Effects of physical exercise on depression, neuroendocrine stress hormones and physiological fitness in adolescent females with depressive symptoms
Open accessAbstract
BACKGROUND: Regular physical exercise may improve a variety of physiological and psychological factors in depressive persons. However, there is little experimental evidence to support this assumption for adolescent populations. We conducted a randomized controlled trial to investigate the effect of physical exercise on depressive state, the excretions of stress hormones and physiological fitness variables in adolescent females with depressive symptoms. METHODS: Forty-nine female volunteers (aged 18-20 years; mean 18.8 +/- 0.7 years) with mild-to-moderate depressive symptoms, as measured by the Centre for Epidemiologic Studies Depression (CES-D) scale, were randomly assigned to either an exercise regimen or usual daily activities for 8 weeks. The subjects were then crossed over to the alternate regimen for an additional 8-week period. The exercise program consisted of five 50-min sessions per week of a group jogging training at a mild intensity. The variables measured were CES-D rating scale, urinary cortisol and epinephrine levels, and cardiorespiratory factors at rest and during exercise endurance test. RESULTS: After the sessions of exercise the CES-D total depressive score showed a significant decrease, whereas no effect was observed after the period of usual daily activities (ANOVA). Twenty-four hour excretions of cortisol and epinephrine in urine were reduced due to the exercise regimen. The training group had a significantly reduced resting heart rate and increased peak oxygen uptake and lung capacity. CONCLUSIONS: The findings of this study suggest that a group jogging exercise may be effective in improving depressive state, hormonal response to stress and physiological fitness of adolescent females with depressive symptoms.
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One trial provided data in graphical form only which we were able to include after manually converting the graph into mean and SD values.
“One trial (Nabkasorn 2005) provided data in graphical form only which we were able to include after manually converting the graph into mean and SD values.”
From Exercise for depression (2009) · cites this paper as Nabkasorn 2005
The Results (page unavailable) direct readers to Figure 1 for changes in CES-D depression scores, supporting the claim that relevant outcome data were presented graphically. But the Results also give numerical baseline CES-D scores, and other outcomes appear in a table, so “data in graphical form only” is too broad. The citing authors’ manual conversion is their own action, not something this trial could document. (LLM, conf=0.82)
Experimental — accuracy not yet measuredDepressed individuals have high free-serotonin levels and low platelet-serotonin levels compared with non-depressed individuals.
“In correlation with non-depressed individuals, depressed individuals have been found to have raised plasma catecholamine levels, including norepinephrine, epinephrine, and dopamine, high free-serotonin levels and low platelet-serotonin levels; [23-26]”
From A pilot study on the effects of exercise on depression symptoms using levels of neurotransmitters and EEG as markers (2014) · cites this paper as [23]
The Outcome measurements and Results sections describe depressive-symptom scores and changes in urinary stress hormones after exercise, not free or platelet serotonin. Searches for free-serotonin, platelet-serotonin, and related plasma and platelet measures found no passage comparing depressed with non-depressed individuals on those measures. (LLM, conf=0.76)
Experimental — accuracy not yet measuredDepressed individuals have raised plasma catecholamine levels, including norepinephrine, epinephrine, and dopamine, compared with non-depressed individuals.
“In correlation with non-depressed individuals, depressed individuals have been found to have raised plasma catecholamine levels, including norepinephrine, epinephrine, and dopamine, high free-serotonin levels and low platelet-serotonin levels; [23-26]”
From A pilot study on the effects of exercise on depression symptoms using levels of neurotransmitters and EEG as markers (2014) · cites this paper as [23]
The Outcome measurements and Results sections report 24-hour urinary epinephrine in adolescent females with depressive symptoms, including a reduction after exercise. A search for plasma catecholamines, norepinephrine, dopamine, and a comparison with non-depressed individuals found no passage addressing the claimed comparison. (LLM, conf=0.74)
Experimental — accuracy not yet measuredOf the eight included studies that recruited participants on the basis of elevated symptoms of mental health disorder at baseline, five demonstrated the effect of PA/exercise interventions in reducing symptoms of depression and high substance use.
“Of the eight included studies that recruited participants on the basis of elevated symptoms of mental health disorder at baseline, five demonstrated the effect of PA/exercise interventions in reducing symptoms of depression38 39 46 47 and high substance use,49 indicating the potential of PA/exercise as an indicated or targeted prevention strategy.”
