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Physical Activity and Incident Depression: A Meta-Analysis of Prospective Cohort Studies.
Am J Psychiatry. 2018 Jul 01; 175(7):631-648.AJ

Abstract

OBJECTIVE

The authors examined the prospective relationship between physical activity and incident depression and explored potential moderators.

METHOD

Prospective cohort studies evaluating incident depression were searched from database inception through Oct. 18, 2017, on PubMed, PsycINFO, Embase, and SPORTDiscus. Demographic and clinical data, data on physical activity and depression assessments, and odds ratios, relative risks, and hazard ratios with 95% confidence intervals were extracted. Random-effects meta-analyses were conducted, and the potential sources of heterogeneity were explored. Methodological quality was assessed using the Newcastle-Ottawa Scale.

RESULTS

A total of 49 unique prospective studies (N=266,939; median proportion of males across studies, 47%) were followed up for 1,837,794 person-years. Compared with people with low levels of physical activity, those with high levels had lower odds of developing depression (adjusted odds ratio=0.83, 95% CI=0.79, 0.88; I2=0.00). Furthermore, physical activity had a protective effect against the emergence of depression in youths (adjusted odds ratio=0.90, 95% CI=0.83, 0.98), in adults (adjusted odds ratio=0.78, 95% CI=0.70, 0.87), and in elderly persons (adjusted odds ratio=0.79, 95% CI=0.72, 0.86). Protective effects against depression were found across geographical regions, with adjusted odds ratios ranging from 0.65 to 0.84 in Asia, Europe, North America, and Oceania, and against increased incidence of positive screen for depressive symptoms (adjusted odds ratio=0.84, 95% CI=0.79, 0.89) or major depression diagnosis (adjusted odds ratio=0.86, 95% CI=0.75, 0.98). No moderators were identified. Results were consistent for unadjusted odds ratios and for adjusted and unadjusted relative risks/hazard ratios. Overall study quality was moderate to high (Newcastle-Ottawa Scale score, 6.3). Although significant publication bias was found, adjusting for this did not change the magnitude of the associations.

