Depression is an increasing public health concern with rising prevalence. Nevertheless, far from everyone seeks help or receives adequate treatment. Although psychotherapy and antidepressants still constitute the bulk of treatments offered, recent research suggests that physical activity (PA) can be a powerful adjunct therapy while sedentary behavior (SB) is a definite risk factor for developing depression. The aim of the present study was to investigate the relationship between PA, SB and depressive symptoms in a population (n = 962) of applicants for an online treatment study. This study hypothesised that there will be; (1) a positive relationship between SB and depressive symptoms, and (2) a negative relationship between PA and depressive symptoms. In addition we investigated whether the combination of a sedentary lifestyle and physical inactivity increased the risk for depressive symptoms. Finally, we also examined whether gender, age, marital status, educational level, or medication affected the relationship between PA, SB, and depressive symptoms. The results showed a positive correlation between SB and depression. There was, however, no statistically significant support for a negative relation between PA and depressive symptoms. Even though no conclusions about causality can be drawn, our results suggest that high SB, being a woman, being young, not being in a stable relationship, and current or previous medication are risk factors for depression. To be able to determine the causal direction, that is, whether high SB increases the risk for depressive symptoms, or if depressive symptoms increase the likelihood of high SB, further research is needed.

Background: Population aging motivated a focus in contemporary research on factors, e.g. cognitive functioning, that contribute to ‘aging well.’ However, something that has been overlooked is relation between memory functioning, determined by objective tests as well as subjective memory ratings, and subjective well-being (SWB).

Objectives: The aim of the present study was to investigate cross-sectional and longitudinal (cross-lagged) relationships between episodic memory (both subjective and objective) and SWB.

Method: A total of 586 older individuals (60–90 years) were assessed on multiple measures of the targeted constructs at baseline (Time 1) as part of the Betula cohort study. Five years later (Time 2), 354 of the participants returned for follow-up measurements and were included in cross-lagged panel analyses.

Results: As expected, objective memory and subjective memory showed a pattern of cross-sectional age deficits and a mean level longitudinal decline was observed for objective memory. By contrast, SWB showed stable mean levels both across age and time. No cross-sectional or cross-lagged associations were observed between SWB and objective memory, whereas subjective memory and SWB showed a cross-sectional association.

Conclusion: The results underscore that successful aging is a multifaceted construct with no or only weak associations between the investigated components. However, SWB and rate of change at the individual level should be considered to define successful aging.

The present study investigated the effectiveness of an eight-week integrative group treatment, consisting of Affect school (AS), Compassion-focused therapy (CFT), and Virya yoga in comparison with treatment as usual (TAU), an eight-week cognitive behavioural group treatment. The sample consisted of patients with mild to moderate mixed depression and anxiety (N = 31) in a primary healthcare centre. Correlations were investigated between treatment outcomes, and amount of yoga practice between sessions in the intervention group (n = 14). Results showed that both treatments were equally effective. Both groups improved significantly on measures of depression and anxiety, with large within-group effect sizes. The intervention also group improved significantly on measures of self-compassion and alexithymia, with large within-group effect sizes. Significant correlations were found between improvement in alexithymia and amount of yoga practice; between increased self-compassion and greater quality of life, as well as between increased self-compassion and reductions in anxiety symptoms. The present study highlights the practice of yoga as a potential means to improve alexithymia, and provides additional support for working with self-compassion in psychological treatments. Future research may further investigate the long-term effects and moderating variables influencing potential benefits of integrating AS, CFT, and Virya yoga in psychological treatments.

The aim of this thesis was to evaluate and compare four therapist-supported Internet-administered treatments for depression. Three studies were conducted. The first was a systematic review to determine the most effective mode and dose of physical activity (PA) for treating major depressive disorders (MDDs), and to suggest guidelines and recommendations for clinicians. These recommendations included that the PA needs to be individually customized, performed for at least 30 minutes, preferably under supervision, and with a frequency of at least three times per week to be effective for treating MDDs. Recommendations, however, must be viewed in light of the relatively few studies that match the inclusion criteria. The second study aimed to empirically evaluate and compare the effect of four therapist-supported Internet-administered treatments for mild to moderate depression. Two of the treatments were based on PA and two on behavioural activation (BA). One PA group was provided with a rationale; whereas, the other was not. The treatment in one BA group was based on Lewinsohn’s model and the other on Martell’s model. Results showed that all groups (including the control group) significantly reduced their depressive symptoms. Group comparisons revealed that three of the four treatment groups (all except the PA group that did not receive a rationale) had a significantly greater symptom reduction than the control group. This suggests that some sort of rationale is important for symptom reduction. The third study aimed to examine if a relapse prevention program would affect symptom change during a 24-month follow-up. We also examined if symptom change during the acute phase (AP) treatment period predicted symptom change during the follow-up period. A third and final aim was to examine if the number of symptoms post-AP treatment predicted symptom change during the follow-up period. The initial analysis indicated that the introduction of a relapse prevention program did not affect symptom change during follow-up. The symptom change during AP treatment did predict symptom change during follow-up for three of the four treatment groups (all except one of the BA groups). The number of symptoms post-AP treatment, however, did not predict symptom change during follow-up for any of the treatment groups. The main conclusion from this thesis is that PA seems to be effective for treating and preventing depressive symptoms. PA with a rationale is more effective than without one, and an understanding of the person’s situation is important for a treatment outcome. If a symptom change can be achieved during the acute phase, the likelihood for symptom change during the follow-up increases.

