Skip to content
2000
image of Impact of Structured Physical Exercise on Adolescent Depression: A Comprehensive Meta-Analysis of RCTs

Abstract

Introduction

Although research supports the benefits of Physical Exercise (PE) in treating adolescent depression, data remain limited regarding the most effective types, durations, and intensities of exercise. Moreover, most of the research conducted has focused on short-term outcomes, leaving a notable gap in understanding the long-term sustainability of these benefits. Evaluate the effectiveness of PE in alleviating depressive symptoms in adolescents diagnosed with major depressive disorder (CRD number: CRD42024585812).

Methods

The search was conducted from inception to July 2024 in the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, PsycINFO, and SPORTDiscus. Randomized Controlled Trials (RCTs) involving adolescents aged 10-19 years diagnosed with unipolar major depression were included. The intervention group participated in structured PE programs, whereas the control group did not have PE. Two authors independently conducted screening, data extraction, and risk of bias assessment. A data synthesis was performed using a random-effects model to calculate the Standardized Mean Differences (SMD) for continuous outcomes. Heterogeneity was assessed using the I2 statistic. Sensitivity and subgroup analyses were used to explore the effects of different PE modalities and the duration and intensity of the interventions.

Results

13 RCTs: 759 adolescents in the PE group and 695 in the control group were obtained. PE significantly reduced depressive symptoms compared to the control (SMD=-0.55; <0.01; I2=61%). Aerobic exercise showed the largest effect (SMD=-0.69), followed by resistance training (SMD=-0.35) and whole-body vibration (SMD=-0.60). Moderate-intensity PE interventions lasting 30-60 minutes, 2-4 times/week, were associated with the greatest reductions in depressive symptoms.

Discussion

PE demonstrates considerable potential as an adjunctive strategy to pharmacological treatment for depression, suggesting its impact may be further enhanced when implemented alongside pharmacotherapy.

Conclusion

PE, aerobic exercise, and resistance training are effective interventions for reducing depressive symptoms in adolescents. Moderate-intensity exercise of 30-60 minutes offers substantial benefits.

© 2025 Bentham Science Publishers
Loading

Article metrics loading...

/content/journals/cnsnddt/10.2174/0118715273377485251013035653
2025-11-03
2025-12-20

  • From This Site

    /content/journals/cnsnddt/10.2174/0118715273377485251013035653
    dcterms_title,dcterms_subject,pub_keyword
    -contentType:Contributor -contentType:Concept -contentType:Institution
    10
    5
Loading full text...

Full text loading...

