Lipid profile in major depressive disorder: the influence of symptom severity and the impact of combined exercise and pharmacotherapy

This randomized controlled trial investigated the relationship between lipid profiles and depression severity at the time of diagnosis and the effects of physical exercise during 12 weeks on lipid profiles in individuals with major depressive disorders (MDD). At the time of diagnosis were 122 adults with MDD. After assessment, 59 adults with MDD were divided into two groups: a physical exercise group (PE; physical exercise + pharmacotherapy, n = 26; 76.9% female; mean age = 28yrs) and a control group (P; pharmacotherapy only, n = 29; 78.7% female; mean age = 26yrs). The exercise intervention was adjusted by perceived effort and affect (pleasure and enjoyment) toward exercise and lasted 12 weeks. At the pre-treatment phase, participants with severe MDD exhibited significantly higher triglyceride levels as compared to those with mild to moderate depression (p = 0.041), after controlling for BMI. No significant differences were observed in total cholesterol levels between groups. In PE group, total cholesterol levels decreased significantly over time, and this reduction was positively correlated with a decrease in depressive symptoms (p < 0.05; r = 0.289). In contrast, no significant changes in total cholesterol were observed in the P group. Triglyceride levels decreased in both treatment groups: PE (week 5 vs. week 12: p < 0.0001; baseline vs. week 12: p < 0.0001) and P (week 5 vs. week 12: p < 0.0001; baseline vs. week 12: p = 0.002), however, only in PE group was this reduction significantly associated with improvements in depressive symptoms (p < 0.05; r = 0.278). These preliminary results underscore the importance of integrating pharmacological and behavioral interventions to optimize both clinical and metabolic outcomes.