Background: A major problem today is that only about fifty percent of those affected by depression seeks help. One way to reach more sufferers would be by offering easily accessible internet based treatments. The purpose of this study was to compare/evaluate four therapist supported internet administered treatments.

Method/results: Two hundred eighty six participants were included. The treatment period lasted twelve weeks, consisting of the following treatments: 1) physical activity without treatment rational, 2) physical activity with treatment rational, 3) behavioral activation without treatment rational and 4) behavioral activation with treatment rational. All groups (including a control-group) showed a significant decrease in depressive symptoms. When the treatment groups were pooled and compared to the control group, there were significant differences from pretest to posttest (Hedges gav treatment =1.01, control group =0.47). This held true also when each of the four treatment groups was compared to the control group, with one exception: Physical activity without treatment rationale.

Limitations: The differences between how many modules the participants completed could indicate that there are other factors than the treatments that caused the symptom reduction, however, the dose-response analysis did not detect any significant differences on account of modules completed.

Conclusions: The results support the positive effects of internet administered treatments for depression, and highlights the importance of psychoeducation, which tends to affect both the treatment outcome and the probability of remaining in treatment. These aspects need to be considered when developing and conducting new treatments for depression, since they would increase the likelihood of positive treatment outcomes.

A previous cross-sectional study, based on a large scale memory data base (the Betula study), indicated that subjective experiences of memory play a more important role for the individual’s experience of well-being and happiness, than more traditional objective measures of cognitive status (Nyström, Eriksson Sörman, & Nilsson, 2014). The present study is a longitudinal five year follow-up. The same factors as in the first study were controlled for (e.g., physical health, psycho-social aspects). The results indicated that the objective measures, at baseline, did not predict future happiness or well-being, The same was evident for the subjective measures, which contradicted the cross-sectional study. Further, the longitudinal changes in both (i.e., subjective and objective) memory measures were not associated with change in happiness or well-being. To advance the understanding of factors relevant to the experience of happiness and wellbeing in elderly, the field would benefit from studies using complementary subjective cognitive measures, measures for subjective experiences of memory in longitudinal studies.

The purpose of this systematic overview was to determine the most effective mode and doseof physical activity (PA) for treating major depressive disorder (MDD), and to suggest guidelines and recommendations for clinicians. The selection process consisted of a comprehensive search that was conducted up until April 2014 in the following databases: sycINFO, Medline, PubMed and Scopus. The inclusion criteria were: (1) a randomized controlled trial (RCT) design, (2) complete description of intensity, duration and frequency of the PA, (3) the participants had to be diagnosed with MDD according to Diagnostic Statistical Manual 4 th edition (DSM-IV) or International Classification of Disease tenth Revision (ICD-10) criteria (4) if the controls received any treatment, it had to be specified, (5) published after 1990, (6) consist of aerobic or anaerobic treatment PA, and (7) not be a pilotor preliminary study. A quality assessment of each study was conducted independently by two reviewers; this stringent selection process resulted in 12 reviewed studies. Conclusion: individually customized PA, for at least 30 minutes, preferably performed under supervision and with a frequency of at least three times per week is recommended when treating MDD. hese recommendations must be viewed in light of the relatively few studies matching the inclusion criteria.

Studies on internet-administered cognitive behavior therapy (ICBT) frequently use several different sources of recruitment, yet no study has investigated whether different recruitment sources produce different clinical and demographic profiles among participants. Using data from a large sample (n=982) seeking ICBT for depression, we compared these characteristics on the basis of self-reported recruitment source. Recruitment sources that imply more active treatment- seeking behaviors (Google searches, viewing postings on mental health websites) presentedmore severe depression and anxiety than those recruited throughmore passive sources of information (newspaper advertisements, referrals by friends and family). In addition, a number of demographic differences between groups were found. These findings have important implications for ICBT research projects and clinical programs who employ open recruitment procedures and multi-modal recruitment strategies, and who wish to recruit representative samples or target specific subgroups. Replications in other countries will however be required to establish cross-cultural patterns.