Sports Medicine

, Volume 39, Issue 6, pp 491–511 | Cite as

The Antidepressive Effects of Exercise

A Meta-Analysis of Randomized Trials
  • Chad D. RethorstEmail author
  • Bradley M. Wipfli
  • Daniel M. Landers
Review Article


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 3/4 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.


Depressive Symptom Exercise Intensity Beck Depression Inventory Resistance Exercise Exercise Bout 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



No sources of funding were used to assist in the preparation of this review. The authors have no conflicts of interest that are directly relevant to the content of this review.


  1. 1.
    Murray CJL, Lopez AD, editors. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Global Burden of Disease and Injury Series, Vol. 1. Cambridge (MA): Harvard University Press, 1996Google Scholar
  2. 2.
    Ustun T, Satorisus N. Mental illness in general health care: an international study. New York: John Wiley, 1995: 323–34Google Scholar
  3. 3.
    Andrews G, Sanderson K, Corry J, et al. Using epidemiological data to model efficiency in reducing the burden of depression. J Mental Health Pol Econ 2000; 3 (4): 175–86CrossRefGoogle Scholar
  4. 4.
    Trivedi M, Rush A, Wisniewski S, et al. Evaluation of outcomes with citalopram for depression using measurement-based care in STARD: implications for clinical practice. Am J Psychiatr 2000; 163: 28–40CrossRefGoogle Scholar
  5. 5.
    Rush A, Trivedia M, Wisniewski S, et al. Bupropion-SR, sertraline, or venlafaxine-XR after failure of SSRIs for depression. New Engl J Med 2006; 354: 1231–42PubMedCrossRefGoogle Scholar
  6. 6.
    Trivedi M, Fava M, Wisniewski M, et al. Medication augmentation after the failure of SSRIs for depression. New Engl J Med 2006; 354: 1243–52PubMedCrossRefGoogle Scholar
  7. 7.
    Minister for Health and Ageing. Exercise physiologists eligible to provide services under Medicare (ABB106/05) 2005, September 6 [online]. Available from URL: tent/ [Accessed 2009 Apr 1]
  8. 8.
    Mental Health Foundation. Up and running? Exercise therapy and the treatment of mild or moderate depression in primary care [online]. Available from URL: = 38660&type = Full&servicetype = Attachment [Accessed 2006 Nov 1]
  9. 9.
    Craft L, Landers D. The effect of exercise on clinical depression and depression resulting from mental illness: a meta-analysis. J Sport Exerc Psychol 1998; 20 (4): 339–57Google Scholar
  10. 10.
    Stich F. A meta-analysis of physical exercise as a treatment for symptoms of anxiety and depression [dissertation]. Madison (WI): University of Wisconsin-Madison, 1999Google Scholar
  11. 11.
    North T, McCullagh P, Tran Z. The effect of exercise on depression. Exerc Sport Sci Rev 1990; 18: 379–415PubMedCrossRefGoogle Scholar
  12. 12.
    Guyatt G, Gutterman D, Baumann M, et al. Grading strength of recommendations and quality of evidence in clinical guidelines: report from an American College of Chest Physicians Task Force. Chest 2006; 129 (1): 174–81PubMedCrossRefGoogle Scholar
  13. 13.
    Lawlor DA, Hopker SW. The effectiveness of exercise as an intervention in the management of depression: a systematic review and meta-regression analysis of randomized controlled trials [unabridged electronic version]. BMJ 2001; 322: 1–8 [online]. Available from URL: CrossRefGoogle Scholar
  14. 14.
    Schulz KF, Chalmers I, Hayes RJ, et al. Empirical evidence of bias: dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA 1995; 273 (5): 408–12PubMedCrossRefGoogle Scholar
  15. 15.
    Brosse A, Sheets E, Lett H, et al. Exercise and the treatment of clinical depression in adults: recent findings and future directions. Sport Med 2002; 32 (12): 741–60CrossRefGoogle Scholar
  16. 16.
