Exercise as medicine for depressive symptoms? A systematic review and meta-analysis with meta-regression
Heissel A, Heinen D, Brokmeier LL, Skarabis N, Kangas M, Vancampfort D, Stubbs B, Firth J, Ward P, Rosenbaum S, Hallgren M, Schuch FB (2023)
Publication Type: Journal article
Publication year: 2023
Journal
Original Authors: Andreas Heissel, Darlene Heinen, Luisa Leonie Brokmeier, Nora Skarabis, Maria Kangas, Davy Vancampfort, Brendon Stubbs, Joseph Firth, Philip B Ward, Simon Rosenbaum, Mats Hallgren, Felipe Schuch
Pages Range: bjsports-2022-106282
DOI: 10.1136/bjsports-2022-106282
Abstract
Objective To estimate the efficacy of exercise on depressive symptoms compared with non-active control groups and to determine the moderating effects of exercise on depression and the presence of publication bias.
Design Systematic review and meta-analysis with meta-regression.
Data sources The Cochrane Central Register of Controlled Trials, PubMed, MEDLINE, Embase, SPORTDiscus, PsycINFO, Scopus and Web of Science were searched without language restrictions from inception to 13 September2022 (PROSPERO registration no CRD42020210651).
Eligibility criteria for selecting studies Randomised controlled trials including participants aged 18 years or older with a diagnosis of major depressive disorder or those with depressive symptoms determined by validated screening measures scoring above the threshold value, investigating the effects of an exercise intervention (aerobic and/or resistance exercise) compared with a non-exercising control group.
Results Forty-one studies, comprising 2264 participants post intervention were included in the meta-analysis demonstrating large effects (standardised mean difference (SMD)=−0.946, 95% CI −1.18 to −0.71) favouring exercise interventions which corresponds to the number needed to treat (NNT)=2 (95% CI 1.68 to 2.59). Large effects were found in studies with individuals with major depressive disorder (SMD=−0.998, 95% CI −1.39 to −0.61, k=20), supervised exercise interventions (SMD=−1.026, 95% CI −1.28 to −0.77, k=40) and moderate effects when analyses were restricted to low risk of bias studies (SMD=−0.666, 95% CI −0.99 to −0.34, k=12, NNT=2.8 (95% CI 1.94 to 5.22)).
Conclusion Exercise is efficacious in treating depression and depressive symptoms and should be offered as an evidence-based treatment option focusing on supervised and group exercise with moderate intensity and aerobic exercise regimes. The small sample sizes of many trials and high heterogeneity in methods should be considered when interpreting the results.
Authors with CRIS profile
Involved external institutions
University of New South Wales (UNSW)
Australia (AU)
Universität Potsdam
Germany (DE)
Karolinska University Hospital / Karolinska Universitetssjukhuset
Sweden (SE)
Federal University of Santa Maria / Universidade Federal de Santa Maria (UFSM)
Brazil (BR)
Macquarie University
Australia (AU)
South London and Maudsley NHS Foundation Trust
United Kingdom (GB)
Katholieke Universiteit Leuven (KUL) / Catholic University of Leuven
Belgium (BE)
University of Manchester
United Kingdom (GB)
Australia (AU)
Universität Potsdam
Germany (DE)
Karolinska University Hospital / Karolinska Universitetssjukhuset
Sweden (SE)
Federal University of Santa Maria / Universidade Federal de Santa Maria (UFSM)
Brazil (BR)
Macquarie University
Australia (AU)
South London and Maudsley NHS Foundation Trust
United Kingdom (GB)
Katholieke Universiteit Leuven (KUL) / Catholic University of Leuven
Belgium (BE)
University of Manchester
United Kingdom (GB)
How to cite
APA:
Heissel, A., Heinen, D., Brokmeier, L.L., Skarabis, N., Kangas, M., Vancampfort, D.,... Schuch, F.B. (2023). Exercise as medicine for depressive symptoms? A systematic review and meta-analysis with meta-regression. British Journal of Sports Medicine, bjsports-2022-106282. https://dx.doi.org/10.1136/bjsports-2022-106282
MLA:
Heissel, Andreas, et al. "Exercise as medicine for depressive symptoms? A systematic review and meta-analysis with meta-regression." British Journal of Sports Medicine (2023): bjsports-2022-106282.
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