Skip to main content
SpringerLink
Log in

Depressive Symptom Outcomes of Physical Activity Interventions: Meta-analysis Findings

  • Original Article
  • Published:
Annals of Behavioral Medicine

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Franz SL, Hamilton GV. Effect of exercise upon the retardation in condition of depression. Am J Insanity. 1905; 62: 239–256.

    Google Scholar 

  2. Martinsen EW. Physical activity in the prevention and treatment of anxiety and depression. Nord J Psychiatry. 2008; 62(Suppl 47): 25–29.

    Article  PubMed  Google Scholar 

  3. Deslandes A, Moraes H, Ferreira C, et al. Exercise and mental health: Many reasons to move. Neuropsychobiology. 2009; 59: 191–198.

    Article  PubMed  Google Scholar 

  4. Dunn AL, Trivedi MH, O'Neal HA. Physical activity dose-response effects on outcomes of depression and anxiety. Med Sci Sports Exerc. 2001; 33: S587–S597; S609–S510.

    Article  CAS  PubMed  Google Scholar 

  5. Lawlor DA, Hopker SW. The effectiveness of exercise as an intervention in the management of depression: Systematic review and meta-regression of randomised controlled trials. BMJ. 2001; 322: 763–767.

    Article  CAS  PubMed  Google Scholar 

  6. Craft LL, Landers DM. The effects of exercise on clinical depression and depression resulting from mental illness: A meta-regression. J Sport Exerc Psychol. 1998; 20: 339–347.

    Google Scholar 

  7. Stathopoulou G, Powers MB, Berry AC, Smits JAJ, Otto MW. Exercise interventions for mental health: A quantitative and qualitative review. Clin Psychol Sci Pract. 2006; 13: 179–193.

    Article  Google Scholar 

  8. Pinquart M, Duberstein PR, Lyness JM. Effects of psychotherapy and other behavioral interventions on clinically depressed older adults: A meta-analysis. Aging Ment Health. 2007; 11: 645–657.

    Article  CAS  PubMed  Google Scholar 

  9. aan het Rot M, Collins KA, Fitterling HL. Physical exercise and depression. Mt Sinai J Med. 2009; 76: 204–214.

    Article  Google Scholar 

  10. Arent S, Landers DM, Etnier J. The effects of exercise on mood in older adults: A meta-analytic review. J Aging Phys Act. 2000; 8: 407–430.

    Google Scholar 

  11. Sjosten N, Kivela SL. The effects of physical exercise on depressive symptoms among the aged: A systematic review. Int J Geriatr Psychiatry. 2006; 21: 410–418.

    Article  PubMed  Google Scholar 

  12. Daley A, Daley A. Exercise and depression: A review of reviews. J Clin Psychol Med Settings. 2008; 15: 140–147.

    Article  PubMed  Google Scholar 

  13. Penedo FJ, Dahn JR. Exercise and well-being: A review of mental and physical health benefits associated with physical activity. Curr Opin Psychiatry. 2005; 18: 189–193.

    Article  PubMed  Google Scholar 

  14. North TC, McCullagh P, Tran ZV. Effect of exercise on depression. Exerc Sport Sci Rev. 1990; 18: 379–415.

    Article  CAS  PubMed  Google Scholar 

  15. Cooper H, Hedges L, Valentine J, eds. The Handbook of Research Synthesis and Meta-Analysis. 2nd ed. New York: Russell Sage; 2009.

  16. White H. Scientific communication and literature retrieval. In: Cooper H, Hedges L, Valentine J, eds. The Handbook of Research Synthesis and Meta-Analysis. 2nd ed. New York: Russell Sage; 2009: 51–71.

    Google Scholar 

  17. Reed J, Baxter P. Using reference databases. In: Cooper H, Hedges L, Valentine J, eds. The Handbook of Research Synthesis and Meta-Analysis. 2nd ed. New York: Russell Sage; 2009: 73–101.

    Google Scholar 

  18. Rothstein HR, Hopewell S. Grey literature. In: Cooper H, Hedges L, Valentine J, eds. The Handbook of Research Synthesis and Meta-Analysis. 2nd ed. New York: Russell Sage; 2009: 103–125.

    Google Scholar 

  19. Shadish W, Haddock C. Combining estimates of effect size. In: Cooper H, Hedges L, Valentine J, eds. The Handbook of Research Synthesis and Meta-Analysis. 2nd ed. New York: Russell Sage; 2009: 257–277.