    Biddle S. The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials [online]. Available from URL: [Accessed 2006 Jul 13]
  17. 17.
    Mutrie N. The relationship between physical activity and clinically defined depression. In: Biddle S, Fox K, Boutcher S, editors. Physical activity and psychological well-being. London: Routledge, 2001: 46–63Google Scholar
  18. 18.
    Mutrie N. Healthy body, healthy mind? Psychologist 2002; 15 (8): 412–3Google Scholar
  19. 19.
    Callaghan P. Exercise: a neglected intervention in mental health care? J Psychiatr Mental Health Nurs 2004; 11 (4): 476–783CrossRefGoogle Scholar
  20. 20.
    Stathopoulou G, Power M, Berry A, et al. Exercise interventions for mental health: a quantitative and qualitative review. Clin Psychol: Sci Pract 2006; 13 (2): 179–93CrossRefGoogle Scholar
  21. 21.
    Hedges LV, Olkin I. Statistical methods for meta-analysis. Orlando (FL): Academic Press, 1985Google Scholar
  22. 22.
    Hunter JE, Schmidt FE. Methods of meta-analysis: correcting error and bias in research findings. Thousand Oaks (CA): Sage, 2004Google Scholar
  23. 23.
    Shadish WR, Haddock CK. Combining estimates of effect size. In: Cooper H, Hedges LV, editors. The handbook of research synthesis. New York: Russell Sage Foundation, 2004: 231–44Google Scholar
  24. 24.
    Higgins JPT, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analysis. BMJ 2003; 327: 557–60PubMedCrossRefGoogle Scholar
  25. 25.
    Hedges LV. Fixed effects models. In: Cooper H, Hedges LV, editors. The handbook of research synthesis. New York: Russell Sage Foundation, 1994: 285–99Google Scholar
  26. 26.
    Powers SK, Howley ET. Exercise physiology: theory and applications to fitness and performance. New York: McGraw-Hill, 2003Google Scholar
  27. 27.
    Cohen J, Cohen P, West S, et al. Applied multiple regression/correlation analysis for the behavioral sciences. Mahwah (NJ): Lawrence Erlbaum Associates, 2003Google Scholar
  28. 28.
    Antunes HKM, Stella SG, Santos RF, et al. Depression, anxiety, and quality of life scores in seniors after an endurance exercise program. Rev Brasil Psiquiatr 2005; 27 (4): 266–71CrossRefGoogle Scholar
  29. 29.
    Bartholomew J, Morrison D, Ciccolo J. Effects of acute exercise on mood and well-being in patients with major depressive disorder. Med Sci Sport Exerc 2005; 37 (12): 2032–7CrossRefGoogle Scholar
  30. 30.
    Berger B, Friedmann E, Eaton M. Comparison of jogging, the relaxation response, and group interaction for stress reduction. J Sport Exerc Psychol 1988; 10 (4): 431–47Google Scholar
  31. 31.
    Blumenthal J, Emery C, Madden D, et al. Long-term effects of exercise on psychological functioning in older men and women. J Gerontol 1991; 46 (6): 352–61CrossRefGoogle Scholar
  32. 32.
    Blumenthal J, Sherwood A, Babyak M, et al. Effects of exercise and stress management training on markers of cardiovascular risk in patients with ischemic heart disease: a randomized controlled trial. JAMA 2005; 293 (13): 1626–34PubMedCrossRefGoogle Scholar
  33. 33.
    Broocks A, Bandelow B, Pekrun G, et al. Comparison of aerobic exercise, clomipramine, and placebo in the treat ment of panic disorder. Am J Psychiatr 1998; 155 (5): 603–9PubMedGoogle Scholar
  34. 34.
    Brown MA, Goldstein-Shirley J, Robinson J, et al. The effects of a multi-modal intervention trial of light exercise and vitamins on women’s mood. Women Health 2001; 34 (3): 93–112PubMedCrossRefGoogle Scholar
  35. 35.
