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Published in: BMC Public Health 1/2020

Open Access 01-12-2020 | Affective Disorder | Research article

Exercise interventions for the prevention of depression: a systematic review of meta-analyses

Authors: Mandy X. Hu, David Turner, Ellen Generaal, Daniel Bos, M. Kamran Ikram, M. Arfan Ikram, Pim Cuijpers, Brenda W. J. H. Penninx

Published in: BMC Public Health | Issue 1/2020

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Abstract

Background

Exercise may be a promising target for depression interventions. However, evidence for a beneficial effect of exercise interventions on the prevention of depression differs substantially across different studies.

Methods

A systematic search was performed up to July 2018 using PubMed, Embase, PsycINFO, and Cochrane. Articles were included if a meta-analysis of randomized controlled trials was performed that examined the effect of exercise interventions on the onset of depression or depressive symptoms in the general population. Meta-analyses focusing on treatment of diagnosed depression were excluded. Two authors independently screened the articles and graded the quality of included meta-analyses using AMSTAR 2.

Results

Eight meta-analyses were included that showed little overlap in 134 included studies. All meta-analyses reported on depressive symptoms rather than onset of depression. Five of these were rated as moderate quality and three of low quality. Six meta-analyses found significant effects, and two found non-significant effects of exercise interventions in reducing depressive symptoms in children, adolescents, adults and the elderly (effect sizes ranging from − 0.10 to − 0.81). Scarce evidence did not allow to draw conclusions about the role of sex and characteristics of exercise on depression. However, some findings suggest that low intensity exercise was as effective as high intensity exercise. Heterogeneity among primary studies was high, likely caused by differences in study quality and exercise characteristics.

