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Differential impact of physical activity type on depression in adults with congenital heart disease: A multi-center international study.

Journal article
Authors Jong Mi Ko
Kamila S White
Adrienne H Kovacs
Kristen M Tecson
Silke Apers
Koen Luyckx
Corina Thomet
Werner Budts
Junko Enomoto
Maayke A Sluman
Jou-Kou Wang
Jamie L Jackson
Paul Khairy
Stephen C Cook
Shanthi Chidambarathanu
Luis Alday
Katrine Eriksen
Mikael Dellborg
Malin Berghammer
Bengt Johansson
Andrew S Mackie
Samuel Menahem
Maryanne Caruana
Gruschen Veldtman
Alexandra Soufi
Susan M Fernandes
Edward Callus
Shelby Kutty
Philip Moons
Ari M Cedars
Published in Journal of psychosomatic research
Volume 124
ISSN 1879-1360
Publication year 2019
Published at University of Gothenburg Centre for person-centred care (GPCC)
Institute of Medicine
Institute of Health and Care Sciences
Language en
Subject categories Health Sciences, Nursing, Psychology


This study aimed to examine the association between physical activity (PA) and depression in a large international cohort of adults with congenital heart disease (ACHD) as data about the differential impact of PA type on depression in this population are lacking.In 2018, we conducted a cross-sectional assessment of 3908 ACHD recruited from 24 ACHD-specialized centers in 15 countries between April 2013 to March 2015. The Hospital Anxiety and Depression Scale was used to assess self-reported depressive symptoms and the Health-Behavior Scale-Congenital Heart Disease was used to collect PA information. Cochran-Armitage tests were performed to assess trends between depressive symptom levels and PA participation. Chi-Square and Wilcoxon Rank Sum tests were utilized to examine relations between depressive symptom levels and patient characteristics. Stepwise multivariable models were then constructed to understand the independent impact of PA on depressive symptoms.The overall prevalence of elevated depressive symptoms in this sample was 12% with significant differences in rates between countries (p < .001). Physically active individuals were less likely to be depressed than those who were sedentary. Of the 2 PA domains examined, sport participation rather than active commute was significantly associated with reduced symptoms of depression. After adjustment in multivariable analysis, sport participation was still significantly associated with 38% decreased probability of depressive symptoms (p < .001).Sport participation is independently associated with reduced depressive symptoms. The development and promotion of sport-related exercise prescriptions uniquely designed for ACHD may improve depression status in this unique population.

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