    Burrus M. The effects of a running treatment program on depressed adolescents [dissertation]. Miami (FL): University of Miami, 1984Google Scholar
  36. 36.
    Castro CM, Wilcox S, O’Sullivan P, et al. An exercise program for women who are caring for relatives with dementia. Psychosom Med 2002; 64 (13): 458–68PubMedGoogle Scholar
  37. 37.
    Chin A Paw M, van Poppel NMN, et al. Effects of anaerobic exercise and all-around, functional training on quality of life, vitality, and depression of older adults living in long-term care facilities: a randomized controlled trial [abstract]. Biomed Central Geriatr 2004; 4: 5Google Scholar
  38. 38.
    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 (4–5): 437–49PubMedCrossRefGoogle Scholar
  39. 39.
    Crews DJ, Lochbaum MR, Landers DM. Aerobic physical activity effects on psychological well-being in low-income Hispanic children. Percept Motor Skills 2004; 98 (1): 319–24PubMedCrossRefGoogle Scholar
  40. 40.
    Deivert RG. Efficacy of an aerobic exercise program as treatment for depression and anxiety in alcohol and chemically dependent adults [dissertation]. State College (PA): Pennsylvania State University, 1990Google Scholar
  41. 41.
    DePalma MT. The effects of exercise on anxiety, depression, and type A behavior [dissertation]. Ithaca (NY): Cornell University, 1989Google Scholar
  42. 42.
    DiLorenzo TM, Bargman EP, Stucky-Ropp R, et al. Long-term effects of aerobic exercise on psychological outcomes. Prevent Med 1999; 28 (1): 75–85CrossRefGoogle Scholar
  43. 43.
    Dugmore LD, Tipson RJ, Phillips MH, et al. Changes in cardiorespiratory fitness, psychological wellbeing, quality of life, and vocational status following a 12 month cardiac exercise rehabilitation programme. Heart 1999; 81 (4): 359–66PubMedGoogle Scholar
  44. 44.
    Dunn AL, Trivedi MH, Kampert JB, et al. Exercise treatment for depression: efficacy and dose response. Am J Prevent Med 2005; 28 (1): 1–8CrossRefGoogle Scholar
  45. 45.
    Eby JM. An investigation into the effects of aerobic exercise on anxiety and depression [dissertation]. Toronto (ON): University of Toronto, 1984Google Scholar
  46. 46.
    Emery CF, Schein RL, Hauck ER, et al. Psychological and cognitive outcomes of a randomized trial of exercise among patients with chronic obstructive pulmonary Disease. Health Psychol 1998; 17 (3): 232–40PubMedCrossRefGoogle Scholar
  47. 47.
    Epstein D. Aerobic activity versus group cognitive therapy: an evaluative study of contrasting interventions for the alleviation of clinical depression [dissertation]. Reno (NV): University of Nevada, 1986Google Scholar
  48. 48.
    Favilla G. The role of self-efficacy as a mediator in the relationship between muscle strength training and mood in the elderly [dissertation]. San Diego (CA): California School of Professional Psychology-San Diego, 1992Google Scholar
  49. 49.
    Gowans S, DeHueck A, Abbey S. Measuring exercise-induced mood changes in fibromyalgia: a comparison of several measures. Arthritis Rheum 2002; 47 (6): 603–9PubMedCrossRefGoogle Scholar
  50. 50.
    Gowans SE, DeHueck A, Voss S, et al. Effects of a randomized, controlled trial of exercise on mood and physical function in individuals with fibromyalgia. Arthritis Care Res 2001; 45 (6): 519–29CrossRefGoogle Scholar
  51. 51.
    Hembree L. Exercise and its effect on hopelessness and depression in an aging female population in Eastern Oklahoma [dissertation]. Fayetteville (AR): University of Arkansas, 2000Google Scholar
  52. 52.
    Hilyer JC, Wilson DG, Cillon C, et al. Physical fitness training and counseling as treatment for youthful offenders. J Counsel Psychol 1982; 29 (3): 292–303CrossRefGoogle Scholar
  53. 53.
