Physical Exercise Interventions May Improve Depressive Symptoms in Children

Physical activity interventions may reduce symptoms of depression among children and adolescents, according to results of a systematic review and meta-analysis published in JAMA Pediatrics.

Investigators from the University of Hong Kong searched publication databases through February 2022 for studies evaluating the effect of physical activity interventions on pediatric depression. A total of 21 studies comprising 2441 children and adolescents, with a mean age of 14 years, were included in this analysis.

The studies were published between 1987 and 2021, 3 studies only recruited girls, and the most common target populations were obese or overweight (n=7) children or children with depression or depressive symptoms (n=6). Nine studies used vigorous exercise interventions whereas 7 used low to moderate intensity interventions and the average duration of the exercise was 50 (range, 30-120) minutes. The comparator interventions included no intervention (n=9), usual care (n=7), attention control (n=3), waitlist (n=1), and stretching (n=1).

Most studies (n=17) reported a decrease in depressive symptoms after the exercise interventions with an overall effect size of -0.29 (95% CI, -0.47 to -0.10; P =.004). However, among the 4 studies that evaluated symptoms of depression at follow-up, no lasting effect was found (g, -0.39; 95% CI, -1.01 to 0.24; P =.14). Both postintervention (I², 62.9%; P <.001) and follow-up (I², 61.8%; P =.04) comparisons had significant heterogeneity.

In the moderator analysis, child’s health status (β, -0.16; P =.28), intervention total physical activity volume (β, 0.00; P =.07), treatment concealment (β, 0.08; P =.56), and study design (β, 0.14; P =.42) did not have significant effects.

The limitations of this study included study heterogeneity and incompletely reported data.

Study authors concluded, “The results of this systematic review and meta-analysis suggest that physical activity interventions can alleviate symptoms of depression in children and adolescents. Results were corroborated by stringent sensitivity and moderator analyses that revealed greater reductions in depressive symptoms in participants aged 13 years and older and in those with a mental illness and/or depression diagnosis.”