Exercise is an effective treatment for positive valence symptoms in major depression.

Introduction: Measurement of symptoms domains and their response to treatment in relative isolation from diagnosed mental disorders has gained new urgency, as reflected by the National Institute of Mental Health's introduction of the Research Domain Criteria (RDoC). The Snaith Hamilton Pleasure Scale (SHAPS) and the Motivation and Energy Inventory (MEI) are two scales measuring positive valence symptoms. We evaluated the effect of exercise on positive valence symptoms of Major Depressive Disorder (MDD).

Methods: Subjects in the Treatment with Exercise Augmentation for Depression (TREAD) study completed self-reported SHAPS and MEI during 12 weeks of exercise augmentation for depression. We evaluated the effect of exercise on SHAPS and MEI scores, and whether the changes were related to overall MDD severity measured with the Quick Inventory of Depression Symptomatology (QIDS).

Results: SHAPS and MEI scores significantly improved with exercise. MEI score change had larger effect size and greater correlation with change in QIDS score. MEI also showed significant moderator and mediator effects of exercise in MDD.

Limitations: Generalizability to other treatments is limited. This study lacked other bio-behavioral markers that would enhance understanding of the relationship of RDoC and the measures used.

Conclusions: Positive valence symptoms improve with exercise treatment for depression, and this change correlates well with overall outcome. Motivation and energy may be more clinically relevant to outcome of exercise treatment than anhedonia.