    Jorgensen C. Aerobic conditioning in the therapeutic treatment of chronic schizophrenia [dissertation]. Flagstaff (AZ): Northern Arizona University, 1986Google Scholar
  54. 54.
    Kanner KD. High versus low intensity exercise as part of an inpatient treatment program for childhood and adolescent depression [dissertation]. San Diego (CA): California School of Professional Psychology, 1990Google Scholar
  55. 55.
    King A, Taylor C, Haskell W. Effects of differing intensities and formats of 12 months of exercise training on psychological outcomes in older adults. Health Psychol 1993; 12 (4): 292–300PubMedCrossRefGoogle Scholar
  56. 56.
    King AC, Taylor C, Haskell WL, et al. Influence of regular aerobic exercise on psychological health: a randomized, controlled trial of healthy middle-aged adults. Health Psychol 1989; 8 (3): 305–24PubMedCrossRefGoogle Scholar
  57. 57.
    Klein MH, Greist JH, Gurman AS, et al. A comparative outcome study of group psychotherapy vs exercise treatments for depression. Int J Mental Health 1985; 13 (3–4): 148–76Google Scholar
  58. 58.
    Koukouvou G, Kouidi E, Iacovides A, et al. Quality of life, psychological, and physiological changes following exercise training in patients with chronic heart failure. J Rehabili Med 2004; 36 (1): 36–41CrossRefGoogle Scholar
  59. 59.
    Lennox S, Bedell J, Stone A. The effect of exercise on normal mood. J Psychosom Res 1990; 34 (6): 629–36PubMedCrossRefGoogle Scholar
  60. 60.
    Levin S. The effects of a ten-week jogging program as an adjunctive treatment for patients in a social rehabilitation clinic [dissertation]. Garden City (NY): Adelphi University, 1983Google Scholar
  61. 61.
    Martinsen E, Medhus A, Danvik L. Effects of aerobic exercise on depression: a controlled study [abstract]. BMJ 1985; 291 (6488): 109PubMedCrossRefGoogle Scholar
  62. 62.
    McCann IL, Holmes DS. Influence of aerobic exercise on depression. J Personality Soc Psychol 1984; 46 (5): 1142–7CrossRefGoogle Scholar
  63. 63.
    McNeil JK, LeBlanc EM, Joyner M. The effect of exercise on depressive symptoms in the moderately depressed elderly. Psychol Aging 1991; 6 (3): 487–8PubMedCrossRefGoogle Scholar
  64. 64.
    Mutrie N. Exercise as a treatment for depression within the UK Health Service. Paper presented at Proceedings of the Sport, Health, Psychology and Exercise Symposium. London: The Sports Council, 1988Google Scholar
  65. 65.
    Neidig JL, Smith BA, Brashers DE. Aerobic exercise training for depressive symptom management in adults living with HIV infection. J Assoc Nurse AIDS Care 2003; 14 (2): 30–40CrossRefGoogle Scholar
  66. 66.
    Newton M, Mutrie N, McArthur JD. The effects of exercise in a coronary rehabilitation programme. Scot Med J 1991; 38 (2): 38–41Google Scholar
  67. 67.
    Norris R, Carrol D, Cochrane R. The effects of physical activity and exercise training on psychological stress and well-being in an adolescent population. J Psychosom Res 1992; 36 (1): 55–65PubMedCrossRefGoogle Scholar
  68. 68.
    Norvell N, Belles D. Psychological and physical benefits of circuit weight training in law enforcement personnel. J Consult Clin Psychol 1993; 61 (3): 520–7PubMedCrossRefGoogle Scholar
  69. 69.
    Petajan JH, Gappmaier E, White AT, et al. Impact of aerobic training on fitness and quality of life in multiple sclerosis. Ann Neurol 1996; 39 (4): 432–41PubMedCrossRefGoogle Scholar
  70. 70.
