Background The Covid-19 pandemic is affecting the entire world population. During the first spread, most governments have implemented quarantine and strict social distancing procedures. Similar measures during recent pandemics resulted in an increase in post-traumatic stress, anxiety and depression symptoms. The development of novel interventions to mitigate the mental health burden are of utmost importance. Objective In this rapid review, we aimed to provide a systematic overview of the literature with regard to associations between physical activity (PA) and depression and anxiety during the COVID-19 pandemic. Data Source We searched major databases (PubMed, EMBASE, SPORTDiscus, and Web of Science) and preprint servers (MedRxiv, SportRxiv, ResearchGate, and Google Scholar), for relevant papers up to 25/07/2020. Study Eligibility Criteria We included observational studies with cross-sectional and longitudinal designs. To qualify for inclusion in the review, studies must have tested the association of PA with depression or anxiety, using linear or logistic regressions. Depression and anxiety must have been assessed using validated rating scales. Study Appraisal and Synthesis Methods Effect sizes were represented by fully adjusted standardized betas and odds ratios (OR) alongside 95% confidence intervals (CI). In case standardized effects could not be obtained, unstandardized effects were presented and indicated. Results We identified a total of 21 observational studies (4 longitudinal, 1 cross-sectional with retrospective analysis, and 16 cross-sectional), including information of 42,293 (age 6–70 years, median female = 68%) participants from five continents. The early evidence suggests that people who performed PA on a regular basis with higher volume and frequency and kept the PA routines stable, showed less symptoms of depression and anxiety. For instance, those reporting a higher total time spent in moderate to vigorous PA had 12–32% lower chances of presenting depressive symptoms and 15–34% of presenting anxiety. Conclusion Performing PA during Covid-19 is associated with less depression and anxiety. To maintain PA routines during Covid-19, specific volitional and motivational skills might be paramount to overcome Covid-19 specific barriers. Particularly, web-based technologies could be an accessible way to increase motivation and volition for PA and maintain daily PA routines.

Introduction: Social distancing and quarantine measures applied during the COVID-19 pandemic might result in mental health problems. In this cross-sectional study we examined if perceived social support, exercise in minutes per week and change in exercise are protective factors regarding symptoms of depression, anxiety, and sleeping disorders. Method: In April 2020, n = 4271 German adults completed an online survey including mental health questionnaires regarding depression (PHQ-D), anxiety (PHQ-D) and sleep (PSQI), as well as questionnaires related to protective factors such as exercise (BSA-F), physical activity-related health competence (PAHCO) and social support (F-SozU). Results: Complete case analysis (n = 3700; mean age 33.13 ± 11.73 years, 78.6 % females) resulted in elevated prevalence of depressive disorder (31.4%), panic disorder (5.7%) and other anxiety disorders (7.4%). 58.3% reported symptoms of insomnia. Three separate models of multiple regression were conducted. Perceived social support was associated with lower values of anxiety (beta = -0.10; t(19) = -6.46; p >0.001), lower values of depressive symptoms (beta = -0.22; t(19) = -15.71; p < .001) and lower values of sleeping disorder symptoms (beta = -0.15; t(19) = -9.55; p < .001). Change towards less exercise compared to the time before Covid-19 was associated with and higher values of anxiety (beta = -0.05; t(19) = -2.85; p= .004), higher values of depressive symptoms (beta = -0.08; t(19) = -5.69; p < .001), and higher values of sleeping disorder symptoms (beta = -0.07; t(19) = -4.54; p < .000). Post-hoc analysis (ANOVAs) revealed that a change towards less exercise was significantly associated with more depressive, anxiety and sleeping disorder symptoms whereas a positive change was not. No significant association was found for exercise in minutes per week for all outcomes. Conclusion: The COVID-19 pandemic seems to have a negative impact on mental health in the German population. Social Support and a stable amount of exercise might attenuate these negative mental health consequences. Ongoing monitoring of the impact of the pandemic on mental health and possible protective factors is needed in order to create a basis for the development of appropriate prevention and intervention measures.