    Google Scholar 

  20. Borenstein M, Hedges L, Higgins JP, Rothstein HR. Introduction to Meta-Analysis. UK: Wiley; 2009.

    Book  Google Scholar 

  21. Raudenbush SW. Analyzing effect sizes: Random-effect models. In: Cooper H, Hedges L, Valentine J, eds. The Handbook of Research Synthesis and Meta-Analysis. 2nd ed. New York: Russell Sage; 2009: 295–316.

    Google Scholar 

  22. Wood W, Eagly A. Advantages of certainty and uncertainty. In: Cooper H, Hedges L, Valentine J, eds. The Handbook of Research Synthesis and Meta-Analysis. 2nd ed. New York: Russell Sage; 2009: 455–472.

    Google Scholar 

  23. Conn VS, Hafdahl AR, Brown SA, et al. Meta-analysis of patient education interventions to increase physical activity among chronically ill adults. Patient Educ Couns. 2008; 70: 157–172.

    Article  PubMed  Google Scholar 

  24. Sutton AJ. Publication bias. In: Cooper H, Hedges L, Valentine J, eds. The Handbook of Research Synthesis and Meta-Analysis. 2nd ed. New York: Russell Sage; 2009: 435–452.

    Google Scholar 

  25. Borenstein M. Effect sizes of continuous data. In: Cooper H, Hedges L, Valentine J, eds. The Handbook of Research Synthesis and Meta-Analysis. 2nd ed. New York: Russell Sage; 2009: 221–235.

    Google Scholar 

  26. *Andersen RE, Wadden TA, Bartlett SJ, et al. Effects of lifestyle activity vs. structured aerobic exercise in obese women: A randomized trial. JAMA. 1999; 281: 335–340.

    Google Scholar 

  27. *Annesi JJ, Westcott WL. Age as a moderator of relations of physical self-concept and mood changes associated with 10 weeks of programmed exercise in women. Percept Mot Skills. 2005; 101: 840–844.

    Google Scholar 

  28. *Annesi JJ, Westcott WW, Gann S. Preliminary evaluation of a 10-wk. resistance and cardiovascular exercise protocol on physiological and psychological measures for a sample of older women. Percept Mot Skills. 2004; 98: 163–170.

    Google Scholar 

  29. *Annesi JJ. Sex differences in relations of cardiorespiratory and mood changes associated with self-selected amounts of cardiovascular exercise. Psychol Rep. 2003; 93: 1339–1346.

    Google Scholar 

  30. *Anshel MH. Effect of chronic aerobic exercise and progressive relaxation on motor performance and affect following acute stress. Behav Med. 1996; 21: 186–196.

    Google Scholar 

  31. *Atlantis E, Chow CM, Kirby A, Singh MF. An effective exercise-based intervention for improving mental health and quality of life measures: A randomized controlled trial. Prev Med. 2004; 39: 424–434.

    Google Scholar 

  32. *Bacon L, Keim NL, Van Loan MD, et al. Evaluating a 'non-diet' wellness intervention for improvement of metabolic fitness, psychological well-being and eating and activity behaviors. Int J Obes Relat Metab Disord. 2002; 26: 854–865.

    Google Scholar 

  33. *Blair SN, Smith M, Collingwood TR, et al. Health promotion for educators: Impact on absenteeism. Prev Med. 1986; 15: 166–175.

    Google Scholar 

  34. *Blumenthal JA, Emery CF, Madden DJ, et al. Long-term effects of exercise on psychological functioning in older men and women. J Gerontol. 1991; 46: P352–P361.

    Google Scholar 

  35. *Boileau RA, McAuley E, Demetriou D, et al. Aerobic exercise training and cardiorespiratory fitness in older adults: A randomized trial. J Aging Phys Act. 1999; 7: 374–385.

    Google Scholar 

  36. *Brown D, Wang Y, Ward A, et al. Chronic psychological effects of exercise and exercise plus cognitive strategies. Med Sci Sports Exerc. 1995; 27: 765–775.

    Google Scholar 

  37. *Brown RS, Ramirez DE, Taub JM. The prescription of exercise for depression. Phys Sportsmed. 1978; 6: 34–49.

    Google Scholar 

  38. *Byrom JM. The Effects of a Cardiovascular Fitness Program on Depression, Anxiety, Self-Concept, and Perceived Physical Fitness in College Women [dissertation]. California School of Professional Psychology; 1983.

  39. *Casal DC. Effects of 2000 Kilocalories Per Week of Treadmill Walking and Stairclimbing on Physical Fitness and Coronary Risk Factors of Obese Young Men [dissertation]. University of Minnesota; 1984.