References

  1. Polanczyk G.V. Salum G.A. Sugaya L.S. Caye A. Rohde L.A. Annual Research Review: A meta‐analysis of the worldwide prevalence of mental disorders in children and adolescents. J. Child Psychol. Psychiatry 2015 56 3 345 365 10.1111/jcpp.12381 25649325
    [Google Scholar]
  2. Thapar A. Collishaw S. Pine D.S. Thapar A.K. Depression in adolescence. Lancet 2012 379 9820 1056 1067 10.1016/S0140‑6736(11)60871‑4 22305766
    [Google Scholar]
  3. Garber J. Depression in children and adolescents: Linking risk research and prevention. Am J Prev Med 2006 31 6 104 25.(Suppl. 1) 10.1016/j.amepre.2006.07.007 17175406
    [Google Scholar]
  4. Li Z. Page A. Martin G. Taylor R. Attributable risk of psychiatric and socio-economic factors for suicide from individual-level, population-based studies: A systematic review. Soc. Sci. Med. 2011 72 4 608 616 10.1016/j.socscimed.2010.11.008 21211874
    [Google Scholar]
  5. Fergusson D.M. Horwood L.J. Ridder E.M. Beautrais A.L. Subthreshold depression in adolescence and mental health outcomes in adulthood. Arch. Gen. Psychiatry 2005 62 1 66 72 10.1001/archpsyc.62.1.66 15630074
    [Google Scholar]
  6. Copeland W.E. Shanahan L. Costello E.J. Angold A. Childhood and adolescent psychiatric disorders as predictors of young adult disorders. Arch. Gen. Psychiatry 2009 66 7 764 772 10.1001/archgenpsychiatry.2009.85 19581568
    [Google Scholar]
  7. Weisz J.R. McCarty C.A. Valeri S.M. Effects of psychotherapy for depression in children and adolescents: A meta-analysis. Psychol. Bull. 2006 132 1 132 149 10.1037/0033‑2909.132.1.132 16435960
    [Google Scholar]
  8. Watanabe N. Hunot V. Omori I.M. Churchill R. Furukawa T.A. Psychotherapy for depression among children and adolescents: A systematic review. Acta Psychiatr. Scand. 2007 116 2 84 95 10.1111/j.1600‑0447.2007.01018.x 17650269
    [Google Scholar]
  9. Friedrich M.J. Depression is the leading cause of disability around the world. JAMA 2017 317 15 1517 10.1001/jama.2017.3826 28418490
    [Google Scholar]
  10. Li J. Zhou X. Huang Z. Shao T. Effect of exercise intervention on depression in children and adolescents: A systematic review and network meta-analysis. BMC Public Health 2023 23 1 1918 10.1186/s12889‑023‑16824‑z 37794338
    [Google Scholar]
  11. Gu J. Physical activity and depression in adolescents: Evidence from China family panel studies. Behav. Sci. 2022 12 3 71 10.3390/bs12030071 35323390
    [Google Scholar]
  12. Philippot A. Dubois V. Lambrechts K. Impact of physical exercise on depression and anxiety in adolescent inpatients: A randomized controlled trial. J. Affect. Disord. 2022 301 145 153 10.1016/j.jad.2022.01.011 35007642
    [Google Scholar]
  13. Recchia F. Bernal J.D.K. Fong D.Y. Physical activity interventions to alleviate depressive symptoms in children and adolescents. JAMA Pediatr. 2023 177 2 132 140 10.1001/jamapediatrics.2022.5090 36595284
    [Google Scholar]
  14. Ge M.W. Shen L.T. Hu F.H. Physical exercise time and depression among adolescents: A nonlinear dose–response association. Pediatr. Exerc. Sci. 2025 1 9 10.1123/pes.2024‑0096 39947191
    [Google Scholar]
  15. Li L. Ren K. Fan B. The effects of physical exercise, parent-child interaction and peer relationship on adolescent depression: An empirical analysis based on CEPS data. PLoS One 2024 19 12 e0313489 10.1371/journal.pone.0313489 39630661
    [Google Scholar]
  16. Velazquez B. Petresco S. Pereira R. Physical activity and depressive symptoms among adolescents in a school-based sample. Br. J. Psychiatry 2022 44 3 313 316 10.1590/1516‑4446‑2021‑2235 35262617
    [Google Scholar]
  17. Wang X. Cai Z. Jiang W. Fang Y. Sun W. Wang X. Systematic review and meta-analysis of the effects of exercise on depression in adolescents. Child Adolesc. Psychiatry Ment. Health 2022 16 1 16 10.1186/s13034‑022‑00453‑2 35227300
    [Google Scholar]
  18. Biddle S.J.H. Asare M. Physical activity and mental health in children and adolescents: A review of reviews. Br. J. Sports Med. 2011 45 11 886 895 10.1136/bjsports‑2011‑090185 21807669