Background: This systematic review and meta-analysis assesses the efficacy of regular, moderate to vigorous physical activity (MVPA) for attention deficit hyperactivity disorder (ADHD) in children and adolescents in randomized controlled trials (RCTs). Methods: RCTs including children and adolescents with clinically diagnosed ADHD, implementing regular MVPA, and assessing ADHD core-symptoms on a valid rating scale post-intervention (primary outcome) were included. Outcomes were pooled through random-effects meta-analysis. Prospero registration: CRD42019142166. Results: MVPA had a small effect on total ADHD core symptoms ( n = 11; g = −0.33; 95% CI [−0.63; −0.02]; p = .037). Conclusions: MVPA could serve as an alternative treatment for ADHD. New RCTs are necessary to increase the understanding of the effect regarding frequency, intensity, type of MVPA interventions, and differential effects on age groups.

Background Exercise efficaciously reduces disorder-specific symptoms of psychiatric disorders. The current study aimed to examine the efficacy of a group exercise intervention on global symptom severity and disorder-specific symptoms among a mixed outpatient sample. Methods Groups of inactive outpatients, waiting for psychotherapy, with depressive disorders, anxiety disorders, insomnia, and attention-deficit/hyperactivity disorders were randomized to a manualized 12-week exercise intervention, combining moderate to vigorous aerobic exercise with techniques for sustainable exercise behaviour change (n = 38, female = 71.1% (n = 27), Mage = 36.66), or a passive control group (n = 36, female = 75.0% (n = 27), Mage = 34.33). Primary outcomes were global symptom severity and disorder-specific symptoms, measured with the Symptom Checklist-90-Revised and Pittsburgh Sleep Quality Index pre- and post-treatment. Secondary outcome was the self-reported amount of exercise (Physical Activity, Exercise, and Sport Questionnaire), measured pre-treatment, intermediate-, and post-treatment. Intention-to-treat analyses were conducted using linear mixed models. Linear regressions were conducted to examine the effect of the change of exercise behaviour on the change of symptoms. Results The intervention significantly improved global symptom severity (d = 0.77, p = .007), depression (d = 0.68, p = .015), anxiety (d = 0.87, p = .002), sleep quality (d = 0.88, p = .001), and increased the amount of exercise (d = 0.82, p < .001), compared to the control group. Post-treatment differences between groups were significant for depression (d = 0.63, p = .031), sleep quality (d = 0.61, p = .035) and the amount of exercise (d = 1.45, p < .001). Across both groups, the reduction of global symptom severity was significantly predicted by an increase of exercise (b = .35, p = .012). Conclusions The exercise intervention showed transdiagnostic efficacy among a heterogeneous clinical sample in a realistic outpatient setting and led to sustained exercise behaviour change. Exercise may serve as an efficacious and feasible transdiagnostic treatment option improving the existing treatment gap within outpatient mental health care settings. Trial registration The study was registered on ClinicalTrials.gov (ID: NCT03542396, 25/04/2018).

The Covid-19 pandemic is affecting the entire world population. During the first spread, most governments have implemented quarantine and strict social distancing procedures. Similar measures during recent pandemics resulted in an increase in post-traumatic stress, anxiety and depression symptoms. The development of novel interventions to mitigate the mental health burden are of outmost importance. In this rapid review, we aimed to provide a systematic overview of the literature with regard to associations between physical activity (PA) and depression and anxiety during the COVID-19 pandemic. We searched major databases (PubMed, EMBASE, Sportdiscus, Web of Science) and preprint servers (MedRxivs, SportRxiv, ResearchGate and Google scholar), for relevant papers up to 25/07/2020. We identified a total of 21 observational studies (4 longitudinal, one cross-sectional with retrospective analysis and 16 cross-sectional), including information of 42,293 (age range = 6-70 years, median female = 68%) participants from 5 continents. The early evidence suggests that people who performed PA on a regular basis with higher volume and frequency and kept the PA routines stable, showed less symptoms of depression and anxiety. For instance, those reporting a higher total time spent in moderate to vigorous PA had 12% to 32% lower chances of presenting depressive symptoms and 15% to 34% of presenting anxiety. In order to maintain PA routines during Covid-19, specific volitional and motivational skills might be paramount to overcome Covid-19 specific barriers. Particularly, web-based technologies could be an accessible way to increase motivation and volition for PA and maintain daily PA routines.