Efficacy of Exercise on Depression: A Systematic Review

Authors

  • Gioia Mura Department of Public Health and Clinical and Molecular Medicine, University of Cagliari. Author

DOI:

https://doi.org/10.61841/h8j7jt28

Keywords:

depression,, exercise,, physical activity.

Abstract

OBJECTIVES: in the last 30 years, a number of studies have shown that physical activity may reduce depressive symptoms both in healthy populations and in patients diagnosed with MDD. This systematic review of the literature aims to establish the new findings on the effectiveness of exercise on depression.

 

METHODS: the search of significant articles was carried out in PubMed/Medline with the following key words: “exercise”, “physical activity”, “physical fitness”, “depressive disorder”, “depression”, and “depressive symptoms”. Interval was set from January 2000 to December 2012.

 

RESULTS: 46 papers were retrieved by the search. Among the 14 included randomized controlled trials, treatment allocation was adequately conceived in 5 studies, intention-to-treat analysis was performed in 10 studies, and the main outcome assessment was blinded in all but three of the studies. We examined the results of all these trials, finding a small effect of exercise on depression, contaminated by the poor quality of the researches.

 

CONCLUSIONS: in the last 12 years, few progresses were done in showing the efficacy of exercise on depression, due in part to the persistent lack of high quality research, in part to the difficult to establish the real effectiveness of exercise on depressive symptoms. However, there are some promising findings on physical activity combined with antidepressants as an add-on strategy to manage depression, which may be probably more useful in clinical practice

Downloads

Download data is not yet available.

References

1. Moussavi S, Chatterji S, Verdes E, Tandon A, Patel V, Uston B. Depression, chronic disease, and decrements in health: results from the World Health Survey. Lancet. 2007;370:851–8

2. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Arch Gen Psychiatry 2005;62:593–602

3. Mathers CD, Loncar D Projections of global mortality and burden of disease from 2002 to 2030. Plos Med. 2006; 3(11): 2011–2030

4. Hollon SD, Thase ME, Markowitz JC. Treatment and prevention of depression. Psychol Sci Public Interest 2002;3:39–77

5. Gasquet I, Nègre-Pagès L, Fourrier A, Nachbaur G, El-Hasnaoui A, Kovess V, Lépine JP. Psychotropic drug use and mental psychiatric disorders in France; results of the general population ESEMeD/MHEDEA 2000 epidemiological study. Encephale. 2005 Mar-Apr;31(2):195-206

6. Carta MG, Aguglia E, Bocchetta A, Balestrieri M, Caraci F, Casacchia M, et al. The Use of Antidepressant Drugs and the Lifetime Prevalence of Major Depressive Disorders in Italy. Clin Pract Epidemiol Ment Health. 2010. 6: 94-100

7. Smith D, Dempster C, Glanville J, Freemantle N, Anderson I. Efficacy and tolerability of venlafaxine compared with selective serotonin reuptake inhibitors and other antidepressants: a meta-analysis. Br J Psychiatry 2002;180:396–404

8. Blumenthal JA, Emery CF, Madden DJ, George LK, Coleman RE, Riddle MW, et al. Cardiovascular and behavioral effects of aerobic exercise training in healthy older men and women. J Gerontol. 1989;44:M147–57;

9. DiLorenzo TM, Bargman EP, Stucky-Ropp R, Brassington GS, Frensch PA, LaFontaine T. Long-term effects of aerobic exercise on psychological outcomes. Prev Med. 1999;28:75–85

10. Roth DL, Holmes DS. Influence of aerobic exercise training and relaxation training on physical and psychologic health following stressful life events. Psychosom Med. 1987;49:355–65;

11. King AC, Taylor CB, Haskell WL. Effects of differing intensities and formats of 12 months of exercise training on psychological outcomes in older adults. Health Psych. 1993;12:292–300

12. Blumenthal JA, Babyak MA, Moore KA, Craighead WE, Herman S, Khatri P, et al. Effects of exercise training on older patients with major depression. Arch Intern Med. 1999;159:2349–56

