Advertisement

Exercise and Depression: A Review of Reviews

  • Amanda Daley
Article

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 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.

Keywords

Exercise Depression Postnatal depression 

References

  1. Armstrong, K., & Edwards, H. (2003). The effects of exercise and social support on mothers reporting depressive symptoms: A pilot randomized controlled trial. International Journal of Mental Health Nursing, 12, 130–138.PubMedCrossRefGoogle Scholar
  2. Armstrong, K., & Edwards, H. (2004). The effectiveness of a pram-walking exercise programme in reducing depressive symptomatology for postnatal women. International Journal of Nursing Practice, 10, 177–194.PubMedCrossRefGoogle Scholar
  3. Bahrke, M. S., & Morgan, W. P. (1978). Anxiety reduction following exercise and meditation. Cognitive Therapy and Research, 2, 323–333.CrossRefGoogle Scholar
  4. Blumenthal, J. A., Babyak, M. A., Moore, K. A., Craighead, W. E., Herman S., Khatri, P., et al. (1999). Effects of exercise training in older patients with major depression. Archives of Internal Medicine, 159, 2349–2356.PubMedCrossRefGoogle Scholar
  5. Blumenthal, J. A., Babyak, M. A., Doraiswamy P. M., Watkins, L., Hoffman, B. M., Barbour, K. A., et al. (2007). Exercise and pharmacotherapy in the treatment of major depressive disorder. Psychosomatic Medicine, 69, 587–596.PubMedCrossRefGoogle Scholar
  6. Bortz, W. M., Angwin, P., & Mefford, I. N. (1981). Catecholamines, dopamine and endorphin levels during extreme exercise. New England Journal of Medicine, 305, 466–467.PubMedGoogle Scholar
  7. Brenes, G. A., Williamson, J. D., Messier, S. P., Rejeski, W. J., Pahor, M., Ip, E., et al. (2007). Treatment of minor depression in older adults: A pilot study comparing sertraline and exercise. Aging and Mental Health, 11, 61–68.PubMedCrossRefGoogle Scholar
  8. Brosse, A. L., Sheets, E. S., Lett, H. S., & Blumenthal, J. A. (2002). Exercise and the treatment of clinical depression in adults: Recent findings and future directions. Sports Medicine, 32, 741–760.PubMedCrossRefGoogle Scholar
  9. Cox, J., Holden, J., & Sagovsky, R. (1987). Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150, 782–786.PubMedGoogle Scholar
  10. Craft, L. L., & Landers, D. M. (1998). The effects of exercise on clinical depression and depression resulting from mental illness: A meta-analysis. Journal of Sport and Exercise Psychology, 20, 339–357.Google Scholar
  11. Craft, L. L., & Perna, F. M. (2004). The benefits of exercise for the clinically depressed. Primary Care Companion to the Journal of Clinical Psychiatry, 6, 104–111.PubMedGoogle Scholar
  12. Currie, J. L., & Develin, E. D. (2002). Stroll your way to well-being: A survey of the perceived benefits, barriers, community support and stigma associated with pram walking groups designed for new mothers, Sydney. Health Care for Women International, 23, 882–893.PubMedCrossRefGoogle Scholar
  13. Daley, A. J. (2002). Exercise therapy and mental health in clinical populations: Is exercise therapy a worthwhile intervention? Advances in Psychiatric Treatment, 8, 262–270.CrossRefGoogle Scholar
  14. Daley, A.J., Bassi, S., Haththotuwa, H., Hussain, T., Kalhan, M., & Rishi, S. (in press). “Doctor, how much physical activity should I be doing”? How knowledgeable are general practitioners about the Chief Medical Officer’s (2004) recommendations for active living to achieve health benefits? Public Health.Google Scholar
  15. Daley, A. J., MacArthur, C., & Winter, H. (2007). The role of exercise as a treatment of postnatal depression: A review. Journal of Midwifery and Women’s Health, 52, 56–62.PubMedCrossRefGoogle Scholar
  16. Department of Health. (2004). Confidential enquiry into maternal and child health: Why mothers die 2000–2002. Royal College of Obstetricians and Gynaecologists. London: RCOG Press. www.cemach.org.uk/publications/WMD2000_2002/Content.htm. Accessed 11 Jan 2006.
  17. Department of Health. (2004). At least five a week: Evidence on the impact of physical activity and its relationship to health. A report from the Chief Medical Officer. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4080994). Accessed 11 Jan 2006.
  18. Doyne, E. J., Ossip-Klein, D. J., Bowman, E. D., Osborn, K. M., McDougall-Wilson, I. B., & Neimeyer, R. A. (1987). Running versus weight-lifting in the treatment of depression. Journal of Consulting and Clinical Psychology, 55, 748–754.PubMedCrossRefGoogle Scholar
