Scientists have found that physical activity interventions were associated with significant reductions in depressive symptoms in children and adolescents.
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The available evidence supported physical activity interventions as an alternative or adjunctive approach to alleviate depressive symptoms in children and adolescents, substantiating the beneficial influence of physical activity on the mental health of pediatric populations. This systematic review and meta-analysis included 21 studies involving 2441 participants.
Depression is the second most prevalent mental disorder among children and adolescents, with an estimated prevalence rate of 6.2% globally, yet only a small proportion seek or receive disorder-specific treatment.
Early childhood depression is associated with severe adverse outcomes, including difficulties with social functioning, poor mental and physical health, and suicide.
The incidence of depressive symptoms at a young age is a strong predictor of future mental disorders, as it has been shown that up to 67% of youth with depressive symptoms are at risk of developing full-syndrome depressive or anxiety disorders in adulthood.
The available clinical practice guidelines suggest the use of psychotherapy and/or pharmacotherapy to alleviate depressive symptoms in children and adolescents. However, both approaches have limitations that can reduce treatment adherence, the study said.
Lack of time, fear of stigmatization, parental mistrust of the therapist, and no perceived need for treatment can be strong barriers to childhood psychotherapy, whereas adverse effects, including sleep disturbances, gastrointestinal distress, and even suicide, have been associated with antidepressant use in pediatric patients, the study said.
According to the study, physical activity interventions held promise as an alternative or adjunctive approach to clinical treatment for depression, as they have been shown to alleviate depressive symptoms in adults and have been endorsed by international guidelines such as European Psychological Association, the UK National Institute of Health and Care Excellence and the Canadian Network for Mood and Anxiety Treatments as an official treatment for adult depression.
Physical activity was also safer and more accessible than other clinical depression treatments, the study said. The objective of the study was to determine the association of physical activity interventions with depressive symptoms in children and adolescents.
Two independent researchers selected studies that assessed the effects of physical activity interventions on depressive symptoms in children and adolescents compared with a control condition.
PubMed, CINAHL, PsycINFO, EMBASE, and SPORTDiscus were searched from inception to February 2022 for relevant studies written in English, Chinese, or Italian, the study said.
A random-effects meta-analysis using Hedges g was performed. Hedges g measures how much the experimental group differs from the control group.
Heterogeneity, risk of bias, and publication bias were assessed independently by multiple reviewers. Meta-regressions and sensitivity analyses were conducted to substantiate the overall results. The study followed the PRISMA reporting guideline.
The main outcome was depressive symptoms as measured by validated depression scales at post-intervention and follow-up. Twenty-one studies involving 2441 participants, 1148 (47%) boys and 1293 (53%) girls were included. The mean age was 14 years.
Meta-analysis of the post-intervention differences revealed that physical activity interventions were associated with a reduction in depressive symptoms compared with the control condition with a Hedges g value of -0.29, the study said.
Secondary analyses demonstrated that intervention i.e., less than 12 weeks in duration, 3 times per week, unsupervised and participant characteristics i.e., aged more than 13 years, with a mental illness and/or depression diagnosis may influence the overall treatment effect.
Physical activity interventions may be used to reduce depressive symptoms in children and adolescents. Greater reductions in depressive symptoms were derived from participants older than 13 years and with a mental illness and/or depression diagnosis.
The association with physical activity parameters such as frequency, duration, and supervision of the sessions remained unclear and needed further investigation.