13. Dunn AL, Trivedi MH, Kempert JB, Clark CG, Chambliss OH. Exercise treatment for depression: efficacy and dose response. Am J Prev Med. 2005;28:1–8

14. Singh NA, Stavrinos TM, Scarbek Y, Galambos G, Liber CL, Fiatarone Singh M. A randomized controlled trial of high versus low intensity weight training versus general practitioner care for clinical depression in older adults. J Geront Med Sci. 2005;60A:768–76

15. Martinsen EW, Medhus A, Sandvik L. Effects of aerobic exercise on depression: a controlled study. BMJ. 1985;291:109

16. Klein MH, Greist JH, Gurman AS, Neiberyer DP. A comparative outcome study of group psychotherapy vs. exercise treatments for depression. Int J Mental Health. 1985;13:148–76

17. Veale D, Le Fevre K, Pantelis C, de Souza V, Mann A, Sargeant A. Aerobic exercise in the adjunctive treatment of depression: a randomized controlled trial. J R Soc Med. 1992;85:541–4

18. McNeil JK, LeBlanc EM, Joyner M. The effect of exercise on depressive symptoms in the moderately depressed elderly. Psych Aging. 1991;6:487–8

19. Singh NA, Clements KM, Singh MA. The efficacy of exercise as a long-term antidepressant in elderly subjects: a randomized, controlled trial. J Gerontol A Bio Sci Med Sci. 2001;56:M497–504

20. Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep. 1985 Mar-Apr;100(2):126-31

21. National Institute for Health and Clinical Excellence. Depression: the treatment and management of depression in adults (updated edition). British Psychological Society and Royal College of Psychiatrists, 2009

22. Otto MW, Smits JA. Exercise for mood and anxiety disorders. New York, NY: Oxford University Press; 2009

23. Carta MG, Hardoy MC, Pilu A, Sorba M, Floris AL, Mannu FA, et al. Improving physical quality of life with group physical activity in the adjunctive treatment of major depressive disorder. Clin Pract Epidemiol Ment Health. 2008 Jan 26;4:1. doi: 10.1186/1745-0179-4-1

24. Blake H. Physical activity and exercise in the treatment of depression. Front Psychiatry. 2012;3:106

25. Martin CK, Church TS, Thompson AM, Earnest CP, Blair SN. Exercise dose and quality of life: a randomized controlled trial. Arch Intern Med. 2009 Feb 9;169(3):269-78

26. Searle A, Calnan M, Lewis G, Campbell J, Taylor A, Turner K. Patients' views of physical activity as treatment for depression: a qualitative study. Br J Gen Pract. 2011 Apr;61(585):149-56

27. Blake H, Mo P, Malik S, Thomas S. How effective are physical activity interventions for alleviating depressive symptoms in older people? A systematic review. Clin Rehabil. 2009 Oct;23(10):873-87

28. Bridle C, Spanjers K, Patel S, Atherton NM, Lamb SE. Effect of exercise on depression severity in older people: systematic review and meta-analysis of randomised controlled trials. Br J Psychiatry. 2012 Sep;201(3):180-5

29. Brosse AL, Sheets ES, Lett HS, Blumenthal JA. Exercise and the treatment of clinical depression in adults: recent findings and future directions. Sports Med. 2002;32(12):741-60

30. Conn VS. Depressive Symptom Outcomes of Physical Activity Interventions: Meta-analysis Findings. Ann Behav Med. 2010 May; 39(2): 128–138.

