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Cited by 997Physical Activity and HealthTreatment of Major DepressionAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials

Open access
Lawlor, Debbie A, Hopker, Stephen W·2001·BMJ
DOI 10.1136/bmj.322.7289.763PMC PMC30551
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Abstract

Objective: To determine the effectiveness of exercise as an intervention in the management of depression. Design: Systematic review and meta-regression analysis of randomised controlled trials obtained from five electronic databases (Medline, Embase, Sports Discus, PsycLIT, Cochrane Library) and through contact with experts in the field, bibliographic searches, and hand searches of recent copies of relevant journals. Main outcome measures: Standardised mean difference in effect size and weighted mean difference in Beck depression inventory score between exercise and no treatment and between exercise and cognitive therapy. Results: All of the 14 studies analysed had important methodological weaknesses; randomisation was adequately concealed in only three studies, intention to treat analysis was undertaken in only two, and assessment of outcome was blinded in only one. The participants in most studies were community volunteers, and diagnosis was determined by their score on the Beck depression inventory. When compared with no treatment, exercise reduced symptoms of depression (standardised mean difference in effect size −1.1 (95% confidence interval −1.5 to −0.6); weighted mean difference in Beck depression inventory −7.3 (−10.0 to −4.6)). The effect size was significantly greater in those trials with shorter follow up and in two trials reported only as conference abstracts. The effect of exercise was similar to that of cognitive therapy (standardised mean difference −0.3 (95% confidence interval −0.7 to 0.1)). Conclusions: The effectiveness of exercise in reducing symptoms of depression cannot be determined because of a lack of good quality research on clinical populations with adequate follow up. What is already known on this topic: Depression is common Management is often inadequate and many patients do not comply with antidepressant medication The effect of exercise on depression has been a subject of interest for many years What this study adds: Most studies of the effect of exercise on depression are of poor quality, have brief follow up, and are undertaken on non-clinical volunteers Exercise may be efficacious in reducing symptoms of depression in the short term but its effectiveness in clinical populations is unknown A well designed, randomised controlled trial with long term follow up is needed

AI snapshot

Written from the paper’s full text.

TL;DR

This systematic review and meta-regression of 14 randomised controlled trials found that exercise reduced depressive symptoms compared with no treatment, but the evidence base was methodologically weak. The authors conclude that the effectiveness of exercise in managing depression cannot be determined because of a lack of good-quality research in clinical populations with adequate follow-up.

Key findings

  • Across 14 included studies, most had important methodological weaknesses: allocation concealment was adequate in only 3 studies, intention-to-treat analysis was done in only 2, and outcome assessment was blinded in only 1.
  • Exercise compared with no treatment reduced depressive symptoms: standardised mean difference in effect size −1.1 (95% CI −1.5 to −0.6); weighted mean difference in Beck depression inventory −7.3 (95% CI −10.0 to −4.6).
  • The effect was significantly greater in trials with shorter follow-up and in two trials reported only as conference abstracts; pooled SMD was −0.7 (−1.0 to −0.5; n=8) for journal papers/dissertations versus −2.3 (−2.9 to −1.8; n=2) for conference abstracts.
  • Exercise was similar to cognitive therapy: standardised mean difference −0.3 (95% CI −0.7 to 0.1), with homogeneous results (Q=2.9, P=0.4).

Methods

  • Systematic review and meta-regression of randomised controlled trials identified from Medline, Embase, Sports Discus, PsycLIT, Cochrane Library, plus expert contact, bibliographic searches, and hand searches.
  • Inclusion criteria: adults aged 18 or above diagnosed with depression by any method/severity, randomised controlled trial, depression as an outcome, any language; exclusions included studies comparing different exercise types, single exercise sessions, and anxiety/other neurotic disorders.
  • From 72 potentially relevant studies, 56 were excluded and 14 studies (16 reports) were included; analyses used Cohen’s effect sizes and standardised mean differences, with random-effects meta-analysis for exercise versus no treatment and fixed-effects inverse-variance meta-analysis for exercise versus cognitive therapy.

Limitations

  • The paper states that most studies were of poor quality, with inadequate allocation concealment, intention-to-treat analysis, and blinding; participants in most studies were community volunteers, and diagnosis was often determined by Beck depression inventory score rather than clinical interview.
  • The paper states that only one study followed patients beyond the intervention period, and that the evidence does not support a sustained effect of exercise beyond the intervention period; it concludes that effectiveness in clinical populations is unknown.
  • The paper also notes that screening out unmotivated individuals, using non-clinical volunteers, and lacking intention-to-treat analysis suggest the results overestimate what would happen in real life; evident from the text are the small number of trials, heterogeneity, and the influence of conference abstracts and short follow-up on effect size.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1136/bmj.322.7289.763

Cites

89 of 89 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

5 of 37 cited sources checked · 1 supported · 0 flagged · accuracy not yet measured

  • Findingown data

    Randomisation was adequately concealed in only three of the 14 included studies.

