British Medical Journal (The BMJ)Effect of Exercise for Depression: Systematic Review and Network Meta-analysis of Randomised Controlled Trials

Exercise as a Keystone in Depression Management: A Dive into Effective Modalities and Intensities

In an effort to delineate the most effective exercise regimens for treating major depressive disorder, this study undertakes a systematic review and network meta-analysis, comparing the impact of various exercise forms against psychotherapy, antidepressants, and control conditions.

Study Design:

• Type of Study: Systematic review and network meta-analysis.
• Data Sources: Cochrane Library, Medline, Embase, SPORTDiscus, and PsycINFO databases.
• Participants: The study encompassed 218 unique studies, totaling 14,170 participants, all of whom met clinical criteria for major depression.
• Methodology: The study utilized Bayesian arm-based, multilevel network meta-analyses and employed the CINeMA online tool to grade the evidence quality.

Key Findings:

• Exercise vs. Control: Exercise demonstrated moderate efficacy in reducing depressive symptoms compared to active controls, showcasing notable benefits with walking or jogging, yoga, strength training, mixed aerobic exercises, and tai chi or qigong.
• Intensity Correlation: The benefits of exercise were directly proportional to the prescribed intensity.
• Most Effective Modalities: Walking or jogging, yoga, and strength training emerged as particularly potent, with yoga and strength training also being the most well-tolerated.
• Generalizability: The positive effects of exercise were consistent across individuals with varying levels of depression and comorbidities.
• Recommendation: Exercise should be considered a core treatment for depression, potentially in conjunction with psychotherapy and medication.

HCN Medical Memo
Exercise, particularly walking or jogging, yoga, and strength training, has been demonstrated to be an effective intervention for depression, offering substantial benefits across individuals with varying depression severities and comorbidities. Given their tolerability and efficacy, especially at higher intensities, these exercise modalities should be recognized as fundamental components of depression treatment, alongside psychotherapy and pharmacotherapy.

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