31. Craft LL, Perna FM. The Benefits of Exercise for the Clinically Depressed. Prim Care Companion J Clin Psychiatry. 2004; 6(3): 104–111

32. Daley A. Exercise and depression: a review of reviews. J Clin Psychol Med Settings. 2008 Jun;15(2):140-7

33. Gill A, Womack R, Safranek S. Clinical Inquiries: Does exercise alleviate symptoms of depression? J Fam Pract. 2010 Sep;59(9):530-1

34. Greer TL, Trivedi MH. Exercise in the treatment of depression. Curr Psychiatry Rep. 2009 Dec;11(6):466-72

35. Krogh J, Nordentoft M, Sterne JA, Lawlor DA. The effect of exercise in clinically depressed adults: systematic review and meta-analysis of randomized controlled trials. J Clin Psychiatry. 2011 Apr;72(4):529-38

36. Lawlor D, Hopker SW. The effectiveness of exercise as an intervention in the management of depression: systematic review and meta- regression analysis of randomised controlled trials. BMJ. 2001 March 31; 322(7289): 763

37. Mead GE, Morley W, Campbell P, Greig CA, McMurdo M, Lawlor DA. Exercise for depression. Cochrane Database Syst Rev. 2009 Jul 8; (3):CD004366

38. Perraton LG, Kumar S, Machotka Z. Exercise parameters in the treatment of clinical depression: a systematic review of randomized controlled trials. J Eval Clin Pract. 2010 Jun;16(3):597-604

39. Rethorst CD, Wipfli BM, Landers DM. The antidepressive effects of exercise: a meta-analysis of randomized trials. Sports Med. 2009;39(6):491-511

40. Rimer J, Dwan K, Lawlor DA, Greig CA, McMurdo M, Morley W. Exercise for depression. Cochrane Database Syst Rev. 2012 Jul 11;7:CD004366

41. Ford SJ. Exercise, pharmacotherapy, and depression. Psychosomatic Medicine. 2008 Feb-Mar. 70 (2): 263

42. Ulrik FM. Exercise in the treatment of major depressive disorder: still a long way to go. Psychosomatic Medicine (2008)70:2632

43. Babyak M, Blumenthal JA, Herman S, Khatri P, Doraiswamy PM, Moore K, et al. Exercise Treatment for Major Depression: Maintenance of Therapeutic Benefit at 10 Months. Psychosomatic Medicine. 62:633–638 (2000)

44. Hoffman BM, Babyak MA, Craighead WE, Sherwood A, Doraiswamy PM, Coons MJ, et al. Exercise and Pharmacotherapy in Patients With Major Depression: One-Year Follow-Up of the SMILE Study. Psychosomatic Medicine. February/March 2011 vol. 73 no. 2 127-133

45. Dimeo F, Bauer M, Varahram I, Proest G, Halter U. Benefits from aerobic exercise in patients with major depression: a pilot study. Br J Sports Med. 2001;35:114–117

46. Reid KJ, Glazer Baron K, Lu B, Naylor E, Wolfe L, Zee PC. Aerobic exercise improves self-reported sleep and quality of life in older adults with insomnia. Sleep Med. 2010 October ; 11(9): 934–940

47. 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. Journal of Pediatric Pychology. 2009; 34(9): 929-939

48. Daley AJ, Copeland RJ, Wright NP, Roalfe A, Wales JKH. Exercise therapy as a treatment for psychopathologic conditions in obese and morbidly obese adolescents: a randomized, controlled trial. Pediatrics. 2006; 118 (5): 2126-2134

49. de Zeeuw ELEJ, Tak ECPM, Dusseldorp E, Hendriksen IJM. Workplace exercise intervention to prevent depression: A pilot randomized controlled trial. Mental Health and Physical Activity. 2010; 3(2): 72-77

50. Kolt GS, Schofield GM, Kerse N, Garrett N, Ashton T, Patel A. Healthy Steps Trial: Pedometer-Based Advice and Physical Activity for Low-Active Older Adults. Ann Fam Med. May/June 2012 vol. 10 no. 3 206-212

51. Kubesch S, Bretschneider V, Freudenmann R, Weidenhammer N, Lehmann M, Spitzer M, et al. Aerobic endurance exercise improves executive functions in depressed patients. J Clin Psychiatry. 2003 Sep;64(9):1005-12

52. Legrand F, Heuze JP Antidepressant effects associated with different exercise conditions in participants with depression: a pilot study. J Sport Exerc Psychol. 2007 Jun;29(3):348-64

