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Titre du document / Document title

The Effect of Exercise in Clinically Depressed Adults: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Auteur(s) / Author(s)

KROGH Jesper (1) ; NORDENTOFT Merete (1) ; STERNE Jonathan A. C. (2) ; LAWLOR Debbie A. (2) ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

(1) Psychiatric Center Bispebjerg, Faculty of Health Sciences, Copenhagen University Hospital, Copenhagen, DANEMARK
(2) Department of Social Medicine, University of Bristol, Bristol, ROYAUME-UNI

Résumé / Abstract

Objective: To assess the effectiveness of exercise in adults with clinical depression. Data Sources: The databases CINAHL, Embase, Cochrane Database of Systematic reviews, Cochrane Controlled Trials Register, MEDLINE, and PsycINFO were searched (1806―2008) using medical subject headings (MeSH) and text word terms depression, depressive disorder and exercise, aerobic, non-aerobic, physical activity, physical fitness, walk*, jog*, run*, bicycling, swim*, strength, and resistance. Study Selection: Randomized trials including adults with clinical depression according to any diagnostic system were included. Data Extraction: Two investigators evaluated trials using a prepiloted structured form. Data Synthesis: Thirteen trials were identified that fulfilled the inclusion criteria. Eight had adequate allocation concealment, 6 had a blinded outcome, and 5 used intention-to-treat analyses. The pooled standardized mean difference (SMD) calculated using a random-effects model was ―0.40 (95% CI, ―0.66 to ―0.14), with evidence of heterogeneity between trials (I2 = 57.2%, P= .005). There was an inverse association between duration of intervention and the magnitude of the association of exercise with depression (P= .002). No other characteristics were related to between-study heterogeneity. Pooled analysis of 5 trials with long-term follow-up (ie, that examined outcomes beyond the end of the intervention) suggested no long-term benefit (SMD, ―0.01; 95% CI, ―0.28 to 0.26), with no strong evidence of heterogeneity in this pooled analysis (I2 = 23.4%, P= .27). There was no strong statistical evidence for small study bias (P>.27). Only 3 studies were assessed as high quality (adequately concealed random allocation, blinded outcome assessment, and intention-to-treat analysis). When we pooled results from these, the estimated beneficial effect of exercise was more modest (SMD, ―0.19; 95% CI, ―0.70 to 0.31) than the pooled result for all 13 studies, with no strong evidence of benefit. Conclusions: Our results suggest a short-term effect of exercise on depression: on average, depression scores 0.4 of a standard deviation lower in clinically depressed patients randomly assigned to an exercise intervention at the end of that intervention compared to those randomly assigned to a none exercise group. There is little evidence of a long-term beneficial effect of exercise in patients with clinical depression.

Revue / Journal Title

The Journal of clinical psychiatry    ISSN  0160-6689 

Source / Source

2011, vol. 72, no4, pp. 529-538 [10 page(s) (article)] (40 ref.)

Langue / Language

Anglais

Editeur / Publisher

Physicians Postgraduate Press, Memphis, TN, ETATS-UNIS  (1978) (Revue)

Mots-clés anglais / English Keywords

Mood disorder

;

Human

;

Adult

;

Controlled therapeutic trial

;

Metaanalysis

;

Review

;

Depression

;

Physical exercise

;

Mots-clés français / French Keywords

Trouble de l'humeur

;

Homme

;

Adulte

;

Essai thérapeutique contrôlé

;

Métaanalyse

;

Article synthèse

;

Etat dépressif

;

Exercice physique

;

Mots-clés espagnols / Spanish Keywords

Trastorno humor

;

Hombre

;

Adulto

;

Ensayo terapéutico controlado

;

Meta-análisis

;

Artículo síntesis

;

Estado depresivo

;

Ejercicio físico

;

Localisation / Location

INIST-CNRS, Cote INIST : 9069, 35400018978800.0140

Nº notice refdoc (ud4) : 24138075



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