  40. *Cormier A, Prefontaine M, MacDonald H, Stuart RB. Lifestyle change on the campus: pilot test of a program to improve student health practices. In: Davidson PO, Davidson SM, eds. Behavioral Medicine: Changing Health Lifestyles. New York: Brunner/Mazel; 1980: 222–255.

  41. *Craft L, Freund KM, Culpepper L, Perna FM. Intervention study of exercise for depressive symptoms in women. J Womens Health. 2007; 16: 1499–1509.

    Google Scholar 

  42. *Cramer SR, Nieman DC, Lee JW. The effects of moderate exercise training on psychological well-being and mood state in women. J Psychosom Res. 1991; 35: 437–449.

    Google Scholar 

  43. *Dennis KD, Pane, KW, Adams BK, Qi BB. The impact of a shipboard weight control program. Obes Res. 1999; 7: 60–67.

    Google Scholar 

  44. *DiLorenzo TM, Bargman EP, Stucky-Ropp R, et al. Long-term effects of aerobic exercise on psychological outcomes. Prev Med. 1999; 28: 75–85.

    Google Scholar 

  45. *Dunai A, Novak M, Chung SA, et al. Moderate exercise and bright light treatment in overweight and obese individuals. Obes Res. 2007; 15: 1749–1757.

    Google Scholar 

  46. *Eby JM. An investigation into the effects of aerobic exercise on anxiety and depression [dissertation]. University of Toronto; 1984.

  47. *Elavsky S, McAuley E. Physical activity and mental health outcomes during menopause: A randomized controlled trial. Ann Behav Med. 2007; 33: 132–142.

    Google Scholar 

  48. *Elliot DL, Goldberg L, Duncan TE, et al. The PHLAME firefighters' study: Feasibility and findings. Am J Health Behav. 2004; 28: 13–23.

    Google Scholar 

  49. *Emery CF, Blumenthal JA. Effects of exercise training on psychological functioning in healthy type A men. Psychol Health. 1988; 2: 367–379.

    Google Scholar 

  50. *Emery CF, Gatz M. Psychological and cognitive effects of an exercise program for community-residing older adults. Gerontologist. 1990; 30: 184–188.

    Google Scholar 

  51. *Engels HJ, Drouin J, Zhu W, Kazmierski JF. Effects of low-impact, moderate-intensity exercise training with and without wrist weights on functional capacities and mood states in older adults. Gerontology. 1998; 44: 239–244.

    Google Scholar 

  52. *Galletly C, Clark A, Tomlinson L, Blaney F. A group program for obese, infertile women: Weight loss and improved psychological health. J Psychosom Obstet Gynaecol. 1996; 17: 125–128.

    Google Scholar 

  53. *Glisky ML: Interventions for Cognitive and Psychosocial Functioning in Older Adults: a Comparison of Aerobic Exercise and Cognitive Training [dissertation]. University of Arizona; 1997.

  54. *Guest RS, Klose KJ, Needham-Shropshire BM, Jacobs PL. Evaluation of a training program for persons with SCI paraplegia using the Parastep 1 ambulation system: Effect on physical self-concept and depression. Arch Phys Med Rehabil. 1997; 78: 804–807.

    Google Scholar 

  55. *Gusi N, Reyes MC, Gonzalez-Guerrero JL, Herrera E, Garcia JM. Cost-utility of a walking programme for moderately depressed, obese, or overweight elderly women in primary care: a randomised controlled trial. BMC Public Health [serial online]. 2008; 8: 231. Available from http://www.biomedcentral.com/1471-2458/8/231. Accessed December 9, 2009.

  56. *Harralson TL, Emig JC, Polansky M, et al. Un Corazon Saludable: Factors influencing outcomes of an exercise program designed to impact cardiac and metabolic risks among urban Latinas. J Community Health. 2007; 32: 401–412.

    Google Scholar 

  57. *Hassmen P, Koivula N. Mood, physical working capacity and cognitive performance in the elderly as related to physical activity. Aging Clin Exp Res. 1997; 9: 136–142.

    Google Scholar 

  58. *Hayward LM, Sullivan AC, Libonati JR. Group exercise reduces depression in obese women without weight loss. Percept Mot Skills. 2000; 90: 204–208.

    Google Scholar 

  59. *Hicks AL, Martin KA, Ditor DS, et al. Long-term exercise training in persons with spinal cord injury: effects on strength, arm ergometry performance and psychological well-being. Spinal Cord. 2003; 41: 34–43.

    Google Scholar 

  60. *Holder JD. The Effects of Low Level Aerobic Activity Upon Systolic Blood Pressure Heart Rate and Depression Levels among the Elderly [dissertation]. Boston University School of Education; 1982.