53. Sturm J, Plöderl M, Fartacek C, Kralovec K, Neunhäuserer D, Niederseer D, et al. Physical exercise through mountain hiking in high-risk suicide patients. A randomized crossover trial. Acta Psychiatr Scand. 2012 Apr 6

54. Callaghan P, Khalil E, Morres I, Carter I. Pragmatic randomised controlled trial of preferred intensity exercise in women living with depression. BMC Public Health. 2011, 11:465

55. Trivedi MH, Greer TL, Church TS, Carmody TJ, Grannemann BD, Galper DI, et al. Exercise as an Augmentation Treatment for Nonremitted Major Depressive Disorder: A Randomized, Parallel Dose Comparison. J Clin Psychiatry. 2011;72(5):677–684

56. Rethorst CD, Sunderajan P, Greer TL, Grannemann BD, Nakonezny PA, Carmody TJ, et al. Does exercise improve selfreported sleep quality in nonremitted major depressive disorder?. Psychological Medicine. Available on CJO 2012 doi:10.1017/S0033291712001675

57. Blumenthal JA, Babyak MA, Doraiswamy PM, Watkins L, Hoffman BM, Barbour KA, et al. Exercise and Pharmacotherapy in the Treatment of Major Depressive Disorder. Psychosomatic Medicine. September 2007 vol. 69 no. 7 587-596

58. Knubben K, Reischies FM, Adli M, Schlattmann P, Bauer M, Dimeo F. A randomised, controlled study on the effects of a short‐term endurance training programme in patients with major depression. Br J Sports Med. 2007 January; 41(1): 29–33

59. Hua Chu I, Buckworth J, Kirby TE, Emery CF. Effect of exercise intensity on depressive symptoms in woman. Mental Hearth and Physical Activity. 2009, 2 (1): 37-43

60. Pilu A, Sorba M, Hardoy MC, Floris AL, Mannu F, Seruis ML, et al. Efficacy of physical activity in the adjunctive treatment of major depressive disorders: preliminary results. Clin Pract Epidemiol Ment Health. 2007, 3:8

61. Mota-Pereira J, Silverio J, Carvalho S, Ribeiro JC, Fonte D, Ramos J. Moderate exercise improves depression parameters in treatment- resistant patients with major depressive disorder. Journal of Psychiatric Research. 2011 Aug. 45(8): 1005-11

62. Chalder M, Wiles NJ, Campbell J, Hollinghurst S, Haase AM, Taylor AH, et al. Facilitated physical activity as a treatment for depressed adults: randomised controlled trial. BMJ. 2012;344: e2758

63. Krogh J, Saltin B, Gluud C, Nordentoft M. The DEMO trial: a randomized, parallel-group, observer-blinded clinical trial of strength versus aerobic versus relaxation training for patients with mild to moderate depression. J Clin Psychiatry. 2009 Jun;70(6):790-800

64. Krogh J, Videbech P, Thomsen C, Gluud C, Nordentoft M. DEMO-II Trial. Aerobic Exercise versus Stretching Exercise in Patients with Major Depression—A Randomised Clinical Trial. PLoS One. 2012; 7(10): e48316

65. Singh NA, Clements KM and Fiatarone Singh MA. The efficacy of exercise as a long-term antidepressant in elderly subjects. A randomized, controlled trial. J Gerontol A Biol Sci Med Sci. 2001; 56(8); M497-M504

66. Mather AS, Rodriguez C, Guthrie MF, McHarg AM, Reid IC, McMurdo MET. Effects of exercise on depressive symptoms in older adults with poorly responsive depressive disorder. Randomised controlled trial. The British Journal of Psychiatry (2002)180: 411-415

67. Pakkala I, Read S, Leinonen R, Hirvensalo M, Lintunen T, Rantanen T. The effects of physical activity counselling on mood among 75-81 year-old people: A randomized controlled trial. Preventive Medicine. 2008 May; 46(5): 412-8