  19. Dunn, A. L., Reigle, T. G., Youngstedt, S. D., Armstrong, R. B., & Dishman, R. K. (1996). Brain norepinephrine and metabolites after treadmill training and wheel running in rats. Medicine and Science in Sport and Exercise, 28, 204–209.Google Scholar
  20. Dunn, A. L., Trivedi, H., Kampert, J. B., & Clark, C. G. (2005). Exercise treatment for depression: Efficacy and dose response. American Journal of Preventive Medicine, 28, 1–8.PubMedCrossRefGoogle Scholar
  21. Elley, C. R., Kerse, N., Arroll, B., & Robinson, E. (2003). Effectiveness of counselling patients on physical activity in general practice: Cluster randomised controlled trial. British Medical Journal, 326, 793–798.PubMedCrossRefGoogle Scholar
  22. Eriksen, W., & Bruusgaard, D. (2004). Do physical leisure time activities prevent fatigue? A 15-month prospective study of nurses’ aids. British Journal of Sports Medicine, 38, 331–336.PubMedCrossRefGoogle Scholar
  23. Ernst, C., Olson, A. K., Pinel, J. P. J., Lam, R. W., & Christie, B. R. (2006). Antidepressant effects of exercise: Evidence for an adult-neurogenesis hypothesis? Journal of Psychiatry and Neuroscience, 31, 84–92.PubMedGoogle Scholar
  24. Etnier, J., Salazar, W., Landers, D., Petruzzello, S. J., Han, M., & Nowell, P. (1997). The influence of physical fitness and exercise upon cognitive functioning: A meta-analysis. Journal of Sport and Exercise Psychology, 19, 249–277.Google Scholar
  25. Farrell, P. A., Gates, W. K., & Maksud, M. G. (1982). Increases in plasma beta-endorphin/beta-lipotropin immunoreactivity after treadmill running in humans. Journal of Applied Physiology, 52, 1245–1249.PubMedGoogle Scholar
  26. Faulkner, G., & Biddle, S. J. H. (2001). Exercise and mental health: It’s just not psychology! Journal of Sports Sciences, 19, 433–444.PubMedCrossRefGoogle Scholar
  27. Fox, K. R. (2000). The effects of exercise on self-perceptions and self-esteem. In S. J. H. Biddle, K. R. Fox, & S. H. Boutcher (Eds.), Physical activity and psychological well-being (pp. 88–117). London: Routledge.Google Scholar
  28. Gleser, J., & Mendelberg, H. (1990). Exercise and sport in mental health: A review of the literature. Israel Journal of Psychiatry and Related Science, 27, 99–112.Google Scholar
  29. Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry, 23, 56–62.Google Scholar
  30. Hay, D., Pawlby, S., Sharp, D., Asten, P., Mills, A., & Kumar, R. (2001). Intellectual problems shown by 11-year-old children whose mothers had postnatal depression. Journal of Child Psychology and Psychiatry, 42, 871–889.PubMedCrossRefGoogle Scholar
  31. Heliovaara, M., & Aromaa, A. (1981). Parity and obesity. Journal of Epidemiology and Community Health, 35, 197–199.PubMedGoogle Scholar
  32. Isaacs, A. J., Critchley, J. A., Tai, S., Buckingham, K., Westley, D., Harridge, S. D., et al. (2007). Exercise Evaluation Randomised Trial (EXERT): A randomised trial comparing GP referral for leisure centre-based exercise, community-based walking and advice only. Health Technology Assessment, 11, 1–184.PubMedGoogle Scholar
  33. Jenkin, W., & Tiggermann, M. (1997). Psychological effects of weight retained after pregnancy. Women and Health, 25, 89–98.CrossRefGoogle Scholar
  34. Knubben, K., Reischies, F. M., Adil, M., Schlattmann P., Bauer M., & Dimeo F. (2007). A randomized, controlled study on the effects of a short-term endurance training programme in patients with major depression. British Journal of Sports Medicine, 41, 29–33.PubMedCrossRefGoogle Scholar
  35. LaCoursiere, Y. D., Baksh, L., Bloebaum, L., & Varner, M. W. (2006). Maternal body mass index and self-reported postpartum depressive symptoms. Maternal and Child Health Journal, 10, 385–390.PubMedCrossRefGoogle Scholar
  36. Lawlor, D. A., & Hopker, S. W. (2001). The effectiveness of exercise as an intervention in the management of depression: Systematic review and meta-regression analysis of randomized controlled trials. British Medical Journal, 322, 1–8.CrossRefGoogle Scholar
  37. Legrand, F., & Heuze, J. P. (2007). Antidepressant effects associated with different exercise conditions in participants with depression: A pilot study. Journal of Sport and Exercise Psychology, 29, 348–364.PubMedGoogle Scholar