CONCLUSIONS

Available evidence supports the notion that physical activity can confer protection against the emergence of depression regardless of age and geographical region.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Schuch FB
From La Salle University, Canoas, Brazil; the School of Physical Education, Physiotherapy, and Dance and the Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; KU Leuven-University of Leuven, Department of Rehabilitation Sciences, and University Psychiatric Center, Leuven-Kortenberg, Belgium; the NICM Health Research Institute, School of Science and Health, University of Western Sydney, Sydney, Australia; the School of Psychiatry, University of New South Wales Sydney, Black Dog Institute, and Schizophrenia Research Unit, Ingham Institute of Applied Medical Research, Sydney, Australia; the Department of Public Health Sciences, Karolinska Institute, Stockholm; the Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil; the Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; the Department of Psychiatry, University of Toronto, and the Centre for Addiction and Mental Health, Toronto; the Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; and the Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London.
Vancampfort D
From La Salle University, Canoas, Brazil; the School of Physical Education, Physiotherapy, and Dance and the Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; KU Leuven-University of Leuven, Department of Rehabilitation Sciences, and University Psychiatric Center, Leuven-Kortenberg, Belgium; the NICM Health Research Institute, School of Science and Health, University of Western Sydney, Sydney, Australia; the School of Psychiatry, University of New South Wales Sydney, Black Dog Institute, and Schizophrenia Research Unit, Ingham Institute of Applied Medical Research, Sydney, Australia; the Department of Public Health Sciences, Karolinska Institute, Stockholm; the Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil; the Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; the Department of Psychiatry, University of Toronto, and the Centre for Addiction and Mental Health, Toronto; the Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; and the Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London.
Firth J
From La Salle University, Canoas, Brazil; the School of Physical Education, Physiotherapy, and Dance and the Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; KU Leuven-University of Leuven, Department of Rehabilitation Sciences, and University Psychiatric Center, Leuven-Kortenberg, Belgium; the NICM Health Research Institute, School of Science and Health, University of Western Sydney, Sydney, Australia; the School of Psychiatry, University of New South Wales Sydney, Black Dog Institute, and Schizophrenia Research Unit, Ingham Institute of Applied Medical Research, Sydney, Australia; the Department of Public Health Sciences, Karolinska Institute, Stockholm; the Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil; the Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; the Department of Psychiatry, University of Toronto, and the Centre for Addiction and Mental Health, Toronto; the Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; and the Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London.
Rosenbaum S
From La Salle University, Canoas, Brazil; the School of Physical Education, Physiotherapy, and Dance and the Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; KU Leuven-University of Leuven, Department of Rehabilitation Sciences, and University Psychiatric Center, Leuven-Kortenberg, Belgium; the NICM Health Research Institute, School of Science and Health, University of Western Sydney, Sydney, Australia; the School of Psychiatry, University of New South Wales Sydney, Black Dog Institute, and Schizophrenia Research Unit, Ingham Institute of Applied Medical Research, Sydney, Australia; the Department of Public Health Sciences, Karolinska Institute, Stockholm; the Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil; the Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; the Department of Psychiatry, University of Toronto, and the Centre for Addiction and Mental Health, Toronto; the Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; and the Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London.
Ward PB
From La Salle University, Canoas, Brazil; the School of Physical Education, Physiotherapy, and Dance and the Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; KU Leuven-University of Leuven, Department of Rehabilitation Sciences, and University Psychiatric Center, Leuven-Kortenberg, Belgium; the NICM Health Research Institute, School of Science and Health, University of Western Sydney, Sydney, Australia; the School of Psychiatry, University of New South Wales Sydney, Black Dog Institute, and Schizophrenia Research Unit, Ingham Institute of Applied Medical Research, Sydney, Australia; the Department of Public Health Sciences, Karolinska Institute, Stockholm; the Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil; the Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; the Department of Psychiatry, University of Toronto, and the Centre for Addiction and Mental Health, Toronto; the Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; and the Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London.
Silva ES
From La Salle University, Canoas, Brazil; the School of Physical Education, Physiotherapy, and Dance and the Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; KU Leuven-University of Leuven, Department of Rehabilitation Sciences, and University Psychiatric Center, Leuven-Kortenberg, Belgium; the NICM Health Research Institute, School of Science and Health, University of Western Sydney, Sydney, Australia; the School of Psychiatry, University of New South Wales Sydney, Black Dog Institute, and Schizophrenia Research Unit, Ingham Institute of Applied Medical Research, Sydney, Australia; the Department of Public Health Sciences, Karolinska Institute, Stockholm; the Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil; the Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; the Department of Psychiatry, University of Toronto, and the Centre for Addiction and Mental Health, Toronto; the Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; and the Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London.
Hallgren M
