The effect of exercise in clinically depressed adults: systematic review and meta-analysis of randomized controlled trials

摘要: Objective To assess the effectiveness of exercise in adults with clinical depression. Data sources The databases CINAHL, Embase, Cochrane Database Systematic reviews, Controlled Trials Register, MEDLINE, and PsycINFO were searched (1806-2008) using medical subject headings (MeSH) text word terms depression, depressive disorder exercise, aerobic, non-aerobic, physical activity, fitness, walk*, jog*, run*, bicycling, swim*, strength, resistance. Study selection Randomized trials including depression according to any diagnostic system included. extraction Two investigators evaluated a prepiloted structured form. synthesis Thirteen identified that fulfilled inclusion criteria. Eight had adequate allocation concealment, 6 blinded outcome, 5 used intention-to-treat analyses. pooled standardized mean difference (SMD) calculated random-effects model was -0.40 (95% CI, -0.66 -0.14), evidence heterogeneity between (I(2) = 57.2%, P .005). There an inverse association duration intervention magnitude (P .002). No other characteristics related between-study heterogeneity. Pooled analysis long-term follow-up (ie, examined outcomes beyond end intervention) suggested no benefit (SMD, -0.01; 95% -0.28 0.26), strong this 23.4%, .27). statistical for small study bias > Only 3 studies assessed as high quality (adequately concealed random allocation, outcome assessment, analysis). When we results from these, estimated beneficial effect more modest -0.19; -0.70 0.31) than result all 13 studies, benefit. Conclusions Our suggest short-term on depression: average, scores 0.4 standard deviation lower clinically depressed patients randomly assigned at compared those none group. is little