  61. *Hunter M, O'Dea I. An evaluation of a health education intervention for mid-aged women: five year follow-up effects upon knowledge, impact of menopause and health. Patient Educ Couns. 1999; 38: 249–255.

    Google Scholar 

  62. *King AC, Baumann K, O'Sullivan P, Wilcox S, Castro C. Effects of moderate-intensity exercise on physiological, behavioral, and emotional responses to family caregiving: A randomized controlled trial. J Gerontol. 2002; 57: M26-M36.

  63. *King AC, Brassington G. Enhancing physical and psychological functioning in older family caregivers: The role of regular physical activity. Ann Behav Med. 1997; 19: 91–100.

    Google Scholar 

  64. *King AC, Taylor CB, Haskell WL. Effects of differing intensities and formats of 12 months of exercise training on psychological outcomes in older adults. Health Psychol. 1993; 12: 292–300.

    Google Scholar 

  65. *Klein MH, Greist JH, Gurman AS, et al. A comparative outcome study of group psychotherapy vs. exercise treatments for depression. Int J Ment Health. 1985; 13: 148–177.

    Google Scholar 

  66. *Knittle VR. Effect of Twelve Weeks of Exercise on Depression, Self-Esteem, and Locus-of-Control in a Wellness Program Sample of Women Aged 65 and Older [thesis]. The University of Arizona; 1988.

  67. *Kohut ML, McCann DA, Russell DW, et al. Aerobic exercise, but not flexibility/resistance exercise, reduces serum IL-18, CRP, and IL-6 independent of beta-blockers, BMI, and psychosocial factors. Brain Behav Immun. 2006; 20: 201–209.

    Google Scholar 

  68. *Lane A, Mills M, Terry P. Mood regulation among corporate workers: Effects of exercise on mood. J Sports Sci. 1998; 16: 87.

    Google Scholar 

  69. *Lennox SS. The Effect of Aerobic Exercise on Self-Reported Mood [dissertation]. State University of New York at Stony Brook; 1987.

  70. *McDonald DG, Norton JP, Hodgdon JA. Training success in U.S. Navy special forces. Aviat Space Environ Med. 1990; 61: 548–554.

    Google Scholar 

  71. *McSherry WC, II. Effects of Aerobic Fitness Training on Migraine Headache [dissertation]. University of North Dakota; 1993.

  72. *Melanson KJ, Dell'Olio J, Carpenter MR, Angelopoulos TJ. Changes in multiple health outcomes at 12 and 24 weeks resulting from 12 weeks of exercise counseling with or without dietary counseling in obese adults. Nutrition. 2004; 20: 849–856.

    Google Scholar 

  73. *Mellin L, Croughan-Minihane M, Dickey L. The Solution Method: 2-year trends in weight, blood pressure, exercise, depression, and functioning of adults trained in development skills. J Am Diet Assoc. 1997; 97: 1133–1138.

    Google Scholar 

  74. *Morgan WP, Costill DL, Flynn MG, Raglin JS, O'Connor PJ. Mood disturbance following increased training in swimmers. Med Sci Sports Exerc. 1988; 20: 408–414.

    Google Scholar 

  75. *Morgan WP, Roberts JA, Brand FR, Feinerman AD. Psychological effect of chronic physical activity. Med Sci Sports Exerc. 1970; 2: 213–217.

    Google Scholar 

  76. *Nagy S, Frazier S. The impact of exercise on locus of control, self-esteem, and mood states. J Soc Behav Pers. 1988; 3: 263–268.

    Google Scholar 

  77. *Nieman D, Warren B, Dotson R, Butterworth D, Henson D. Physical activity, psychological well-being, and mood state in elderly. J Aging Phys Act. 1993; 1: 22–33.

    Google Scholar 

  78. *Palmer LK. Effects of a walking program on attributional style, depression, and self-esteem. Percept Mot Skills. 1995; 81: 891–898.

    Google Scholar 

  79. *Pensabene T. Impact of a Walking Intervention on Perimenopausal Symptoms (Menopause) [dissertation]. Texas Women’s University; 1997.

  80. *Perri S, II, Templer DI. The effects of an aerobic exercise program on psychological variables in older adults. Int J Aging Hum Dev. 1985; 20: 167–172.

  81. *Rapoport L, Clark M, Wardle J. Evaluation of a modified cognitive-behavioural programme for weight management. Int J Obes Relat Metab Disord. 2000; 24: 1726–1737.