From La Salle University, Canoas, Brazil; the School of Physical Education, Physiotherapy, and Dance and the Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; KU Leuven-University of Leuven, Department of Rehabilitation Sciences, and University Psychiatric Center, Leuven-Kortenberg, Belgium; the NICM Health Research Institute, School of Science and Health, University of Western Sydney, Sydney, Australia; the School of Psychiatry, University of New South Wales Sydney, Black Dog Institute, and Schizophrenia Research Unit, Ingham Institute of Applied Medical Research, Sydney, Australia; the Department of Public Health Sciences, Karolinska Institute, Stockholm; the Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil; the Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; the Department of Psychiatry, University of Toronto, and the Centre for Addiction and Mental Health, Toronto; the Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; and the Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London.
Ponce De Leon A
From La Salle University, Canoas, Brazil; the School of Physical Education, Physiotherapy, and Dance and the Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; KU Leuven-University of Leuven, Department of Rehabilitation Sciences, and University Psychiatric Center, Leuven-Kortenberg, Belgium; the NICM Health Research Institute, School of Science and Health, University of Western Sydney, Sydney, Australia; the School of Psychiatry, University of New South Wales Sydney, Black Dog Institute, and Schizophrenia Research Unit, Ingham Institute of Applied Medical Research, Sydney, Australia; the Department of Public Health Sciences, Karolinska Institute, Stockholm; the Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil; the Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; the Department of Psychiatry, University of Toronto, and the Centre for Addiction and Mental Health, Toronto; the Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; and the Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London.
Dunn AL
From La Salle University, Canoas, Brazil; the School of Physical Education, Physiotherapy, and Dance and the Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; KU Leuven-University of Leuven, Department of Rehabilitation Sciences, and University Psychiatric Center, Leuven-Kortenberg, Belgium; the NICM Health Research Institute, School of Science and Health, University of Western Sydney, Sydney, Australia; the School of Psychiatry, University of New South Wales Sydney, Black Dog Institute, and Schizophrenia Research Unit, Ingham Institute of Applied Medical Research, Sydney, Australia; the Department of Public Health Sciences, Karolinska Institute, Stockholm; the Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil; the Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; the Department of Psychiatry, University of Toronto, and the Centre for Addiction and Mental Health, Toronto; the Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; and the Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London.
Deslandes AC
From La Salle University, Canoas, Brazil; the School of Physical Education, Physiotherapy, and Dance and the Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; KU Leuven-University of Leuven, Department of Rehabilitation Sciences, and University Psychiatric Center, Leuven-Kortenberg, Belgium; the NICM Health Research Institute, School of Science and Health, University of Western Sydney, Sydney, Australia; the School of Psychiatry, University of New South Wales Sydney, Black Dog Institute, and Schizophrenia Research Unit, Ingham Institute of Applied Medical Research, Sydney, Australia; the Department of Public Health Sciences, Karolinska Institute, Stockholm; the Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil; the Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; the Department of Psychiatry, University of Toronto, and the Centre for Addiction and Mental Health, Toronto; the Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; and the Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London.
Fleck MP
From La Salle University, Canoas, Brazil; the School of Physical Education, Physiotherapy, and Dance and the Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; KU Leuven-University of Leuven, Department of Rehabilitation Sciences, and University Psychiatric Center, Leuven-Kortenberg, Belgium; the NICM Health Research Institute, School of Science and Health, University of Western Sydney, Sydney, Australia; the School of Psychiatry, University of New South Wales Sydney, Black Dog Institute, and Schizophrenia Research Unit, Ingham Institute of Applied Medical Research, Sydney, Australia; the Department of Public Health Sciences, Karolinska Institute, Stockholm; the Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil; the Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; the Department of Psychiatry, University of Toronto, and the Centre for Addiction and Mental Health, Toronto; the Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; and the Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London.
Carvalho AF
From La Salle University, Canoas, Brazil; the School of Physical Education, Physiotherapy, and Dance and the Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; KU Leuven-University of Leuven, Department of Rehabilitation Sciences, and University Psychiatric Center, Leuven-Kortenberg, Belgium; the NICM Health Research Institute, School of Science and Health, University of Western Sydney, Sydney, Australia; the School of Psychiatry, University of New South Wales Sydney, Black Dog Institute, and Schizophrenia Research Unit, Ingham Institute of Applied Medical Research, Sydney, Australia; the Department of Public Health Sciences, Karolinska Institute, Stockholm; the Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil; the Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; the Department of Psychiatry, University of Toronto, and the Centre for Addiction and Mental Health, Toronto; the Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; and the Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London.
Stubbs B
From La Salle University, Canoas, Brazil; the School of Physical Education, Physiotherapy, and Dance and the Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; KU Leuven-University of Leuven, Department of Rehabilitation Sciences, and University Psychiatric Center, Leuven-Kortenberg, Belgium; the NICM Health Research Institute, School of Science and Health, University of Western Sydney, Sydney, Australia; the School of Psychiatry, University of New South Wales Sydney, Black Dog Institute, and Schizophrenia Research Unit, Ingham Institute of Applied Medical Research, Sydney, Australia; the Department of Public Health Sciences, Karolinska Institute, Stockholm; the Department of Epidemiology, Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil; the Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; the Department of Psychiatry, University of Toronto, and the Centre for Addiction and Mental Health, Toronto; the Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; and the Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London.