Conclusions

The evidence from this study suggests that exercise interventions have a beneficial effect on depressive symptoms in the general population across a wide age-range.
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Literature
1.
go back to reference World Health Organization. Depression and other common mental disorders: global health estimates. Geneva: WHO; 2017. World Health Organization. Depression and other common mental disorders: global health estimates. Geneva: WHO; 2017.
2.
go back to reference Ormel J, Cuijpers P, Jorm AF, Schoevers R. Prevention of depression will only succeed when it is structurally embedded and targets big determinants. World Psychiatry. 2019;18:111–2 Blackwell Publishing Ltd.PubMedPubMedCentralCrossRef Ormel J, Cuijpers P, Jorm AF, Schoevers R. Prevention of depression will only succeed when it is structurally embedded and targets big determinants. World Psychiatry. 2019;18:111–2 Blackwell Publishing Ltd.PubMedPubMedCentralCrossRef
3.
go back to reference Blazer DG, Kessler RC, McGonagle KA, Swartz MS. The prevalence and distribution of major depression in a national community sample: The National Comorbidity Survey. Am J Psychiatry. 1994;151(7):979–86 American Psychiatric Association.PubMedCrossRef Blazer DG, Kessler RC, McGonagle KA, Swartz MS. The prevalence and distribution of major depression in a national community sample: The National Comorbidity Survey. Am J Psychiatry. 1994;151(7):979–86 American Psychiatric Association.PubMedCrossRef
5.
go back to reference Sim K, Lau WK, Sim J, Sum MY, Baldessarini RJ. Prevention of relapse and recurrence in adults with major depressive disorder: systematic review and meta-analyses of controlled trials. Int J Neuropsychopharmacol. 2016;19(2):pyv076.CrossRef Sim K, Lau WK, Sim J, Sum MY, Baldessarini RJ. Prevention of relapse and recurrence in adults with major depressive disorder: systematic review and meta-analyses of controlled trials. Int J Neuropsychopharmacol. 2016;19(2):pyv076.CrossRef
6.
go back to reference Ströhle A. Physical activity, exercise, depression and anxiety disorders. J Neural Transm. 2009;116(6):777–84.PubMedCrossRef Ströhle A. Physical activity, exercise, depression and anxiety disorders. J Neural Transm. 2009;116(6):777–84.PubMedCrossRef
7.
go back to reference King AC, Taylor CB, Haskell WL, DeBusk RF. Influence of regular aerobic exercise on psychological health: a randomized, controlled trial of healthy middle-aged adults. Health Psychol. 1989;8(3):305–24.PubMedCrossRef King AC, Taylor CB, Haskell WL, DeBusk RF. Influence of regular aerobic exercise on psychological health: a randomized, controlled trial of healthy middle-aged adults. Health Psychol. 1989;8(3):305–24.PubMedCrossRef
8.
go back to reference Atlantis E, Chow CM, Kirby A, Singh MF. An effective exercise-based intervention for improving mental health and quality of life measures: a randomized controlled trial. Prev Med. 2004;39(2):424–34.PubMedCrossRef Atlantis E, Chow CM, Kirby A, Singh MF. An effective exercise-based intervention for improving mental health and quality of life measures: a randomized controlled trial. Prev Med. 2004;39(2):424–34.PubMedCrossRef
9.
go back to reference Stubbs B, Koyanagi A, Schuch FB, Firth J, Rosenbaum S, Veronese N, et al. Physical activity and depression: a large cross-sectional, population-based study across 36 low- and middle-income countries. Acta Psychiatr Scand. 2016;134(6):546–56.PubMedCrossRef Stubbs B, Koyanagi A, Schuch FB, Firth J, Rosenbaum S, Veronese N, et al. Physical activity and depression: a large cross-sectional, population-based study across 36 low- and middle-income countries. Acta Psychiatr Scand. 2016;134(6):546–56.PubMedCrossRef
10.
go back to reference McDowell CP, Carlin A, Capranica L, Dillon C, Harrington JM, Lakerveld J, et al. Associations of self-reported physical activity and depression in 10,000 Irish adults across harmonised datasets: a DEDIPAC-study. BMC Public Health. 2018a;18(1):779.CrossRef McDowell CP, Carlin A, Capranica L, Dillon C, Harrington JM, Lakerveld J, et al. Associations of self-reported physical activity and depression in 10,000 Irish adults across harmonised datasets: a DEDIPAC-study. BMC Public Health. 2018a;18(1):779.CrossRef
11.
