Depressive Symptom Outcomes of Physical Activity Interventions: Meta-analysis Findings
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ORIGINAL ARTICLE
Depressive Symptom Outcomes of Physical Activity Interventions: Meta-analysis Findings Vicki S. Conn, Ph.D.
Published online: 27 April 2010 # The Society of Behavioral Medicine 2010
Abstract Background Physical activity (PA) is consistently linked to mental health outcomes. Purpose This meta-analysis synthesized depressive symptom outcomes of supervised and unsupervised PA interventions among healthy adults. Methods Comprehensive searching and coding were applied to PA interventions among adults without clinical depression. Analyses included random-effects standardized means, Q, and moderator analysis using analysis of variance and regression meta-analytic analogues. Results Treatment versus control comparisons yielded a standardized mean effect size of 0.372 among 38 supervised PA studies and 0.522 among 22 unsupervised PA studies. Preliminary moderator analyses suggested that supervised PA interventions may be more effective when they include flexibility/resistance and low-intensity exercise. Unsupervised PA interventions may be more effective when they recommend center-based PA. Methodological moderators (random assignment, control group management) were identified. Conclusions These findings document that PA interventions reduce depressive symptoms even in adults without clinical depression. Moderator analyses suggest directions for future research as well as practice. Keywords Meta-analysis . Exercise . Depression . Intervention studies
V. S. Conn (*) University of Missouri, Columbia, MO, USA e-mail: [email protected]
Introduction Numerous studies link physical activity (PA) and mental health. Research examining the influence of exercise interventions on clinical depression has been published for more than a century [1]. The link between PA and clinical depression has been documented [2]. Narrative reviews and meta-analyses have examined the sizable empirical literature testing the effect of PA interventions on subjects with clinical depression [3–8]. Longitudinal descriptive research suggests that PA may be effective for preventing clinical depression [2, 9]. Some depressive symptoms are common among people without clinical depression. Depressive symptoms include cognitive-affective and somatic symptoms [3, 10–12]. Depressive symptoms may precede clinical depression, which is related to health state and physical disease [12]. Many PA intervention studies conducted with healthy adults have measured depressive symptom outcomes because these symptoms are an important component of mental health and quality of life [2, 3, 10]. The mechanism by which PA may reduce depressive symptoms is not well understood [3, 12]. Biochemical or physiological explanations include endogenous opiates, endocannabinoids, brain neurotransmitters, anti-inflammatory cytokines, cerebral blood flow, and hypothalamic–pituitary–adrenal axis function [3, 12]. Hypothesized psychological mechanisms include distraction and enhanced self-efficacy, self-esteem, behavioral activation, sense of achievement/mastery, and self-deter
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