    [Google Scholar]
  19. Biddle S.J.H. Ciaccioni S. Thomas G. Vergeer I. Physical activity and mental health in children and adolescents: An updated review of reviews and an analysis of causality. Psychol. Sport Exerc. 2019 42 146 155 10.1016/j.psychsport.2018.08.011
    [Google Scholar]
  20. Carter T. Guo B. Turner D. Preferred intensity exercise for adolescents receiving treatment for depression: A pragmatic randomised controlled trial. BMC Psychiatry 2015 15 1 247 10.1186/s12888‑015‑0638‑z 26467764
    [Google Scholar]
  21. Lubans D. Richards J. Hillman C. Physical activity for cognitive and mental health in youth: A systematic review of mechanisms. Pediatrics 2016 138 3 e20161642 10.1542/peds.2016‑1642 27542849
    [Google Scholar]
  22. de Sá Filho A. de Souza Moura A. Lamego M. Potential therapeutic effects of physical exercise for bipolar disorder. CNS Neurol. Disord. Drug Targets 2015 14 10 1255 1259 10.2174/1871527315666151111122219 26556085
    [Google Scholar]
  23. Sá Filho A.S. Cheniaux E. de Paula C.C. Exercise is medicine: A new perspective for health promotion in bipolar disorder. Expert Rev. Neurother. 2020 20 11 1099 1107 10.1080/14737175.2020.1807329 32762382
    [Google Scholar]
  24. Sá Filho A.S. Barsanulfo S.R. Faria S.S. Inacio P.A. Ayatizadeh F. Machado S. Exerkines: A crosstalk between lactate production, exercise and mental health. CNS Neurol. Disord. Drug Targets 2024 23 9 1057 1060 10.2174/0118715273250928231009054658 37842902
    [Google Scholar]
  25. Legey S. Sá Filho A.S. Inacio P.A. Association between body image and mental health in adolescents: A social issue. Fronteiras J Soc Technol Environ Sci 2023 12 3 141 151 10.21664/2238‑8869.2023v12i3.p141‑151
    [Google Scholar]
  26. Mandolesi L. Polverino A. Montuori S. Effects of physical exercise on cognitive functioning and wellbeing: Biological and psychological benefits. Front. Psychol. 2018 9 509 10.3389/fpsyg.2018.00509 29755380
    [Google Scholar]
  27. Legey S. Filho A.S.S. Yadollahpour A. Health-related fitness as a predictor of anxiety levels among school adolescents: An observational cross-sectional study. Clin. Pract. Epidemiol. Ment. Health 2022 18 e174501792208151 10.2174/17450179‑v18‑e2208151 37274858
    [Google Scholar]
  28. de Souza Moura A. Lamego M. Paes F. Effects of aerobic exercise on anxiety disorders: A systematic review. CNS Neurol. Disord. Drug Targets 2015 14 9 1184 1193 10.2174/1871527315666151111121259 26556089
    [Google Scholar]
  29. de Souza Moura A. Lamego M. Paes F. Comparison among aerobic exercise and other types of interventions to treat depression: A systematic review. CNS Neurol. Disord. Drug Targets 2015 14 9 1171 1183 10.2174/1871527315666151111120714 26556090
    [Google Scholar]
  30. Brown H.E. Pearson N. Braithwaite R.E. Brown W.J. Biddle S.J.H. Physical activity interventions and depression in children and adolescents: A systematic review and meta-analysis. Sports Med. 2013 43 3 195 206 10.1007/s40279‑012‑0015‑8 23329611
    [Google Scholar]
  31. Kelley G.A. Kelley K.S. Callahan L.F. Community-deliverable exercise and anxiety in adults with arthritis and other rheumatic diseases: A systematic review with meta-analysis of randomised controlled trials. BMJ Open 2018 8 2 e019138 10.1136/bmjopen‑2017‑019138 29455165
    [Google Scholar]
  32. Page M.J. McKenzie J.E. Bossuyt P.M. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ 2021 372 n71 10.1136/bmj.n71 33782057
    [Google Scholar]
  33. Ouzzani M. Hammady H. Fedorowicz Z. Elmagarmid A. Rayyan—A web and mobile app for systematic reviews. Syst. Rev. 2016 5 1 210 10.1186/s13643‑016‑0384‑4 27919275
    [Google Scholar]
  34. Sterne J.A.C. Savovic J. Page M.J. RoB 2: A revised tool for assessing risk of bias in randomised trials. BMJ 2019 366 l4898 10.1136/bmj.l4898 31462531
    [Google Scholar]
  35. McGuinness L.A. Higgins J.P.T. Risk‐of‐bias VISualization (robvis): An R package and Shiny web app for visualizing risk‐of‐bias assessments. Res. Synth. Methods 2021 12 1 55 61 10.1002/jrsm.1411 32336025