    Pierce TW, Madden DJ, Siegel WC, et al. Effects of aerobic exercise on cognitive and psychosocial functioning in patients with mild hypertension. Health Psychol 1993; 12 (4): 286–91PubMedCrossRefGoogle Scholar
  71. 71.
    Pinchasov BB, Shurgaja AM, Grischin OV, et al. Mood and energy regulation in seasonal and non-seasonal depression before and after midday treatment with physical exercise or bright light. Psychiatr Res 2000; 94 (1): 29–42CrossRefGoogle Scholar
  72. 72.
    Roth D, Homes D. Influence of aerobic exercise training and relaxation training on physical and psychologic health following stressful life events. Psychosom Med 1987; 49 (4): 355–65PubMedGoogle Scholar
  73. 73.
    Roth DL. Acute emotional and psychophysiological effects of aerobic exercise. Psychophysiology 1989; 25 (5): 593–602CrossRefGoogle Scholar
  74. 74.
    Setaro JL. Aerobic exercise and group counseling in the treatment of anxiety and depression [dissertation]. College Park (MD): University of Maryland, 1985Google Scholar
  75. 75.
    Simons CW, Birkimer JC. An exploration of factors predicting the effects of aerobic conditioning on mood state. J Psychosom Res 1988; 32 (1): 63–75PubMedCrossRefGoogle Scholar
  76. 76.
    Singh NA, Clements KM, Fiatarone MA. A randomized controlled trial of progressive resistance training in depressed elders. J Gerontol 1997; 52A(1): M27–35CrossRefGoogle Scholar
  77. 77.
    Singh N, Clements KM, Fiatrone-Singh MA. The efficacy of exercise as a long-term antidepressant in elderly subjects: a randomized controlled trial. J Gerontol 2001; 56A(8): M497–504Google Scholar
  78. 78.
    Singh NA, Stavrinos TM, Scarbek Y, et al. A randomized controlled trial of high versus low intensity weight training versus general practitioner care for clinical depression in older adults. J Gerontol 2005; 60A(6): 768–76Google Scholar
  79. 79.
    Sorenson M, Anderssen S, Hjerman I, et al. 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 (5): 369–77CrossRefGoogle Scholar
  80. 80.
    Taylor MW. Effects of initial stress level, social support, and participation in an exercise or music condition on the post-treatment stress, depression, and anxiety of nurses [dissertation]. New York: St. John’s University, 1991Google Scholar
  81. 81.
    van den Berg-Emons R, Balk A, Bussmann H, et al. Does aerobic training lead to a more active lifestyle and improved quality of life in patients with chronic heart failure? Eur J Heart Fail 2004; 6: 95–100PubMedCrossRefGoogle Scholar
  82. 82.
    Veale D, LeFevre K, Pantelis C, et al. Aerobic exercise in the adjunctive treatment of depression: a randomized controlled trial. J Royal Soc Med 1992; 85 (9): 541–4Google Scholar
  83. 83.
    Wigers S, Stiles T, Vogel P. Effects of aerobic exercise versus stress management treatment in fibromyalgia. Scand J Rheum 1996; 25 (2): 77–86PubMedCrossRefGoogle Scholar
  84. 84.
    Williams P, Lord S. Effects of group exercise on cognitive functioning and mood in older women. Aust N Z J Pub Health 1997; 21 (1): 45–52CrossRefGoogle Scholar
  85. 85.
    Wilson LM. The effects of an exercise conditioning program on reducing the stress response in nurses [dissertation]. Detroit (MI): Wayne State University, 1985Google Scholar
  86. 86.
    Zentner R. Psychological effects of a running program [dissertation]. Eugene (OR): University of Oregon, 1981Google Scholar
  87. 87.
    VandenHoek D. Long slow distance running as a treatment for moderate depression of outpatients [master’s thesis]. Kalamazoo (MI): Western Michigan University, 1983Google Scholar
  88. 88.
