The Relationship Between Physical Activity and Depression in College Students: A Systematic Review and Meta-Analysis.

Objectives: Depression is a significant and growing global concern with substantial societal impact. College students, being particularly vulnerable to depression, necessitate exploration of physical activity (PA) as a potential mitigating factor. This study aims to examine the relationship between PA and depression in college students. Methods: Studies were identified through systematic searches of PubMed, Embase, Cochrane, Scopus, and Web of Science. The Pearson correlation coefficient was utilized to assess the PA-depression relationship. Heterogeneity was evaluated, and subgroup analyses were performed. Sensitivity analysis via the leave-one-out method was conducted. Quality assessment was assessed using the Joanna Briggs Institute literature quality assessment approach, resulting in the inclusion of 38 high-quality, low-risk studies. Results: A significant negative correlation between PA and depression was found (r = -0.238; 95% CI, -0.307 to -0.173; p < 0.001). Subgroup analyses revealed notable PA-depression correlations post-COVID-19 (r = -0.324; 95% CI, -0.493 to -0.132; p < 0.001), in developing countries (r = -0.202; 95% CI, -0.213 to -0.191; p < 0.001), and in physical education majors (r = -0.390; 95% CI, -0.589 to -0.147; p < 0.001). Moderate PA levels were associated with reduced depression (r = -0.428; 95% CI, -0.708 to -0.031; p = 0.035). Conclusions: This systematic review and meta-analysis suggests that PA is significantly and negatively associated with depression and plays a crucial role in alleviating depression in college students. Various influences, including the pandemic, national development level, student major, and PA intensity, moderate this relationship. Post-pandemic, developing countries, physical education majors, and moderate PA intensity emerged as optimal factors for enhancing the depression-alleviating effects of PA.