go back to reference McDowell CP, Dishman RK, Hallgren M, MacDonncha C, Herring MP. Associations of physical activity and depression: results from the Irish Longitudinal Study on Ageing. Exp Gerontol. 2018b;112:68–75.PubMedCrossRef McDowell CP, Dishman RK, Hallgren M, MacDonncha C, Herring MP. Associations of physical activity and depression: results from the Irish Longitudinal Study on Ageing. Exp Gerontol. 2018b;112:68–75.PubMedCrossRef
12.
go back to reference Jerstad SJ, Boutelle KN, Ness KK, Stice E. Prospective reciprocal relations between physical activity and depression in female adolescents. J Consult Clin Psychol. 2010;78(2):268–72 NIH Public Access.PubMedPubMedCentralCrossRef Jerstad SJ, Boutelle KN, Ness KK, Stice E. Prospective reciprocal relations between physical activity and depression in female adolescents. J Consult Clin Psychol. 2010;78(2):268–72 NIH Public Access.PubMedPubMedCentralCrossRef
13.
go back to reference Mammen G, Faulkner G. Physical activity and the prevention of depression: a systematic review of prospective studies. Am J Prev Med. 2013;45(5):649–57.PubMedCrossRef Mammen G, Faulkner G. Physical activity and the prevention of depression: a systematic review of prospective studies. Am J Prev Med. 2013;45(5):649–57.PubMedCrossRef
14.
go back to reference Schuch FB, Vancampfort D, Firth J, Rosenbaum S, Ward PB, Silva ES, et al. Physical activity and incident depression: a meta-analysis of prospective cohort studies. Am J Psychiatry. 2018;175(7):631–48.PubMedCrossRef Schuch FB, Vancampfort D, Firth J, Rosenbaum S, Ward PB, Silva ES, et al. Physical activity and incident depression: a meta-analysis of prospective cohort studies. Am J Psychiatry. 2018;175(7):631–48.PubMedCrossRef
15.
go back to reference Petty KH, Davis CL, Tkacz J, Young-Hyman D, Waller JL. Exercise effects on depressive symptoms and self-worth in overweight children: a randomized controlled trial. J Pediatr Psychol. 2009;34(9):929–39 Oxford University Press.PubMedPubMedCentralCrossRef Petty KH, Davis CL, Tkacz J, Young-Hyman D, Waller JL. Exercise effects on depressive symptoms and self-worth in overweight children: a randomized controlled trial. J Pediatr Psychol. 2009;34(9):929–39 Oxford University Press.PubMedPubMedCentralCrossRef
16.
go back to reference Singh NA, Clements KM, Singh MAF. The efficacy of exercise as a long-term antidepressant in elderly subjects: a randomized, controlled trial. J Gerontol Ser A Biol Sci Med Sci. 2001;56(8):M497–504 Oxford University Press.CrossRef Singh NA, Clements KM, Singh MAF. The efficacy of exercise as a long-term antidepressant in elderly subjects: a randomized, controlled trial. J Gerontol Ser A Biol Sci Med Sci. 2001;56(8):M497–504 Oxford University Press.CrossRef
17.
go back to reference Rethorst CD, Wipfli BM, Landers DM. The antidepressive effects of exercise. Sports Med. 2009;39(6):491–511.PubMedCrossRef Rethorst CD, Wipfli BM, Landers DM. The antidepressive effects of exercise. Sports Med. 2009;39(6):491–511.PubMedCrossRef
18.
20.
go back to reference Forsman AK, Schierenbeck I, Wahlbeck K. Psychosocial interventions for the prevention of depression in older adults: systematic review and meta-analysis. J Aging Health. 2011;23(3):387–416.PubMedCrossRef Forsman AK, Schierenbeck I, Wahlbeck K. Psychosocial interventions for the prevention of depression in older adults: systematic review and meta-analysis. J Aging Health. 2011;23(3):387–416.PubMedCrossRef
21.
go back to reference Rebar AL, Stanton R, Geard D, Short C, Duncan MJ, Vandelanotte C. A meta-meta-analysis of the effect of physical activity on depression and anxiety in non-clinical adult populations. Health Psychol Rev. 2015;9(3):366–78.PubMedCrossRef Rebar AL, Stanton R, Geard D, Short C, Duncan MJ, Vandelanotte C. A meta-meta-analysis of the effect of physical activity on depression and anxiety in non-clinical adult populations. Health Psychol Rev. 2015;9(3):366–78.PubMedCrossRef
22.
go back to reference Smith V, Devane D, Begley CM, Clarke M. Methodology in conducting a systematic review of systematic reviews of healthcare interventions. BMC Med Res Methodol. 2011;11:15.PubMedPubMedCentralCrossRef Smith V, Devane D, Begley CM, Clarke M. Methodology in conducting a systematic review of systematic reviews of healthcare interventions. BMC Med Res Methodol. 2011;11:15.PubMedPubMedCentralCrossRef
