Effects of chronic exercise on different central features of depression in adults with depression: A systematic review and meta-analysis of random controlled trials.

BACKGROUND

Exercise is considered an effective treatment for improving central symptoms of depression. However, the antidepressant effects of exercise on specific central features in adults with depression and the optimal exercise prescription remain unclear. The present review aimed to explore the impact of exercise on emotion regulation (ER) and executive function (EF) among adults living with depression as well as the moderating effects of exercise prescription characteristics.

METHODS

Two Chinese databases and two English databases were systematically searched from January 1, 2000 to October 30, 2023 to identify relevant randomized controlled trials (RCTs). Based on the results of heterogeneity analyses, the random effects model was used for the meta-analysis of rumination (260 participants in 5 studies), inhibition (578 participants in 7 studies) and updating (832 participants in 9 studies), whereas the fixed effects model was used for the meta-analysis for shifting (802 participants in 8 studies).

RESULTS

Exercise improved rumination (standardized mean difference [SMD] = -0.59, p = 0.02); however, these benefits were observed only for moderate-intensity aerobic exercise in one or two 31-60 min sessions per week for 5-8 weeks. The results indicated significant post-exercise improvement in shifting (SMD = -0.22, p = 0.002) but not inhibition (SMD = -0.21, p = 0.18) or updating (SMD = 0.15, p = 0.14). Moreover, substantial improvements in shifting were observed only from high-intensity aerobic exercise in three or four 31-60 min sessions per week for more than 8 weeks.

CONCLUSIONS

Exercise improved ER (i.e., rumination) and EF (i.e., shifting) in adults with depression. It is important to consider symptoms when prescribing exercise to adults with depression. However, given the limited number of included RCTs, these findings are preliminary and tentative.