed people already know that getting advice does not cure depression.
But hey, now we know from _science._ )

So much for "advice" and "encouragement." But we aren't doctors -- we want to
know about the effects of exercise itself. The study did measure both exercise
and depression as outcomes, so maybe they were able to draw some conclusions
about the relationship between physical activity and depression. Hmmm....

 _Although our intervention increased physical activity, the increase may not
have been sufficiently large to influence depression outcomes. The absolute
difference between the randomised groups in terms of the proportion meeting
our physical activity threshold was about 15% so there is still a possibility
that physical activity itself might have some benefits for depression._

Also: _A better understanding of the underlying mechanisms that might link
physical activity and mood could lead to new therapeutic opportunities._

Ah. So the authors themselves don't believe the conclusion trumpeted in the
headlines. It must have been some other researchers who drew such conclusions
from the study. The BBC article does mention that some researchers have given
critical attention to the study, so maybe they journalist found some who felt
that stronger conclusions could be drawn about exercise? ... <crickets>
Apparently not, though when I checked out the earlier media coverage, I found
this one, single quote in all the articles:

"Exercise and activity appeared to offer promise as one such treatment, but
this carefully designed research study has shown that exercise does not appear
to be effective in treating depression."

That single statement is the basis of the ENTIRE media coverage of this
article. As you might guess, it came not from a research article but from a
Bristol University press release (<http://bristol.ac.uk/news/2012/8529.html>)
Not only that, it came from one of the authors of the study! Seems like the
first thing a journalist would do is ask him why his statement in the press
release about the study contradicts the conclusions in the article he co-
authored about the very same study. But that would ruin the story, wouldn't
it?

Once again it seems that journalists can rise high in their profession by
serving as an aggregation service for sensationalistic press releases, and
some scientists are willing to openly whore for attention via non-peer-
reviewed channels.

------
kjhughes
Professor William Morgan's distraction hypothesis sounds plausible -- that the
distraction takes people's minds off of worrying. Along those lines,
productive activities in general may have positive effects not just for their
distraction properties but for their intrinsic ability to contribute to a
sense of accomplishment.

The distraction hypothesis probably doesn't sit well with those who argue that
depression has a physiological basis and must be addressed medically. It's not
clear to me whether one side is right and the other wrong or if it's a
difference of degree. It seems to parallel ADHD treatment issues, at least on
the surface.

~~~
pragone
Interestingly enough, depression is a comorbidity of ADHD.

------
marshc1
Can't see from the UK

"We're sorry but this site is not accessible from the UK as it is part of our
international service and is not funded by the licence fee."

I am also concerned that the BBC is blocking British users!

~~~
iloveponies
What is your concern exactly? Your TV license didn't pay for that content.

~~~
sheff
My opinion is that without the £3.5 billion a year that comes from the UK
license fee, and the infrastructure and resources that the Beeb has built up
over the years due to that income (plus what they also get from general
taxation), they would be hard pressed to make these kinds of programs.

As a license is required for pretty much everyone who wants to watch any live
TV in the UK, its always worth the trouble for any license fee payer to ask
them to justify why BBC content is (apparently) available to non UK based
viewers but not to those in the UK .
<http://www.bbc.co.uk/complaints/complain-online/>

~~~
iloveponies
It appears you're lumping the "BBC" in as one entity, when it is in fact many
entities. World Service and the Domestic BBC are separate entities - and World
Service's profits go back to the domestic BBC so more revenue beyond your
license fee is available.

What are these general taxation revenues you are talking about? As to why the
content isn't available, you didn't pay for it, so what's the problem? I'm
willing to bet it's not available because of some rights restriction.

------
pella
similar:

<http://news.ycombinator.com/item?id=4446400>

