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Cited by 113Physical Activity and HealthMental Health Treatment and AccessAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Physical activity and depression and anxiety disorders: A systematic review of reviews and assessment of causality

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Wanjau, Mary Njeri, Möller, Holger, Haigh, Fiona, Milat, Andrew, Hayek, Rema, Lucas, Peta, Veerman, J. Lennert·2023·AJPM Focus
DOI 10.1016/j.focus.2023.100074PMC PMC10546525
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Abstract

Introduction: Globally, depressive and anxiety disorders are the leading contributors to mental ill health. Physical activity reduces symptoms of depression and anxiety and has been proposed as an adjunct treatment therapy for depression and anxiety. Prospective studies suggest that physical activity may reduce the incidence of depression and anxiety. We conducted a systematic review of reviews with the aim to provide a comprehensive overview of available epidemiologic evidence on the strength of the association between physical activity and incident cases of depression and anxiety and to assess the likelihood of these associations being causal. Methods: We searched Embase and PubMed databases for systematic reviews published between January 1, 2000 and March 19, 2020 that reported findings on the strength of association between physical activity and incidence of depression and anxiety. We updated this search to October 15, 2022. Two reviewers independently assessed the methodologic quality of the included reviews using the Assessment of Multiple Systematic Reviews rating scale. We carried out a narrative synthesis of the evidence. We used the Bradford Hill criteria to assess the likelihood of associations being causal. Results: The initial search yielded 770 articles, of which 4 remained for data extraction. Two of the included reviews were scored as high quality, and 2 were scored as low quality. From the 2 included reviews that reported pooled estimates, people with high physical activity levels were found to have a decreased risk of incident depression (adjusted RR=0.83, 95% CI=0.76, 0.90) and reduced odds of developing anxiety (adjusted OR=0.74,95% CI=0.62, 0.88) when compared with those with low physical activity levels. We assessed physical activity to be probably causally related to both depression and anxiety. Discussion: Our evidence is drawn from systematic reviews of observational data. Further high-quality studies, such as randomized control trials, would help to strengthen the evidence base of the associations between physical activity and depression and anxiety. Nonetheless, our findings provide empirical support for the consideration of physical activity in strategies for the prevention of mental ill health.

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  • Regular PA is associated with higher PWB levels.

    “Findings from this study support earlier studies indicating that regular PA is associated with higher PWB levels [16,43].”

    From Relationships Between Physical Activity, Sleep, Psychological Well-Being, and Academic Performance Among Native American College Students (2026) · cites this paper as [16]

    The Results (Review Findings; page unavailable) associate higher physical activity with lower subsequent risks of depression and anxiety. The paper does not establish higher psychological well-being (PWB) levels, a broader positive outcome, and its Limitations note that most studies measured activity only at baseline rather than tracking regular activity. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Lifestyle factors such as physical activity and sleep duration may play an important role in shaping psychological well-being.

    “Lifestyle factors, such as physical activity (PA) and sleep duration, may play an important role in shaping psychological well-being (PWB) [13,14,15,16].”

    From Relationships Between Physical Activity, Sleep, Psychological Well-Being, and Academic Performance Among Native American College Students (2026) · cites this paper as [16]

    The Introduction and Discussion (page numbers unavailable) support a role for physical activity in mental health, particularly depression and anxiety. Our copy does not report findings on sleep duration or its relationship to psychological well-being, so it supports only the physical-activity part of the sentence. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

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Research works printed but not linked: 2

  1. [29]Rothman KJ Greenland S Lash TL Modern Epidemiology, 3/e (paperback) 2008 Lippincott Philadelphia, PA https://books.google.com.au/books?id=Bt7puQEACAAJ
  2. [32]Covidence Systematic Review Software. Veritas Health Innovation. www.covidence.org.

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Authors
Wanjau, M. N., Möller, H., Haigh, F., Milat, A., Hayek, R., Lucas, P., & Veerman, J. L.
Affiliations
  • Griffith University (AU)
  • UNSW Sydney (AU)
  • The University of Sydney (AU)
  • New South Wales Department of Health (AU)
ORCID
Venue
AJPM Focus
Publisher
Elsevier BV
Published
2023-06
Volume
2
Issue
2
Pages
100074
ISSN
2773-0654 (ISSN-L)
DOI
10.1016/j.focus.2023.100074
PMC
PMC10546525
OpenAlex
W4319065961
Cited by
111
References
45
Citations by year
2026: 40 · 2025: 43 · 2024: 19 · 2023: 8 · 2022: 1
FWCI
3.92
Type
journal article
Language
en
Open access
Licence
Locations
  • AJPM Focus (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Griffith Research Online (submittedVersion, cc-by-nc-nd)
Funders
  • Griffith University
  • NSW Ministry of Health
Topics
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
physical activity, depression, anxiety disorders, depression incidence, causal inference, Bradford Hill criteria, mental illness prevention, methodological quality of systematic reviews

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