    Blumenthal J, Babyak M, Moore K. Effects of exercise on training on older patients with major depression. Arch Intern Med 1999; 159 (19): 2349–56PubMedCrossRefGoogle Scholar
  89. 89.
    Herman S, Blumenthal JA, Babyak M, et al. Exercise therapy for depression in middle-aged and older adults: predictors of early dropout and treatment failure. Health Psychol 2002; 21 (6): 553–63PubMedCrossRefGoogle Scholar
  90. 90.
    Fremont J, Craighead LW. Aerobic exercise and cognitive therapy in the treatment of dysphoric moods. Cognit Ther Res 1987; 11 (2): 241–51CrossRefGoogle Scholar
  91. 91.
    Partonen T, Leppamaki S, Hurme J, et al. Randomized trial of physical exercise alone or combined with bright light on mood and health-related quality of life. Psychol Med 1998; 28 (6): 1359–64PubMedCrossRefGoogle Scholar
  92. 92.
    Duman R, Heninger G, Nestler E. A molecular and cellular theory of depression. Arch Gen Psychiatr 1997; 54: 597–606PubMedCrossRefGoogle Scholar
  93. 93.
    Malberg J, Eish A, Nestler E, et al. Chronic antidepressant treatment increases neurogenesis in adult rat hippocampus. J Neurosci 2000; 20 (24): 9104–10PubMedGoogle Scholar
  94. 94.
    Ernst C, Olson A, Pinel J, et al. Antidepressant effects of exercise: evidence for an adult-neurogenesis hypothesis? J Psychiatr Neurosci 2006; 31 (2): 84–92Google Scholar
  95. 95.
    Persson A, Thorlin T, Bull C, et al. Mu- and delta-opioid receptor antagonists decrease proliferation and increase neurogenesis in cultures of rat adult hippocampal progenitors. Eur J Neurosci 2003; 17: 1159–72PubMedCrossRefGoogle Scholar
  96. 96.
    Colt E, Wardlaw S, Frantz A. The effect of running on plasma delta-endorphin. Life Sci 1981; 28 (14): 1637–40PubMedCrossRefGoogle Scholar
  97. 97.
    Schobersberger W, Hobisch-Hagen P, Fries D, et al. Increase in immune activation, vascular endothelial growth factor and erythropoietin after an ultramarathon run at moderate altitude. Immunobiology 2000; 201 (5): 611–20PubMedCrossRefGoogle Scholar
  98. 98.
    Pereira A, Huddleston D, Brickman A, et al. An in vivo correlate of exercise-induced neurogenesis in the adult dentate gyrus. Proc Natl Acad Sci U S A 2007; 104 (13): 5638–43PubMedCrossRefGoogle Scholar
  99. 99.
    Jin K, Zhu Y, Sun Y, et al. Vascular endothelial growth factor (VEGF) stimulates neurogenesis in vitro and in vivo. Proc Natl Acad Sci 2003; 99 (18): 11946–50CrossRefGoogle Scholar
  100. 100.
    Fabel K, Fabel K, Tam B, et al. VEGF is necessary for exercise-induced adult hippocampal neurogenesis. Eur J Neurosci 2003; 18 (10): 2803–12PubMedCrossRefGoogle Scholar
  101. 101.
    Cotman C, Berchtold N. Exercise: a behavioral intervention to enhance brain health and plasticity. Trends Neurosci 2002; 25 (6): 295–301PubMedCrossRefGoogle Scholar
  102. 102.
    Wozniak W. Brain-derived neurotrophic factor (BDNF): role in neuronal development and survival. Folia Morphol 1993; 52 (4): 173–81Google Scholar
  103. 103.
    Russo-Neustadt A, Ha R, Ramirez R. Physical activityantidepressant treatment combination: impact on brain-derived neurotrophic factor and behavior in an animal model. Behav Brain Res 2001; 120: 87–95PubMedCrossRefGoogle Scholar
  104. 104.