MeSH

AdultDepressionExerciseFemaleHumansIncidenceMaleOdds RatioProspective StudiesRisk

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29690792

Clinical Trial Links

Comparison of the Effects of Aerobic-Anaerobic Exercises on Hormonal and Immune Biomarkers
Moderate-to-Vigorous Intensity Physical Activity and Severe Mental Illness

Citation

Schuch, Felipe B., et al. "Physical Activity and Incident Depression: a Meta-Analysis of Prospective Cohort Studies." The American Journal of Psychiatry, vol. 175, no. 7, 2018, pp. 631-648.
Schuch FB, Vancampfort D, Firth J, et al. Physical Activity and Incident Depression: A Meta-Analysis of Prospective Cohort Studies. Am J Psychiatry. 2018;175(7):631-648.
Schuch, F. B., Vancampfort, D., Firth, J., Rosenbaum, S., Ward, P. B., Silva, E. S., Hallgren, M., Ponce De Leon, A., Dunn, A. L., Deslandes, A. C., Fleck, M. P., Carvalho, A. F., & Stubbs, B. (2018). Physical Activity and Incident Depression: A Meta-Analysis of Prospective Cohort Studies. The American Journal of Psychiatry, 175(7), 631-648. https://doi.org/10.1176/appi.ajp.2018.17111194
Schuch FB, et al. Physical Activity and Incident Depression: a Meta-Analysis of Prospective Cohort Studies. Am J Psychiatry. 2018 07 1;175(7):631-648. PubMed PMID: 29690792.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Physical Activity and Incident Depression: A Meta-Analysis of Prospective Cohort Studies. AU - Schuch,Felipe B, AU - Vancampfort,Davy, AU - Firth,Joseph, AU - Rosenbaum,Simon, AU - Ward,Philip B, AU - Silva,Edson S, AU - Hallgren,Mats, AU - Ponce De Leon,Antonio, AU - Dunn,Andrea L, AU - Deslandes,Andrea C, AU - Fleck,Marcelo P, AU - Carvalho,Andre F, AU - Stubbs,Brendon, Y1 - 2018/04/25/ PY - 2018/4/25/pubmed PY - 2019/7/10/medline PY - 2018/4/26/entrez KW - Depression KW - Exercise KW - Incidence KW - Mood Disorders-Unipolar KW - Physical Activity SP - 631 EP - 648 JF - The American journal of psychiatry JO - Am J Psychiatry VL - 175 IS - 7 N2 - OBJECTIVE: The authors examined the prospective relationship between physical activity and incident depression and explored potential moderators. METHOD: Prospective cohort studies evaluating incident depression were searched from database inception through Oct. 18, 2017, on PubMed, PsycINFO, Embase, and SPORTDiscus. Demographic and clinical data, data on physical activity and depression assessments, and odds ratios, relative risks, and hazard ratios with 95% confidence intervals were extracted. Random-effects meta-analyses were conducted, and the potential sources of heterogeneity were explored. Methodological quality was assessed using the Newcastle-Ottawa Scale. RESULTS: A total of 49 unique prospective studies (N=266,939; median proportion of males across studies, 47%) were followed up for 1,837,794 person-years. Compared with people with low levels of physical activity, those with high levels had lower odds of developing depression (adjusted odds ratio=0.83, 95% CI=0.79, 0.88; I2=0.00). Furthermore, physical activity had a protective effect against the emergence of depression in youths (adjusted odds ratio=0.90, 95% CI=0.83, 0.98), in adults (adjusted odds ratio=0.78, 95% CI=0.70, 0.87), and in elderly persons (adjusted odds ratio=0.79, 95% CI=0.72, 0.86). Protective effects against depression were found across geographical regions, with adjusted odds ratios ranging from 0.65 to 0.84 in Asia, Europe, North America, and Oceania, and against increased incidence of positive screen for depressive symptoms (adjusted odds ratio=0.84, 95% CI=0.79, 0.89) or major depression diagnosis (adjusted odds ratio=0.86, 95% CI=0.75, 0.98). No moderators were identified. Results were consistent for unadjusted odds ratios and for adjusted and unadjusted relative risks/hazard ratios. Overall study quality was moderate to high (Newcastle-Ottawa Scale score, 6.3). Although significant publication bias was found, adjusting for this did not change the magnitude of the associations. CONCLUSIONS: Available evidence supports the notion that physical activity can confer protection against the emergence of depression regardless of age and geographical region. SN - 1535-7228 UR - https://www.unboundmedicine.com/medline/citation/29690792/full_citation DB - PRIME DP - Unbound Medicine ER -
High [↓679]

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