    Google Scholar 

  82. *Rhodes DL. Mens Sana, Corpore Sano: A Study of the Effect of Jogging on Depression, Anxiety and Self Concept [dissertation]. Duke University; 1980.

  83. *Roth DL, Holmes DS. Influence of aerobic exercise training and relaxation training on physical and psychologic health following stressful life events. Psychosom Med. 1987; 49: 355–365.

    Google Scholar 

  84. *Simons CW, Birkimer JC. An exploration of factors predicting the effects of aerobic conditioning on mood state. J Psychosom Res. 1988; 32: 63–75.

    Google Scholar 

  85. *Sinatra S, Allen G, Camaione D, Abraham A. Effects of continuous passive motion, walking, and a placebo intervention on physical and psychological well-being. J Cardiopulm Rehabil. 1990; 10: 279–286.

    Google Scholar 

  86. *Sorensen M, Anderssen S, Hjerman I, Holme I, Ursin H. The effect of exercise and diet on mental health and quality of life in middle-aged individuals with elevated risk factors for cardiovascular disease. J Sports Sci. 1999; 17: 369–377.

    Google Scholar 

  87. *Stevenson DB. A Comparison of Group and Individual Physical Training Programs and Their Effect on Mood [dissertation]. The American University; 1990.

  88. *Swoap RA, Norvell N, Graves JE, Pollock ML. High versus moderate intensity aerobic exercise in elderly: Psychological and physiological effects. J Aging Phys Act. 1994; 2: 293–303.

    Google Scholar 

  89. *Teixeira PJ. Weight Reduction in Middle-Aged Women: Readiness Profiles and Correlates of Success in a Lifestyle Intervention [dissertation]. The University of Arizona; 2001.

  90. *Wadden TA, Stunkard AJ: Controlled trial of very low calorie diet, behavior therapy, and their combination in the treatment of obesity. J Consult Clin Psychol. 1996; 54: 482–488.

    Google Scholar 

  91. *Wallace JI, Buchner DM, Grothaus L, et al. Implementation and effectiveness of a community-based health promotion program for older adults. J Gerontol. 1998; 53A: M301-M306.

  92. *Weaver DC. A Study to Determine the Effect of Exercise on Depression in Middle-Aged Women [dissertation]. Middle Tennessee State University; 1984.

  93. *Wilson LFM. The Effects of an Exercise Conditioning Program on Reducing the Stress Response in Nurses [dissertation]. Wayne State University; 1985.

  94. *Young RJ. The effect of regular exercise on cognitive functioning and personality. Br J Sports Med. 1979; 13: 110–117.

    Google Scholar 

  95. *Zigun SM. Multimodal Approach to Treatment of Obesity [dissertation]. The Union Institute; 1989.

  96. Paluska SA, Schwenk TL. Physical activity and mental health: Current concepts. Sports Med. 2000; 29: 167–180.

    Article  CAS  PubMed  Google Scholar 

  97. Teychenne M, Ball K, Salmon J. Physical activity and likelihood of depression in adults: A review. Prev Med. 2008; 46: 397–411.

    Article  PubMed  Google Scholar 

  98. Ernst C, Olson AK, Pinel JP, Lam RW, Christie BR. Antidepressant effects of exercise: Evidence for an adult-neurogenesis hypothesis? J Psychiatry Neurosci. 2006; 31: 84–92.

    PubMed  Google Scholar 

  99. Conn VS, Valentine JC, Cooper HM. Interventions to increase physical activity among aging adults: A meta-analysis. Ann Behav Med. 2002; 24: 190–200.

    Article  PubMed  Google Scholar 

Download references

Acknowledgement

Financial support provided by a grant from the National Institutes of Health (R01NR009656) to Vicki Conn, principal investigator. The content is solely the responsibility of the author and does not necessarily represent the official views of the National Institutes of Health.

Conflict of interest

The author declares no conflicts of interest. The author has no financial relationship with the funding agency (NIH). The author has full control of all primary data and agrees to allow the journal to review the data.

Author information

Authors and Affiliations

  1. University of Missouri, Columbia, MO, USA

    Vicki S. Conn Ph.D.

Authors
  1. Vicki S. Conn Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Vicki S. Conn Ph.D..

Additional information

Primary studies included in the meta-analysis marked with asterisk.

About this article

Cite this article

Conn, V.S. Depressive Symptom Outcomes of Physical Activity Interventions: Meta-analysis Findings. ann. behav. med. 39, 128–138 (2010). https://doi.org/10.1007/s12160-010-9172-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12160-010-9172-x

Keywords

Search

Navigation