Exercise in prevention and treatment of anxiety and depression among children and young people
- 19 July 2006
- journal article
- research article
- Published by Wiley in Emergencias
- No. 3,p. CD004691
- https://doi.org/10.1002/14651858.cd004691.pub2
Abstract
Depression and anxiety are common psychological disorders for children and adolescents. Psychological (e.g. psychotherapy), psychosocial (e.g. cognitive behavioral therapy) and biological (e.g. SSRIs or tricyclic drugs) treatments are the most common treatments being offered. The large variety of therapeutic interventions give rise to questions of clinical effectiveness and side effects. Physical exercise is inexpensive with few, if any, side effects. To assess the effects of exercise interventions in reducing or preventing anxiety or depression in children and young people up to 20 years of age. We searched the Cochrane Controlled Trials Register (latest issue available), MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC and Sportdiscus up to August 2005. Randomised trials of vigorous exercise interventions for children and young people up to the age of 20, with outcome measures for depression and anxiety. Two authors independently selected trials for inclusion, assessed methodological quality and extracted data. The trials were combined using meta-analysis methods. A narrative synthesis was performed when the reported data did not allow statistical pooling. Sixteen studies with a total of 1191 participants between 11 and 19 years of age were included.Eleven trials compared vigourous exercise versus no intervention in a general population of children. Six studies reporting anxiety scores showed a non-significant trend in favour of the exercise group (standard mean difference (SMD) (random effects model) -0.48, 95% confidence interval (CI) -0.97 to 0.01). Five studies reporting depression scores showed a statistically significant difference in favour of the exercise group (SMD (random effects model) -0.66, 95% CI -1.25 to -0.08). However, all trials were generally of low methodological quality and they were highly heterogeneous with regard to the population, intervention and measurement instruments used. One small trial investigated children in treatment showed no statistically significant difference in depression scores in favour of the control group (SMD (fixed effects model) 0.78, 95% CI -0.47 to 2.04). No studies reported anxiety scores for children in treatment. Five trials comparing vigorous exercise to low intensity exercise show no statistically significant difference in depression and anxiety scores in the general population of children. Three trials reported anxiety scores (SMD (fixed effects model) -0.14, 95% CI -0.41 to 0.13). Two trials reported depression scores (SMD (fixed effects model) -0.15, 95% CI -0.44 to 0.14). Two small trials found no difference in depression scores for children in treatment (SMD (fixed effects model) -0.31, 95% CI -0.78 to 0.16). No studies reported anxiety scores for children in treatment. Four trials comparing exercise with psychosocial interventions showed no statistically significant difference in depression and anxiety scores in the general population of children. Two trials reported anxiety scores (SMD (fixed effects model) -0.13, 95% CI -0.43 to 0.17). Two trials reported depression scores (SMD (fixed effects model) 0.10, 95% CI-0.21 to 0.41). One trial found no difference in depression scores for children in treatment (SMD (fixed effects model) -0.31, 95% CI -0.97 to 0.35). No studies reported anxiety scores for children in treatment. Whilst there appears to be a small effect in favour of exercise in reducing depression and anxiety scores in the general population of children and adolescents, the small number of studies included and the clinical diversity of participants, interventions and methods of measurement limit the ability to draw conclusions. It makes little difference whether the exercise is of high or low intensity. The effect of exercise for children in treatment for anxiety and depression is unknown as the evidence base is scarce.Keywords
This publication has 19 references indexed in Scilit:
- Improving physical fitness and emotional well-being in adolescents of low socioeconomic status in Chile: results of a school-based controlled trialHealth Promotion International, 2005
- Physical Activity and Psychological Well-BeingPublished by Taylor & Francis Ltd ,2003
- Anxiety responses to maximal exercise testing.British Journal of Sports Medicine, 1995
- Effects of Physical Activity on Psychological Variables in AdolescentsPediatric Exercise Science, 1994
- How Much Physical Activity is Good for Health?Annual Review of Public Health, 1992
- Aerobic Exercise in the Psychological Treatment of AdolescentsPerceptual and Motor Skills, 1992
- Comparison of Jogging, the Relaxation Response, and Group Interaction for Stress ReductionJournal of Sport and Exercise Psychology, 1988
- Influence of aerobic exercise training and relaxation training on physical and psychologic health following stressful life events.Psychosomatic Medicine, 1987
- Influence of aerobic exercise on depression.Journal of Personality and Social Psychology, 1984
- Physical fitness training and counseling as treatment for youthful offenders.Journal of Counseling Psychology, 1982