From Physical activity and exercise in youth mental health promotion: a scoping review (2020) · cites this paper as [39]
There was less support for moderate-intensity interventions in reducing depression symptoms, with only two positive studies from seven.
“There was less support for moderate-intensity interventions in reducing depression symptoms, with only two positive studies from seven39 42 and only one positive study for anxiety59 and stress59 from the four that measured these outcomes.”
From Physical activity and exercise in youth mental health promotion: a scoping review (2020) · cites this paper as [39]
Only five included studies included follow-up assessments.
“Only five studies included follow-up assessments39 42 46 50 56 and none assessed whether PA/exercise prevented the onset of future episodes of threshold mental disorder, rendering longer-term preventive effects unknown.”
From Physical activity and exercise in youth mental health promotion: a scoping review (2020) · cites this paper as [39]
Some studies have observed significant effects after aerobic training or holistic training, while others have shown non-significant changes after strength or aerobic training or holistic activities.
“Some studies have observed significant effect after aerobic training 25,26 or holistic training, 27,28 while others have shown non-significant changes after strength or aerobic training 29,30 or holistic activities.[31][32][33]”
From Can physical exercise modulate cortisol level in subjects with depression? A systematic review and meta-analysis (2018) · cites this paper as [26]
Visual analysis of the funnel plot showed asymmetry of two articles (three trials) within the studies.
“Visual analysis of the funnel plot showed asymmetry of two articles 26,29 (three trials) within the studies,”
From Can physical exercise modulate cortisol level in subjects with depression? A systematic review and meta-analysis (2018) · cites this paper as [26]
Cortisol measurement was made in saliva (n=1), urine (n=1), and plasma (n=3).
“Cortisol measurement was made in the saliva (n = 1), 25 urine (n = 1), 26 and plasma (n = 3) 29,30,39 of the participants, at different times of the day.”
From Can physical exercise modulate cortisol level in subjects with depression? A systematic review and meta-analysis (2018) · cites this paper as [26]
Two studies investigated an active control group (stretching and relaxation), while three studies investigated a non-active control group.
“For example, two studies 25,29 investigated an active control group (stretching and relaxation, respectively), while three studies 26,30,39 investigated a non-active control group.”
From Can physical exercise modulate cortisol level in subjects with depression? A systematic review and meta-analysis (2018) · cites this paper as [26]
Three different types of weekly frequencies were used: two, three and five times per week.
“For example, three different types of weekly frequencies were used: two, 29 three 25 and five times per week.26”
From Can physical exercise modulate cortisol level in subjects with depression? A systematic review and meta-analysis (2018) · cites this paper as [26]
Research in healthy or other clinical populations provides evidence that acute and regular exercise regulate or improve stress-related activation of the HPA axis, including a blunted cortisol response.
“Additional research conducted in healthy or other clinical populations provides evidence that acute and regular exercise regulate or improve one's stress-related activation of the HPA axis, including a blunted cortisol response”
From Exercise Intervention in PTSD: A Narrative Review and Rationale for Implementation (2019) · cites this paper as [115]
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- Authors
- Nabkasorn, C., Miyai, N., Sootmongkol, A., Junprasert, S., Yamamoto, H., Arita, M., & Miyashita, K.
- Affiliations
- Wakayama Medical University (JP)
- Burapha University (TH)
- Corresponding author
- Nabkasorn, Chanudda
- Venue
- European Journal of Public Health
- Publisher
- Oxford University Press (OUP)
- Published
- 2005-08-26
- Volume
- 16
- Issue
- 2
- Pages
- 179-184
- ISSN
- 1101-1262 (ISSN-L)
- 1464-360X
- OpenAlex
- W2139716393
- Cited by
- 353
- References
- 32
- Citations by year
- 2026: 10 · 2025: 15 · 2024: 13 · 2023: 16 · 2022: 21 · 2021: 13 · 2020: 30 · 2019: 14 · 2018: 22 · 2017: 29 · 2016: 21 · 2015: 26 · 2014: 19 · 2013: 17 · 2012: 12
- FWCI
- 4.81
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Journal of Public Health (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- physical activity, depression, depressive symptoms, adolescent girls, stress hormones, cortisol, epinephrine, cardiorespiratory fitness, peak oxygen uptake, resting heart rate, lung capacity, jogging, exercise intervention
- MeSH terms
- Adolescent, Depression, Female, Humans, Running, Thailand, Exercise, Outcome Assessment, Health Care
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