Key result
Exercise programs for resistant depression face primary engagement barriers of fatigue and anhedonia.
Why the study?
Physical activity is a promising adjunct for resistant major depression, yet factors influencing engagement remain poorly understood.
What factors influence engagement in a 12-week supervised exercise program for people with resistant major depression?
What factors influence engagement in a 12-week supervised exercise program for people with resistant major depression?
Engagement in exercise interventions for resistant major depression is shaped by a complex interaction of personal, social, and environmental factors.
Answers are grounded in this paper and cite their sources.
Target fatigue and anhedonia when prescribing exercise for resistant depression; hypothesis-generating for tailored adherence strategies in future trials.
Background: Resistant major depression (RMD) is characterized by persistent depressive symptoms despite adequate pharmacological treatment, leading to functional impairment and increased physical comorbidity. Lifestyle interventions, particularly physical activity, are promising adjuncts, yet factors influencing engagement remain poorly understood. Methods: A purposive sampling approach and thematic analysis informed by a socioecological framework were employed to explore participants’ lived experiences after completing a 12-week supervised combined exercise program. Semi-structured interviews were thematically analyzed. Results: Engagement was influenced by three main themes: intrapersonal (symptoms, lifestyle, medication, program expectations), interpersonal (family, peers, healthcare professionals), and environmental (program location, schedule, session design) factors. Motivation was shaped by emotional, physical, and social goals, while barriers included fatigue, anhedonia, and side effects of medication. Conclusions: Engagement in exercise interventions for RMD is shaped by the interaction of personal, social, and environmental factors. Understanding lived experiences can inform the design of person-centered, sustainable interventions.
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Etxaniz-Oses et al. (2026) studied this question. Engagement in exercise programs for resistant major depression is driven by intrapersonal, interpersonal, and environmental factors, with fatigue and anhedonia acting as primary barriers.
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