    “randomisation was adequately concealed in only three studies”
    • Also stated in: § Quality assessment · hedged
      “allocation might have been adequately concealed in only three studies. 74 75 82”
    Quote in the paperNot a substantial claim2 of 3 sources checked
    • cites [74] Singh, 1997, A randomized controlled trial of progressive resistance training in depressed elders., J Gerontol A Biol Sci Med Sci source

      The Study design section describes randomization in this single trial using a computer-generated list, but does not assess whether allocation was adequately concealed. Searches for the three-of-14-studies claim and for allocation concealment found no passage assessing concealment across included studies. Page numbers were not available in our copy. (LLM, conf=0.76)

      Experimental — accuracy not yet measured
    • cites [75] source
    • cites [82] Martinsen, 1985, Effects of aerobic exercise on depression: a controlled study., BMJ source

      The Patients, methods, and results section describes one trial and says its patients were allocated by block randomisation. It does not assess whether allocation was concealed or report a finding about three of 14 studies. Searches for adequate concealment and 14 included studies found no such passage in our copy. (LLM, conf=0.78)

      Experimental — accuracy not yet measured
  • Findingcitation

    Intention to treat analysis was undertaken in only two of the 14 included studies.

    “intention to treat analysis was undertaken in only two”
    • Also stated in: § Quality assessment · plain
      “Intention to treat analysis was undertaken in two studies.73 74”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites [73] source
    • cites [74] Singh, 1997, A randomized controlled trial of progressive resistance training in depressed elders., J Gerontol A Biol Sci Med Sci source

      The Statistical analysis section describes the trial’s analyses but does not identify them as intention-to-treat. The Results section says all randomized subjects completed the study, but that does not establish whether an intention-to-treat analysis was undertaken. This individual trial also does not address the claim that only two of 14 included studies used that approach; searches for intention-to-treat analysis and all-randomized-subject analyses found no confirming passage. Page numbers are unavailable in our copy. (LLM, conf=0.75)

      Experimental — accuracy not yet measured
  • Premisecitation

    Compliance with antidepressant treatment is often poor: between 20% and 59% of patients in primary care stop taking antidepressants within three weeks of the drugs being prescribed.

    “Compliance with antidepressant treatment is often poor: studies have shown that between 20% and 59% of patients in primary care stop taking antidepressants within three weeks of the drugs being prescribed. 1 2”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites [1] Thompson, 1982, The treatment of depression in general practice: a comparison of L-tryptophan, amitriptyline and a combination of L-tryptophan and amitriptyline with placebo., Psychol Med source
    • cites [2] Johnson, 1973, Treatment of depression in general practice., BMJ source

      The Results (Drug Treatment) report that 59% of patients stopped taking their drugs within 21 days, supporting the upper end of the cited range and the three-week timeframe. This paper does not report that 20% stopped within three weeks, so it does not establish the full range attributed to the two citations. (LLM, conf=0.87)

      Experimental — accuracy not yet measured
  • Findingown data

    Compared with no treatment, exercise reduced symptoms of depression (standardised mean difference in effect size -1.1, 95% confidence interval -1.5 to -0.6).

    “When compared with no treatment, exercise reduced symptoms of depression (standardised mean difference in effect size -1.1 (95% confidence interval -1.5 to -0.6)”
    • Also stated in: § Study populations · plain
      “The pooled standardised mean difference in effect size, calculated using the random effects model, was -1.1 (95% confidence interval -1.5 to -0.6).”
    Quote in the paperSubstantial claim
  • Findingown data

    The effect size of exercise compared with no treatment was significantly greater in trials reported only as conference abstracts.

    “and in two trials reported only as conference abstracts”
    • Also stated in: § Study populations · plain
      “The reported effect of treatment was significantly higher in conference abstracts than in peer reviewed journals or doctoral dissertations (P < 0.01).”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. 16
  • May combine two claims. 17
  • The quote only partly states this claim. 1

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    One of the studies in which depression was confirmed by clinical interview also included patients with dysthymia.

    “One of the studies in which depression was confirmed by clinical interview also included patients with dysthymia (depressed mood, without the full range of symptoms of clinical depression).74”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [74] Singh, 1997, A randomized controlled trial of progressive resistance training in depressed elders., J Gerontol A Biol Sci Med Sci source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Participants in most included studies were community volunteers.

    “The participants in most studies were community volunteers”
    • Also stated in: § Study populations · plain
      “Nine of the studies involved non-clinical populations, 73 74 77 79-81 84 85 87and most participants were recruited through the media.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Diagnosis of depression in most included studies was determined by participants' score on the Beck depression inventory.

    “diagnosis was determined by their score on the Beck depression inventory”
    • Also stated in: § Study populations · plain
      “the remainder using a cut-off point on the self reported Beck depression inventory score”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Eight of the 14 studies compared an exercise group with a no treatment group, and six compared exercise directly with an established form of therapy: four with cognitive therapy, one with psychotherapy, and one with antidepressant treatment.

    “Eight of the 14 studies compared an exercise group with a no treatment group, 74 75 77-79 82 and six compared exercise directly with an established form of therapy: four with cognitive therapy, 80 81 84 87 one with psychotherapy, 88 and one with antidepressant treatment.73”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Through contact with authors we were able to obtain adequate data for a further five studies.

