Systematic review and meta-analysis of the effects of exercise on depression in adolescents

Abstract

Background Depression is widespread among adolescents and seriously endangers their quality of life and academic performance. Developing strategies for adolescent depression has important public health implications. No systematic review on the effectiveness of physical exercise for adolescents aged 12–18 years with depression or depressive symptoms has previously been conducted. This study aims to systematically evaluate the effect of physical exercise on adolescent depression in the hope of developing optimum physical exercise programs. Methods Nine major databases at home and abroad were searched to retrieve randomized controlled trials (RCTs) on exercise interventions among adolescents with depression or depressive symptoms. The retrieval period started from the founding date of each database to May 1, 2021. The methodological quality of the included articles was evaluated using the modified PEDro scale. A meta-analysis, subgroup analysis, sensitivity analysis, and publication bias tests were then conducted. Results Fifteen articles, involving 19 comparisons, with a sample size of 1331, were included. Physical exercise significantly reduced adolescent depression (standardized mean difference [SMD] = − 0.64, 95% CI − 0.89, − 0.39, p < 0.01), with a moderate effect size, in both adolescents with depression (SMD = -0.57, 95% CI − 0.90, − 0.23, p < 0.01) and adolescents with depressive symptoms (SMD = − 0.67, 95% CI − 1.00, − 0.33, p < 0.01). In subgroups of different depression categories (depression or depressive symptoms), aerobic exercise was the main form of exercise for the treatment of adolescents with depression. For adolescents with depression, interventions lasting 6 weeks, 30 min/time, and 4 times/week had optimum results. The effects of aerobic exercise and resistance + aerobic exercise in the subgroup of adolescents with depressive symptoms were significant, while the effect of physical and mental exercise (yoga) was not significant. For adolescents with depressive symptoms, aerobic exercise lasting 8 weeks, 75–120 min/time, and 3 times/week had optimum results. Physical exercise with moderate intensity is a better choice for adolescents with depression and depressive symptoms. Conclusions Physical exercise has a positive effect on the improvement of depression in adolescents. The protocol for this study was registered with INPLASY (202170013). DOI number is 10.37766/inplasy2021.7.0013. Registration Date:2021.7.06.

Depression in Adolescence and Brain-Derived Neurotrophic Factor

“…Electroconvulsive shock therapy, exercise or endurance and muscle-strengthening training are also considered treatments for depression in adults, and these treatments are also applicable in the treatment of depression in adolescents ( Strohle, 2009 ; Wachtel et al, 2011 ; Hughes et al, 2013 ; Gokce et al, 2019 ; Wang et al, 2022 ). These treatments have shown positive effects on adolescent depression, and BDNF has been considered to play a role in their antidepressant actions ( Tsai et al, 2010 ; Murawska-Ciałowicz et al, 2021 ).…”

The Management of Anxiety and Depression in Pediatrics

“…Exercise interventions are among the most studied adjunctive therapies and have proven very effective in reducing symptoms of anxiety and depression in pediatric populations. Furthermore, studies have shown a significantly higher adherence to exercise treatment interventions in adolescents as compared to psychological and drug therapies [39]. Yoga is particularly effective in the reduction of symptoms of anxiety [39,40].…”

“…Furthermore, studies have shown a significantly higher adherence to exercise treatment interventions in adolescents as compared to psychological and drug therapies [39]. Yoga is particularly effective in the reduction of symptoms of anxiety [39,40]. For the most significant improvement, one study recommended participating in yoga sessions at least four times a week for at least six weeks [40].…”

“…For the most significant improvement, one study recommended participating in yoga sessions at least four times a week for at least six weeks [40]. Similarly, aerobic exercise has been repeatedly shown as an effective treatment to reduce depression and depressive symptoms [39,[41][42][43][44]. Current guidelines recommend moderate to vigorous intensity exercise for 60 minutes or more per day for children and adolescents.…”

Is Brain-Derived Neurotrophic Factor a Metabolic Hormone in Peripheral Tissues?

“…When considering together that mBDNF is a well-recognized myokine whose expression is increased after exercise, muscle-derived mBDNF is secreted into the circulation [ 68 ]. Although Pardridge et al demonstrated that BDNF in blood was rapidly degraded and no mBDNF transcytosis through the blood–brain barrier (BBB) in rat was observed [ 139 ], later studies showed that blood-borne mBDNF can enter the CNS by a rapid, saturable transport system of the BBB [ 140 , 141 ], mBDNF concentration in blood is reduced in psychiatric and neurological disorders [ 142 ], and physical exercise is an effective means to alleviate the mental dysfunction in a lot of psychiatric diseases [ 143 ]. Thus, it is tempting to hypothesize that peripheral mBDNF is a beneficial “exerkine” to improve the mental health.…”