    [Google Scholar]
  36. Guyatt G.H. Oxman A.D. Vist G.E. GRADE: An emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008 336 7650 924 926 10.1136/bmj.39489.470347.AD 18436948
    [Google Scholar]
  37. Viechtbauer W. Conducting meta-Analyses in R with the meta for package. J. Stat. Softw. 2010 36 3 1 48 10.18637/jss.v036.i03
    [Google Scholar]
  38. Costigan S.A. Eather N. Plotnikoff R.C. Hillman C.H. Lubans D.R. High-intensity interval training for cognitive and mental health in adolescents. Med. Sci. Sports Exerc. 2016 48 10 1985 1993 10.1249/MSS.0000000000000993 27187097
    [Google Scholar]
  39. Daley A.J. Copeland R.J. Wright N.P. Roalfe A. Wales J.K.H. Exercise therapy as a treatment for psychopathologic conditions in obese and morbidly obese adolescents: A randomized, controlled trial. Pediatrics 2006 118 5 2126 2134 10.1542/peds.2006‑1285 17079587
    [Google Scholar]
  40. Goldfield G.S. Kenny G.P. Alberga A.S. Effects of aerobic training, resistance training, or both on psychological health in adolescents with obesity: The HEARTY randomized controlled trial. J. Consult. Clin. Psychol. 2015 83 6 1123 1135 10.1037/ccp0000038 26322787
    [Google Scholar]
  41. Hughes C.W. Barnes S. Barnes C. DeFina L.F. Nakonezny P. Emslie GJ. Depressed Adolescents Treated with Exercise (DATE): A pilot randomized controlled trial to test feasibility and] establish preliminary effect sizes. Ment. Health Phys. Act. 2013 6 2 119 131 10.1016/j.mhpa.2013.06.006 24244220
    [Google Scholar]
  42. Lin K. Stubbs B. Zou W. Aerobic exercise impacts the anterior cingulate cortex in adolescents with subthreshold mood syndromes: A randomized controlled trial study. Transl. Psychiatry 2020 10 1 155 10.1038/s41398‑020‑0840‑8 32424169
    [Google Scholar]
  43. Noggle J.J. Steiner N.J. Minami T. Khalsa S.B.S. Benefits of yoga for psychosocial well-being in a US high school curriculum: A preliminary randomized controlled trial. J. Dev. Behav. Pediatr. 2012 33 3 193 201 10.1097/DBP.0b013e31824afdc4 22343481
    [Google Scholar]
  44. Dabidy Roshan V. Pourasghar M. Mohammadian Z. The efficacy of intermittent walking in water on the rate of MHPG sulfate and the severity of depression. Iran. J. Psychiatry. Behav. Sci. 2011 5 2 26 31 24644444
    [Google Scholar]
  45. Melnyk B.M. Jacobson D. Kelly S. O’Haver J. Small L. Mays M.Z. Improving the mental health, healthy lifestyle choices, and physical health of Hispanic adolescents: A randomized controlled pilot study. J. Sch. Health 2009 79 12 575 584 10.1111/j.1746‑1561.2009.00451.x 19909421
    [Google Scholar]
  46. Abhar M. A study and comparison of the effect of team sports (soccer and volleyball) and individual sports (table tennis and badminton) on depression among high school students. Aust. J. Basic Appl. Sci. 2011 5 12 51005 51011
    [Google Scholar]
  47. Silva L.A.D. Doyenart R. Henrique Salvan P. Swimming training improves mental health parameters, cognition and motor coordination in children with Attention Deficit Hyperactivity Disorder. Int. J. Environ. Health Res. 2020 30 5 584 592 10.1080/09603123.2019.1612041 31081373
    [Google Scholar]
  48. Talakoub S. Gorbani S. Hasanpour M. Zolaktaf V. Amini M. Impact of exercise on affective responses in female adolescents with type I diabetes. Iran. J. Nurs. Midwifery Res. 2012 17 6 434 439 23922585
    [Google Scholar]
  49. Wunram H.L. Hamacher S. Hellmich M. Whole body vibration added to treatment as usual is effective in adolescents with depression: A partly randomized, three-armed clinical trial in inpatients. Eur. Child Adolesc. Psychiatry 2018 27 5 645 662 10.1007/s00787‑017‑1071‑2 29119301
    [Google Scholar]
  50. Bonhauser M. Fernandez G. Püschel K. Improving physical fitness and emotional well-being in adolescents of low socioeconomic status in Chile: Results of a school-based controlled trial. Health Promot. Int. 2005 20 2 113 122 10.1093/heapro/dah603 15788528
    [Google Scholar]
