Document Detail

The effect of exercise in clinically depressed adults: systematic review and meta-analysis of randomized controlled trials.
MedLine Citation:
PMID:  21034688     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To assess the effectiveness of exercise in adults with clinical depression.
DATA SOURCES: The databases CINAHL, Embase, Cochrane Database of Systematic reviews, Cochrane Controlled Trials Register, MEDLINE, and PsycINFO were searched (1806-2008) using medical subject headings (MeSH) and text word terms depression, depressive disorder and exercise, aerobic, non-aerobic, physical activity, physical fitness, walk*, jog*, run*, bicycling, swim*, strength, and resistance.
STUDY SELECTION: Randomized trials including adults with clinical depression according to any diagnostic system were included.
DATA EXTRACTION: Two investigators evaluated trials using a prepiloted structured form.
DATA SYNTHESIS: Thirteen trials were identified that fulfilled the inclusion criteria. Eight had adequate allocation concealment, 6 had a blinded outcome, and 5 used intention-to-treat analyses. The pooled standardized mean difference (SMD) calculated using a random-effects model was -0.40 (95% CI, -0.66 to -0.14), with evidence of heterogeneity between trials (I(2) = 57.2%, P = .005). There was an inverse association between duration of intervention and the magnitude of the association of exercise with depression (P = .002). No other characteristics were related to between-study heterogeneity. Pooled analysis of 5 trials with long-term follow-up (ie, that examined outcomes beyond the end of the intervention) suggested no long-term benefit (SMD, -0.01; 95% CI, -0.28 to 0.26), with no strong evidence of heterogeneity in this pooled analysis (I(2) = 23.4%, P = .27). There was no strong statistical evidence for small study bias (P > .27). Only 3 studies were assessed as high quality (adequately concealed random allocation, blinded outcome assessment, and intention-to-treat analysis). When we pooled results from these, the estimated beneficial effect of exercise was more modest (SMD, -0.19; 95% CI, -0.70 to 0.31) than the pooled result for all 13 studies, with no strong evidence of benefit.
CONCLUSIONS: Our results suggest a short-term effect of exercise on depression: on average, depression scores 0.4 of a standard deviation lower in clinically depressed patients randomly assigned to an exercise intervention at the end of that intervention compared to those randomly assigned to a none exercise group. There is little evidence of a long-term beneficial effect of exercise in patients with clinical depression.
Jesper Krogh; Merete Nordentoft; Jonathan A C Sterne; Debbie A Lawlor
Related Documents :
11428738 - Comparison of montelukast versus budesonide in the treatment of exercise-induced bronch...
17555468 - What therapies have replaced rofecoxib in ireland?
15801488 - Exercise interventions for cancer patients: systematic review of controlled trials.
18685348 - Oxygen and helium gas mixtures for dyspnoea.
11101268 - Gender differences in metabolism; nutrition and supplements.
15354048 - Consistency of the talk test for exercise prescription.
Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review     Date:  2010-10-19
Journal Detail:
Title:  The Journal of clinical psychiatry     Volume:  72     ISSN:  1555-2101     ISO Abbreviation:  J Clin Psychiatry     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-04-29     Completed Date:  2011-06-29     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  7801243     Medline TA:  J Clin Psychiatry     Country:  United States    
Other Details:
Languages:  eng     Pagination:  529-38     Citation Subset:  IM    
Copyright Information:
© Copyright 2011 Physicians Postgraduate Press, Inc.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Depressive Disorder / therapy*
Exercise Therapy*
Odds Ratio
Randomized Controlled Trials as Topic / standards
Remission Induction
Time Factors
Treatment Outcome
Grant Support
G0600705//Medical Research Council

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Randomized controlled trial of interventions for young people at ultra high risk for psychosis: 6-mo...
Next Document:  Exploring regional variation in antipsychotic coprescribing practice: a Danish questionnaire survey.