Aerobic physical activity may be associated with reduced depressive symptoms in children and adolescents, especially among teens over age 13, according to a study published this week in JAMA Pediatrics.
“There is an urgent need to explore novel treatment approaches that can be safely, feasibly, and widely implemented in the daily routine of children and adolescents with depression,” wrote Francesco Recchia, M.Sc., of the University of Hong Kong and colleagues. “The findings of this systematic review and meta-analysis strengthen the role of physical activity for depressive symptom management and highlight the potential of structured physical education programs in primary and secondary schools for improving the mental health of children and adolescents.”
Recchia and colleagues analyzed randomized clinical trials published in PubMed, CINAHL, PsycINFO, EMBASE, and SPORTDiscus. The researchers specifically focused on studies that investigated the effects of interventions that involved aerobic physical activity on depressive symptoms in children and adolescents aged 18 years and younger. Aerobic physical activity was defined as “an activity in which the body’s large muscle groups move in a rhythmic manner for a sustained period of time.” The interventions lasted four or more weeks and could be implemented alone or alongside treatment as usual, an educational component, or participants’ current physical education routine. The studies also included a control condition in the form of no treatment, waiting list, or treatment as usual.
Twenty-one studies with a total of 2,441 participants were included in the meta-analysis. Physical activity interventions were associated with a reduction in depressive symptoms compared with the control condition. The interventions resulted in greater benefits among participants aged 13 years or older, and among those with a mental illness and/or depression diagnosis. There was no association between physical activity and depressive symptoms at follow-up in the four studies that analyzed this association. The authors suggested this may be due to the small number of studies that investigated follow-up outcomes.
Further, interventions that were shorter than 12 weeks and those that included three physical activity sessions a week had greater benefits on participants’ depressive symptoms compared with interventions of other frequencies and durations. The authors noted that this finding is reflected in the results of similar meta-analyses on the association between physical activity and depressive symptoms, “suggesting that increasing amounts of physical activity may not translate into greater reductions in depressive symptoms.” More research is needed, they continued, to establish the optimal timing of physical activity to manage depressive symptoms.
“Physical activity is remarkable medicine,” wrote Eduardo Bustamante, Ph.D., of the University of Illinois Chicago and colleagues in an accompanying commentary. “[T]he systematic review and meta-analysis by Recchia et al. is part of a potential watershed moment for the field. The evidence that physical activity is effective medicine for mental health is robust; now we need to find ways to get people to take it.”
For related information, see the Psychiatric News article “Physical Activity May Lower, Prevent Depression.”
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