68. Nabkasorn C, Miyai N, Sootmongkol A, Junprasert S, Yamamoto H, Arita M, et al. Effects of physical exercise on depression, neuroendocrine stress hormones and physiological fitness in adolescent females with depressive symptoms. Eur J Public Health (April 2006) 16

(2): 179-184

69. Kerse N, Hayman KJ, Moyes SA, Peri K, Robinson E, Dowell A, et al. Home-based activity program for older people with depressive symptoms: DeLLITE- A randomized controlled trial. Ann Fam Med. 2010 May: 8(3): 214-223

70. Baxter H, Winder R, Chalder M, Sherlock S, Haase A, Wiles NJ, et al. Physical activity as a treatment for depression: the TREAD randomised trial protocol. Trials. 2010 Nov 12;11:105. doi: 10.1186/1745-6215-11-105

71. Kesaniemi YK, Danforth E Jr, Jensen MD, Kopelman PG, Lefèbvre P, Reeder BA. Dose-response issues concerning physical activity and health: an evidence-based symposium. Med Sci Sports Exerc. 2001 Jun;33(6 Suppl):S351-8

72. Helmich I, Latini A, Sigwalt A, Carta MG, Machado S, Velasques B, et al. Neurobiological Alterations Induced by Exercise and Their Impact on Depressive Disorders. Clin Pract Epidemiol Ment Health. 2010, 6, 115-125 115

73. Bjornebekk A, Mathe AA, Brene S. The antidepressant effect of running is associated with increased hippocampal cell proliferation. Int J Neuropsychopharmacol. 2005;8:357–368

74. Elder GA, De Gasperi R, Gama Sosa MA. Research update: neurogenesis in adult brain and neuropsychiatric disorders. Mt Sinai J Med. 2006 Nov;73(7):931-40

75. Lucassen PJ, Meerlo P, Naylor AS, van Dam AM, Dayer AG, Fuchs E, et al. Regulation of adult neurogenesis by stress, sleep disruption, exercise and inflammation: Implications for depression and antidepressant action. Eur Neuropsychopharmacol. 2010 Jan;20(1):1-17

76. Lieberwirth C, Wang Z. The social environment and neurogenesis in the adult Mammalian brain. Front Hum Neurosci. 2012;6:118

77. Yau SY, Lau BW, Tong JB, Wong R, Ching YP, Qiu G, et al. Hippocampal neurogenesis and dendritic plasticity support running-improved spatial learning and depression-like behaviour in stressed rats. PLoS One. 2011;6(9):e24263

78. Marlatt MW, Lucassen PJ, van Praag H. Comparison of neurogenic effects of fluoxetine, duloxetine and running in mice. Brain Res. 2010 Jun 23;1341:93-9

79. Russo-Neustadt AA, Alejandre H, Garcia C. Ivy AS, Chen MJ. Hippocampal brain-derived neurotrophic factor expression following treatment with reboxetine, citalopram, and physical exercise. Neuropsychopharmacology. 2004 Dec;29(12):2189-99

80. Garza AA, Ha TG, Garcia C, Chen MJ, Russo-Neustadt AA. Exercise, antidepressant treatment, and BDNF mRNA expression in the aging brain. Pharmacol Biochem Behav. 2004 Feb;77(2):209-20.

81. Mura G, Carta MG. Physical activity in depressed elderly. A systematic review. Clin Pract Epidem Ment Health. 2013; 9: 125-135. [DOI: 10.2174/1745017901309010125]

82. Trivedi MH, Greer TL, Grannemann BD, Chambliss HO, Jordan AN. Exercise as an augmentation strategy for treatment of major depression. J Psychiatr Pract. 2006 Jul;12(4):205-13

Downloads

Published

31.12.2014

How to Cite

Mura , G. (2014). Efficacy of Exercise on Depression: A Systematic Review. International Journal of Psychosocial Rehabilitation, 18(No. 2), 23-38. https://doi.org/10.61841/h8j7jt28