    Jacobs B. Serotonin motor activity, and depression-related disorders. Am Sci 1994; 82: 456–63Google Scholar
  105. 105.
    Chaouloff F, Laude D, Elghozi J. Physical exercise: evidence for differential consequences of tryptophan on 5-HT synthesis and metabolism in central serotonergic cell bodies and terminals. J Neural Transmission 1989; 78 (2): 1435–63CrossRefGoogle Scholar
  106. 106.
    Brezun J, Daszuta A. Serotonin may stimulate granule cell proliferation in adult hippocampus, as observed in rats grafted with foetal raphe neurons. Eur J Neurosci 2000; 12: 391–6PubMedCrossRefGoogle Scholar
  107. 107.
    Kubitz K, Landers D, Petruzzello S, et al. The effects of acute and chronic exercise on sleep. Sports Med 1996; 21 (4): 277–91PubMedCrossRefGoogle Scholar
  108. 108.
    Youngstedt S, O’Connor P, Dishman R. The effects of acute exercise on sleep: a quantitative synthesis. Sleep 1997; 20 (3): 203–14PubMedGoogle Scholar
  109. 109.
    McGinty D, Harper R. Dorsal raphe neurons: depression of firing during sleep in cats. Brain Res 1976; 101 (3): 569–75PubMedCrossRefGoogle Scholar
  110. 110.
    Dietrich A, McDaniel W. Endocannabinoids and exercise. Br J Sport Med 2004; 3 (8): 536–41CrossRefGoogle Scholar
  111. 111.
    Meng I, Manning B, Martin W, et al. An analgesia circuit activated by cannabinoids. Nature 1998; 395: 381–3PubMedCrossRefGoogle Scholar
  112. 112.
    Sparling P, Giuffrida A, Piomelli D. Exercise activates the endocannabinoid system. Cognit Neurosci Neuropsychol 2003; 14 (17): 2209–11Google Scholar
  113. 113.
    Holsboer F. The corticosteroid receptor hypothesis of depression. Neuropsychopharmacology 2000; 23 (5): 477–501PubMedCrossRefGoogle Scholar
  114. 114.
    Wittert G, Livesey J, Espiner E, et al. Adaptation of the hypothalamopituitary adrenal axis to chronic exercise stress in humans. Med Sci Sport Exerc 1996; 28 (8): 1015–9CrossRefGoogle Scholar
  115. 115.
    Dienstbier RA. Behavioral correlates of sympathoadrenal reactivity: the toughness model. Med Sci Sport Exerc 1991; 23 (7): 846–52CrossRefGoogle Scholar
  116. 116.
    Luger A, Deuster PA, Kyle SB, et al. Acute hypothalamicpituitary-adrenal responses to the stress of treadmill exercise: physiologic adaptations to physical training. New Engl J Med 1987; 316 (21): 1309–15PubMedCrossRefGoogle Scholar
  117. 117.
    Wittert GA, Livesey JH, Espiner EA, et al. Adaptation of the hypothalamopituitary adrenal axis to chronic exercise stress in humans. Med Sci Sport Exerc 1996; 28 (8): 1015–9CrossRefGoogle Scholar
  118. 118.
    Blumenthal JA, Fredrikson M, Matthews KA, et al. Stress reactivity and exercise training in premenopausal and postmenopausal women. Health Psychol 1991; 10 (6): 384–91PubMedCrossRefGoogle Scholar
  119. 119.
    Beyer C, Boikess S, Luo B, et al. Comparison of the effects of antidepressants on norepinephrine and serotonin concentrations in the rat frontal cortex: an in-vivo microdialysis study. J Psychopharmacol 2002; 16 (4): 297–304PubMedCrossRefGoogle Scholar
  120. 120.
    Dishman R. Brain monoamines, exercise, and behavioral stress: animal models. Med Sci Sport Exerc 1997; 29 (1): 63–74CrossRefGoogle Scholar
  121. 121.
