Exercise as a Treatment for Depression
The primary focus of the California Evidence-Based Clearinghouse for Child Welfare (CEBC) is to review and rate selected evidence-based psychosocial programs within child welfare. The CEBC is not designed to, nor does it have the capacity to be able to, review extensive medical and pharmacological treatments. The use of exercise as treatment for depression has been increasingly researched in recent years and studies are showing that it may be an important aspect of treatment, especially for those with mild to moderate depression.
Recent Review Articles
Daley, A. (2008). Exercise and depression: A review of reviews. Journal of Clinical Psychology in Medical Settings, 15(2), 140-147.
Abstract: There has been considerable research interest in the effects of exercise upon depression outcomes. Recently, health agencies in the United Kingdom (UK) and beyond have made several guidance statements on this issue. Therefore, this review seeks to provide a synthesis of evidence regarding the effectiveness of exercise in the management of depression (including postnatal [postpartum] depression) in adults. Studies were identified by searching PubMed, Medline, Cochrane Library (CENTRAL), and PsychINFO using relevant search terms. The article describes how meta-analyses from peer-reviewed journals have reported exercise as treatment for depression is more effective than no treatment, as effective as traditional interventions in some instances, possibly a promising approach to postnatal depression and has equivalent adherence rates to medication. However, reviews have also raised concerns about the methodological quality of trials, possible overestimation of treatment effects, and lack of data regarding long term benefits. Based on the available evidence, it is concluded that while awaiting further high quality trial evidence, it would seem appropriate for exercise to be recommended in combination with other treatments.
Rethorst, C. D., Wipfli, B. M., & Landers, D. M. (2009). The antidepressive effects of exercise: A meta-analysis of randomized trials. Sports Medicine, 39(6), 491-511.
Abstract: Several meta-analyses examining the effects of exercise on depression have been criticized for including studies of poor methodological integrity. More recent meta-analyses addressed the most common criticism by including only randomized control trials; however, these analyses suffer from incomplete literature searches and lack of moderating variable analyses. Using a more extensive search procedure, the current meta-analysis examines the effects of exercise on depressive symptoms in 58 randomized trials (n = 2982). An overall effect size of -0.80 indicates participants in the exercise treatment had significantly lower depression scores than those receiving the control treatment. This SD advantage represents level 1, Grade A evidence for the effects of exercise upon depression. Analysis of moderating variables examined the influence of population characteristics, exercise characteristics, and methodological characteristics. Examination of clinical significance in 16 trials with clinically depressed patients found 9 of 16 exercise treatment groups were classified as recovered at post-treatment, with another three groups classified as improved. Analysis showed dropout rates for the exercise treatment were similar to those found in psychotherapeutic and drug interventions.
Cochrane Collaboration
The Cochrane Collaboration is an international not-for-profit organization providing up-to-date information about the effects of health care.
They have a review of exercise as a treatment for depression: www.cochrane.org/reviews/en/ab004366.html
Abstract: Depression is a common and important illness affecting at least 1 in 5 people during their lifetime. Exercise has been advocated as an adjunct to usual treatment. This review identified all available randomized trials which compared exercise with either no treatment or an established treatment (e.g., talking therapy) for people with a clinical diagnosis of depression. Data from 25 trials were combined. We found exercise did seem to improve the symptoms of depression, but we cannot be sure exactly how effective it is, or the most effective type of exercise. The evidence suggests that exercise probably needs to be continued in the longer-term for benefits on mood to be maintained