23.
go back to reference Stovold E, Beecher D, Foxlee R, Noel-Storr A. Study flow diagrams in Cochrane systematic review updates: an adapted PRISMA flow diagram. Syst Rev. 2014;3(1):54.PubMedPubMedCentralCrossRef Stovold E, Beecher D, Foxlee R, Noel-Storr A. Study flow diagrams in Cochrane systematic review updates: an adapted PRISMA flow diagram. Syst Rev. 2014;3(1):54.PubMedPubMedCentralCrossRef
24.
go back to reference Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ. 2017;358:j4008.PubMedPubMedCentralCrossRef Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ. 2017;358:j4008.PubMedPubMedCentralCrossRef
25.
go back to reference Carter T, Morres ID, Meade O, Callaghan P. The effect of exercise on depressive symptoms in adolescents: a systematic review and meta-analysis. J Am Acad Child Adolesc Psychiatry. 2016;55(7):580–90.PubMedCrossRef Carter T, Morres ID, Meade O, Callaghan P. The effect of exercise on depressive symptoms in adolescents: a systematic review and meta-analysis. J Am Acad Child Adolesc Psychiatry. 2016;55(7):580–90.PubMedCrossRef
26.
go back to reference Gordon BR, McDowell CP, Hallgren M, Meyer JD, Lyons M, Herring MP. Association of efficacy of resistance exercise training with depressive symptoms meta-analysis and meta-regression: analysis of randomized clinical trials. JAMA Psychiatry. 2018;75(6):566–76 American Medical Association.PubMedCrossRef Gordon BR, McDowell CP, Hallgren M, Meyer JD, Lyons M, Herring MP. Association of efficacy of resistance exercise training with depressive symptoms meta-analysis and meta-regression: analysis of randomized clinical trials. JAMA Psychiatry. 2018;75(6):566–76 American Medical Association.PubMedCrossRef
27.
go back to reference Larun L, Nordheim LV, Ekeland E, Hagen KB, Heian F. Exercise in prevention and treatment of anxiety and depression among children and young people. Cochrane Database Syst Rev. 2006;3:CD004691 John Wiley & Sons, Ltd. Larun L, Nordheim LV, Ekeland E, Hagen KB, Heian F. Exercise in prevention and treatment of anxiety and depression among children and young people. Cochrane Database Syst Rev. 2006;3:CD004691 John Wiley & Sons, Ltd.
28.
go back to reference Park SH, Han KS, Kan C. Effects of exercise programs on depressive symptoms, quality of life, and self-esteem in older people: a systematic review of randomized controlled trials. Appl Nurs Res. 2014;27(4):219–26.PubMedCrossRef Park SH, Han KS, Kan C. Effects of exercise programs on depressive symptoms, quality of life, and self-esteem in older people: a systematic review of randomized controlled trials. Appl Nurs Res. 2014;27(4):219–26.PubMedCrossRef
29.
go back to reference Dale LP, Vanderloo L, Moore S, Faulkner G. Physical activity and depression, anxiety, and self-esteem in children and youth: an umbrella systematic review. Ment Health Phys Act. 2019;16:66–79.CrossRef Dale LP, Vanderloo L, Moore S, Faulkner G. Physical activity and depression, anxiety, and self-esteem in children and youth: an umbrella systematic review. Ment Health Phys Act. 2019;16:66–79.CrossRef
30.
go back to reference Furukawa TA, Noma H, Caldwell DM, Honyashiki M, Shinohara K, Imai H, et al. Waiting list may be a nocebo condition in psychotherapy trials: a contribution from network meta-analysis. Acta Psychiatr Scand. 2014;130(3):181–92 Blackwell Publishing Ltd.PubMedCrossRef Furukawa TA, Noma H, Caldwell DM, Honyashiki M, Shinohara K, Imai H, et al. Waiting list may be a nocebo condition in psychotherapy trials: a contribution from network meta-analysis. Acta Psychiatr Scand. 2014;130(3):181–92 Blackwell Publishing Ltd.PubMedCrossRef
31.
go back to reference Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336(7650):924–6.PubMedPubMedCentralCrossRef Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336(7650):924–6.PubMedPubMedCentralCrossRef
Metadata
Title
Exercise interventions for the prevention of depression: a systematic review of meta-analyses
Authors
Mandy X. Hu
David Turner
Ellen Generaal
Daniel Bos
M. Kamran Ikram
M. Arfan Ikram
Pim Cuijpers
Brenda W. J. H. Penninx
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2020
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-020-09323-y

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