    Ossip-Klein DJ, Doyne EJ, Bowman ED, et al. Effects of running or weight lifting on self-concept in clinically depressed women. J Consult Clin Psychol 1989; 57 (1): 158–61PubMedCrossRefGoogle Scholar
  122. 122.
    Jacobsen N, Follette W, Revenstorf D. Psychotherapy outcome research: methods for reporting variability and evaluating clinical significance. Behav Ther 1984; 15 (4): 336–52CrossRefGoogle Scholar
  123. 123.
    Seggar L, Lambert M, Hansen N. Assessing clinical significance: application to the Beck Depression Inventory. Behav Ther 2002; 33 (2): 253–69CrossRefGoogle Scholar
  124. 124.
    Grundy C, Lambert M, Grundy E. Assessing clinical significance: application to the Hamilton Rating Scale for Depression. J Mental Health 1996; 5 (1): 25–33CrossRefGoogle Scholar
  125. 125.
    McGlinchey JB, Atkins DC, Jacobsen NS. Clinical significance methods: which one to use and how useful are they. Behav Ther 2002; 33 (4): 529–50CrossRefGoogle Scholar
  126. 126.
    Zipf G. Human behavior and the principle of least effort:an introduction to human ecology. Cambridge (MA): Addison-Wesley, 1949Google Scholar
  127. 127.
    Anderson I, Tomenson B. Treatment discontinuation with selective serotonin reuptake inhibitors compared with tricyclic antidepressants: a meta-analysis. BMJ 1995; 310: 1433–8PubMedCrossRefGoogle Scholar
  128. 128.
    Montgomery S, Kasper S. Comparison of compliance between serotonin reuptake inhibitors and tricyclic antidepressants: a meta-analysis. Int Clin Psychopharmacol 1995; 9 (4): 33–40PubMedCrossRefGoogle Scholar
  129. 129.
    Steffens D, Krishnan K, Helms M. Are SSRIs better than TCAs? Comparison of SSRIs and TCAs: a meta-analysis. Depress Anxiety 1997; 6: 10–8PubMedCrossRefGoogle Scholar
  130. 130.
    Anderson I. SSRIs versus tricyclic antidepressants in depressed inpatients: a meta-analysis of efficacy and tolerability. Depress Anxiety 1998; 7 Suppl. 1: 11–7PubMedCrossRefGoogle Scholar
  131. 131.
    Gloaguen V, Cottraux J, Cucherat M, et al. A metaanalysis of the effects of cognitive therapy in depressed patients. J Affect Disord 1998; 49 (1): 59–72PubMedCrossRefGoogle Scholar
  132. 132.
    Food and Drug Administration. Sertaline hydrochloride patient information sheet 2006 [online]. Available from URL: [Accessed 2007 Jan 25]
  133. 133.
    US Department of Health and Human Services. Physical activity and health: a report of the Surgeon General. Atlanta (GA): US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 1996Google Scholar
  134. 134.
    Warburton D, Nicol C, Bredin S. Health benefits of physical activity: the evidence. CMAJ 2006; 174 (6): 801–9PubMedCrossRefGoogle Scholar
  135. 135.
    Taylor A, Cable N, Faulkner G, et al. Physical activity and older adults: a review of health benefits and the effectiveness of interventions. J Sport Sci 2004; 22 (8): 703–25CrossRefGoogle Scholar
  136. 136.
    Kelly G, Kelly K, Tran Z. Exercise and bone mineral density in men: a meta-analysis. J Appl Physiol 2000; 88 (5): 1730–60Google Scholar
  137. 137.
    Department of Health and Aging. Exercise physiologists eligible to provide services under Medicare, 2005 [online]. Available from URL: [Accessed 2007 Jan 27]

Copyright information

© Adis Data Information BV 2009

Authors and Affiliations

  • Chad D. Rethorst
    • 1
    Email author
  • Bradley M. Wipfli
    • 1
  • Daniel M. Landers
    • 1
  1. 1.Department of KinesiologyArizona State UniversityTempeUSA

Personalised recommendations