IBNS-CMEDIA: Exercise may reduce symptoms of depression to a degree comparable with psychological therapy, according to an updated Cochrane review led by Professor Andrew Clegg of the University of Lancashire.
Depression is a leading cause of ill health and disability worldwide, affecting more than 280 million people. Exercise is low-cost, widely accessible and offers additional physical health benefits, making it an appealing option for both patients and healthcare providers.
The review, conducted by researchers from the University of Lancashire and supported by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration North-West Coast (ARC NWC), analysed 73 randomised controlled trials involving nearly 5,000 adults with depression.
The studies compared exercise with no treatment or control interventions, as well as with psychological therapies and antidepressant medications. The findings show that exercise provides a moderate reduction in depressive symptoms compared with no treatment or control interventions.
When compared with psychological therapy, exercise demonstrated a similar effect on depressive symptoms, based on moderate-certainty evidence from 10 trials. Comparisons with antidepressant medication also suggested a comparable effect, although the evidence here was limited and of low certainty. Long-term outcomes remain unclear, as few studies followed participants beyond the treatment period.
Side effects were rare. Those who exercised occasionally reported musculoskeletal injuries, while participants taking antidepressants experienced typical medication-related effects such as fatigue and gastrointestinal problems.
“Our findings suggest that exercise appears to be a safe and accessible option for helping to manage symptoms of depression,” said Professor Andrew Clegg, lead author of the review. “This suggests that exercise works well for some people, but not for everyone, and finding approaches that individuals are willing and able to maintain is important.”
The review found that light to moderate intensity exercise may be more beneficial than vigorous exercise. Completing between 13 and 36 exercise sessions was associated with greater improvements in depressive symptoms.
No single type of exercise was clearly superior. However, mixed exercise programmes and resistance training appeared to be more effective than aerobic exercise alone. Some forms of exercise, including yoga, qigong and stretching, were not included in the analysis and represent areas for future research.
This update adds 35 new trials to earlier versions of the review published in 2008 and 2013, which were also supported by the NIHR. Despite the expanded evidence base, the overall conclusions remain largely unchanged, largely because most trials were small, with fewer than 100 participants.
“Although we’ve added more trials in this update, the findings are similar,” Professor Clegg said. “Exercise can help people with depression, but to understand which types work best, for whom, and whether benefits last over time, we still need larger, high-quality studies. One well-conducted large trial is far more valuable than numerous small, poor-quality studies.”