  38. MacGillivray, S., Arnoll, B., Hatcher, S., Ogston S., Ried, I., Sullivan, F., et al. (2003). Efficacy and tolerability of selective serotonin reuptake inhibitors compared with tricyclic antidepressants in depression treated in primary care: Systematic review and meta-analysis. British Medical Journal, 326, 1014.PubMedCrossRefGoogle Scholar
  39. Martinsen, E. W., & Medhus, A. (1989). Adherence to exercise and patients’ evaluation of physical exercise in a comprehensive treatment programme for depression. Nordic Journal of Psychiatry, 43, 411–415.CrossRefGoogle Scholar
  40. McDonald, D. G., & Hodgdon, J. A. (1991). Psychological effects of aerobic fitness training: Research and theory. New York: Springer-Verlag.Google Scholar
  41. McEntee, D. J., & Halgin, R. P. (1996). Therapists’ attitudes about addressing the role of exercise in psychotherapy. Journal of Clinical Psychology, 52, 48–60.PubMedCrossRefGoogle Scholar
  42. National Institute for Clinical Excellence. (2004). CG23 Depression: Management of depression in primary and secondary care. London: National Health Service.Google Scholar
  43. National Institute for Health, Clinical Excellence. (2007). CG45 Antenatal and postnatal mental health. London: National Health Service.Google Scholar
  44. North, T. C., McCullagh, P., & Tran, Z. V. (1990). Effects of exercise on depression. Exercise and Sports Science Reviews, 18, 379–415.Google Scholar
  45. Ormel, J., von Korff, M., Ustun, T., Pini, S., Kortsen, A., & Oldehinkel, T. (1994). Common mental disorders and disability across cultures: Results from the WHO collaborative study on psychological problems in general health care. Journal of the American Medical Association, 272, 1741–1748.PubMedCrossRefGoogle Scholar
  46. Pelham, T., & Campagna, P. (1991). Benefits of exercise in psychiatric rehabilitation of persons with schizophrenia. Canadian Journal of Rehabilitation, 4, 159–168.Google Scholar
  47. Peveler, R., Carson, A., & Rodin, G. (2002). ABC of psychological medicine: Depression in medical patients. British Medical Journal, 149–152, 325.Google Scholar
  48. Pierce, D., Kuppart, I., & Harry, D. (1979). Urinary epinephrine and norepinephrine levels in women athletes during training and competition. European Journal of Applied Physiology, 36, 1–6.CrossRefGoogle Scholar
  49. Sing, N. A., Clements, K. M., & Fiatarone, M. A. (1997). A randomized controlled trial of progressive resistance training in depressed elders. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 52A, M27–M35.Google Scholar
  50. Sjosten, N., & Kivela, S. L. (2006). The effects of physical exercise on depressive symptoms among the aged: A systematic review. International Journal of Geriatric Psychiatry, 21, 410–418.PubMedCrossRefGoogle Scholar
  51. Stathopoulou, G., Powers, M. B., Berry, A. C., Smiths, J., & Otto, M. W. (2006). Exercise interventions for mental health: A quantitative and qualitative review. Clinical Psychology: Science and Practice, 13, 179–193.CrossRefGoogle Scholar
  52. Steinberg, H., & Sykes, E. A. (1985). Introduction to symposium on endorphins and behavioural processes: A review of literature on endorphins and exercise. Pharmacology, Biochemistry and Behaviour, 23, 857–862.CrossRefGoogle Scholar
  53. Taylor, A. H., Doust, J., & Webborn, N. (1998). GP referral randomised controlled trial to examine the effects of a GP exercise referral programme in Hailsham, East Sussex, on modifiable coronary heart disease risk factors. Journal of Epidemiology and Community Health, 52, 595–601.PubMedCrossRefGoogle Scholar
  54. Taylor, A. H., & Fox, K. R. (2005). Effectiveness of a primary care exercise referral intervention for changing physical self-perceptions over 9 months. Health Psychology, 24, 11–21.PubMedCrossRefGoogle Scholar
  55. Whitton, A., Warner, R., & Appleby, L. (1996). The pathway to care in post-natal depression: Women’s attitudes to post-natal depression and its treatment. British Journal of General Practice, 46, 427–428.PubMedGoogle Scholar
  56. Wilkinson, J., Philips, S., Jackson, J., & Walker, K. (2003). “Mad for fitness”: An exercise group to combat a high incidence of postnatal depression. Journal of Family Health Care, 13, 44–48.PubMedGoogle Scholar
  57. Williamson, D., Kahn, H., & Byers, T. (1991). The 10-y incidence of obesity and major weight gain in black and white US women aged 30–53. American Journal of Clinical Nutrition, 53, 1515S–1518S.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  1. 1.Primary Care and General PracticeUniversity of BirminghamBirminghamUK

Personalised recommendations