  51. Kandola A. Ashdown-Franks G. Hendrikse J. Sabiston C.M. Stubbs B. Physical activity and depression: Towards understanding the antidepressant mechanisms of physical activity. Neurosci. Biobehav. Rev. 2019 107 525 539 10.1016/j.neubiorev.2019.09.040 31586447
    [Google Scholar]
  52. Yuan T.F. Paes F. Arias-Carrión O. Ferreira Rocha N. de Sá Filho A. Machado S. Neural mechanisms of exercise: Anti-depression, neurogenesis, and serotonin signaling. CNS Neurol. Disord. Drug Targets 2015 14 10 1307 1311 10.2174/1871527315666151111124402 26556077
    [Google Scholar]
  53. Lamego M. de Souza Moura A. Paes F. Aerobic exercise does not predict brain derived neurotrophic factor and cortisol alterations in depressed patients. CNS Neurol. Disord. Drug Targets 2015 14 9 1116 1128 10.2174/1871527315666151111125402 26556073
    [Google Scholar]
  54. Schuch F.B. Vancampfort D. Richards J. Rosenbaum S. Ward P.B. Stubbs B. Exercise as a treatment for depression: A meta-analysis adjusting for publication bias. J. Psychiatr. Res. 2016 77 42 51 10.1016/j.jpsychires.2016.02.023 26978184
    [Google Scholar]
  55. Oberste M. Medele M. Javelle F. Physical activity for the treatment of adolescent depression: A systematic review and meta-analysis. Front. Physiol. 2020 11 185 10.3389/fphys.2020.00185 32265725
    [Google Scholar]
  56. Cipriani A. Furukawa T.A. Salanti G. Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: A systematic review and network meta-analysis. Lancet 2018 391 10128 1357 1366 10.1016/S0140‑6736(17)32802‑7 29477251
    [Google Scholar]
  57. Practice guideline for the treatment of patients with major depressive disorder (revision). Am. J. Psychiatry 2000 157 4 1 45 [Suppl. 10767867
    [Google Scholar]
  58. Thase M.E. The role of monoamine oxidase inhibitors in depression treatment guidelines. J. Clin. Psychiatry 2012 73 Suppl. 1 10 16 10.4088/JCP.11096su1c.02 22951237
    [Google Scholar]
  59. Kennedy S.H. Lam R.W. McIntyre R.S. Canadian network for mood and anxiety treatments (CANMAT) 2016 clinical guidelines for the management of adults with major depressive disorder. Can. J. Psychiatry 2016 61 9 540 560 10.1177/0706743716659417 27486148
    [Google Scholar]
  60. Blumenthal J.A. Babyak M.A. Moore K.A. Effects of exercise training on older patients with major depression. Arch. Intern. Med. 1999 159 19 2349 2356 10.1001/archinte.159.19.2349 10547175
    [Google Scholar]
  61. Rebar A.L. Stanton R. Geard D. Short C. Duncan M.J. Vandelanotte C. A meta-meta-analysis of the effect of physical activity on depression and anxiety in non-clinical adult populations. Health Psychol. Rev. 2015 9 3 366 378 10.1080/17437199.2015.1022901 25739893
    [Google Scholar]
  62. Dishman R.K. Berthoud H.R. Booth F.W. Neurobiology of Exercise. Obesity 2006 14 3 345 356 10.1038/oby.2006.46 16648603
    [Google Scholar]
  63. Dinas P.C. Koutedakis Y. Flouris A.D. Effects of exercise and physical activity on depression. Ir. J. Med. Sci. 2011 180 2 319 325 10.1007/s11845‑010‑0633‑9 21076975
    [Google Scholar]
  64. Craft L.L. Perna F.M. The benefits of exercise for the clinically depressed. Prim. Care Companion J. Clin. Psychiatry 2004 6 3 104 111 10.4088/pcc.v06n0301 15361924
    [Google Scholar]
/content/journals/cnsnddt/10.2174/0118715273377485251013035653
Loading
Impact of Structured Physical Exercise on Adolescent Depression: A Comprehensive Meta-Analysis of RCTs
Bentham Science Publishers ; https://doi.org/10.2174/0118715273377485251013035653
/content/journals/cnsnddt/10.2174/0118715273377485251013035653
/content/journals/cnsnddt/10.2174/0118715273377485251013035653
Loading

Data & Media loading...

Supplements

PRISMA checklist is available as supplementary material on the publisher’s website along with the published article.

file format download Download

  • Article Type:     Research Article
Keywords: depressive symptoms ; aerobic exercise ; randomized controlled trials ; resistance training ; whole-body vibration ; Health ; meta-analysis

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test