Physical Activity Interventions and Depression in Children and Adolescents
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SYSTEMATIC REVIEW
Physical Activity Interventions and Depression in Children and Adolescents A Systematic Review and Meta-Analysis Helen Elizabeth Brown • Natalie Pearson Rock E. Braithwaite • Wendy J. Brown • Stuart J. H. Biddle
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Published online: 4 January 2013 Ó Springer International Publishing Switzerland 2012
Abstract Context Evidence suggests chronic physical activity (PA) participation may be both protective against the onset of and beneficial for reducing depressive symptoms. Objective The aim of this article is to assess the impact of PA interventions on depression in children and adolescents using meta-analysis. Data sources Published English language studies were located from manual and computerized searches of the following databases: PsycInfo, The Cochrane Database of Systematic Reviews and The Cochrane Central Register of Controlled Trials, Trials Register of Promoting Health Interventions (TRoPHI; EPPI Centre), Web of Science and MEDLINE. Study selection Studies meeting inclusion criteria (1) reported on interventions to promote or increase PA; (2) included children aged 5–11 years and/or adolescents aged 12–19 years; (3) reported on results using a quantitative measure of depression; (4) included a non-physical control
H. E. Brown (&) W. J. Brown S. J. H. Biddle School of Human Movement Studies, The University of Queensland, Brisbane, QLD, Australia e-mail: [email protected] N. Pearson S. J. H. Biddle School of Sport, Exercise & Health Sciences, Loughborough University Leicestershire, Loughborough, UK N. Pearson S. J. H. Biddle The NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Loughborough, Leicestershire, UK R. E. Braithwaite Department of Kinesiology and Recreation Administration, Humboldt State University, Arcata, CA, USA
or comparison group; and (5) were published in peerreviewed journals written in English, up to and including May 2011 (when the search was conducted). Data extraction Studies were coded for methodological, participant and study characteristics. Comprehensive MetaAnalysis version-2 software was used to compute effect sizes, with subgroup analyses to identify moderating characteristics. Study quality was assessed using the Delphi technique. Results Nine studies were included (n = 581); most were school-based randomized controlled trials, randomized by individual. Studies used a variety of measurement tools to assess depressive symptoms. The summary treatment effect was small but significant (Hedges’ g = -0.26, standard error = 0.09, 95% confidence intervals = -0.43, -0.08, p = 0.004). Subgroup analyses showed that methodological (e.g. studies with both education and PA intervention; those with a higher quality score; and less than 3 months in duration) and participant characteristics (e.g. single-gender studies; those targeting overweight or obese groups) contributed most to the reduction in depression. Conclusions There was a small significant overall effect for PA on depression. More outcome-focused, high-quality trial
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