    “Through contact with authors we were able to obtain adequate data for a further five.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Although the effect size remained significant when the two conference abstracts were excluded and when only studies of more than eight weeks' duration were analysed, the effect was reduced.

    “Although the effect size remained significant when the two conference abstracts were excluded and when we analysed only those studies of more than eight weeks' duration, the effect was reduced.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Of 72 potentially relevant studies, 56 were excluded.

    “Of 72 potentially relevant studies, we excluded 56”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Authors of 11 of the 14 studies responded to our request to provide missing data.

    “Authors of 11 of the 14 studies responded to our request to provide missing data, 73-78 80 82-86 88”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    In the one study comparing exercise and standard antidepressant treatment, the Hamilton rating scale of depression did not differ significantly between the exercise, medication, or both groups; and at the end of the intervention period the proportion of patients diagnosed as no longer depressed was similar in each group.

    “Its main outcome measure -the Hamilton rating scale of depression-did not differ significantly between the groups of patients receiving the exercise intervention, medication, or both; and at the end of the intervention period the proportion of patients diagnosed as no longer depressed was similar in each group.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [73] source

  • May combine two claims.

    Findingcitation

    The only study that followed patients beyond the intervention found no effect of exercise compared with control at the end of the intervention (12 weeks); at nine months' follow up the reduction in symptoms remained similar in the exercise, control (meditation), and cognitive therapy groups.

    “This was the only study that found no effect of exercise, compared with the control group, at the end of the intervention period (12 weeks); at nine months' follow up the reduction in symptoms remained similar in the exercise intervention, control (meditation), and cognitive therapy groups.84”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [84] Klein, 1985, A comparative outcome study of group psychotherapy vs. exercise treatments for depression., Int J Ment Health source

  • May combine two claims.

    Findingown data

    Pooling studies according to type of publication gave standardised mean differences of -0.7 for journal papers and dissertations and -2.3 for conference abstracts.

    “Pooling studies according to type of publication gave standardised mean differences, calculated using the fixed effects model, of -0.7 (-1.0 to -0.5; n = 8) for journal papers and dissertations and -2.3 (-2.9 to -1.8; n = 2) for conference abstracts”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingcitation

    Only four of the nine studies with non-clinical participants used clinical interview to confirm the presence of depression; the remainder used a cut-off point on the self reported Beck depression inventory score.

    “Only four of the nine studies with non-clinical participants used clinical interview to confirm the presence of depression, 73 74 79 84 the remainder using a cut-off point on the self reported Beck depression inventory score (each study using a different value).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    None of the participants in the reviewed studies exercised alone; they exercised either with other participants or with a coach.

    “None of the participants in the studies we reviewed exercised alone: they were either with other participants or with a coach.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingnone given

    Table 1 summarises the 11 studies that compared exercise with no treatment, 10 of which had data available for analysis.

    “Table 1 summarises the 11 studies that compared exercise with no treatment, 10 of which had data available for analysis.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingreasoning

    In total 11 studies compared exercise with no treatment and six compared it with an established treatment.

    “thus in total 11 studies compared exercise with no treatment and six compared it with an established treatment (fig 1).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Pooling studies according to duration of intervention gave standardised mean differences of -1.8 for less than eight weeks, -1.3 for eight weeks, and -0.6 for more than eight weeks.

    “pooling according to duration of intervention gave -1.8 (-2.3 to -1.3; n = 2) for less than eight weeks, -1.3 (-1.8 to -0.9; n = 4) for eight weeks, and -0.6 (-0.9 to -0.3; n = 4) for more than eight weeks”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims. The quote only partly states this claim.

    Findingown data

    Table 2 summarises the six studies that compared exercise and standard interventions, four of which compared exercise and cognitive therapy.

    “Table 2 summarises the six studies that compared exercise and standard interventions, four of which”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Most studies used non-clinical participants, so the results may be less generalisable.

    “However, the fact that most studies used non-clinical participants means that the results may be less generalisable.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Three people independently reviewed titles and available abstracts to retrieve potentially relevant studies.

    “Three people independently reviewed titles and available abstracts to retrieve potentially relevant studies; studies needed to be identified by only one person to be retrieved.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Previous meta-analyses pooled data from a range of study types including uncontrolled studies and randomised as well as non-randomised controlled trials; pooled exercise versus no treatment with exercise versus other treatments; and did not explicitly assess study quality.

    “However, these analyses pooled data from a range of study types that included uncontrolled studies and randomised as well as non-randomised controlled trials.They also pooled data from trials that compared exercise and no treatment with data from trials that compared exercise and other forms of treatment, and they did not explicitly assess the quality of the studies.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [9] North, 1990, Effect of exercise on depression., Exerc Sports Sci Rev source
    • cites [10] Carlson DL .The effects of exercise on depression: a review and meta-regression analysis [dissertation]. In: Milwaukee:University of Wisconsin,1991.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [11] Craft, 1998, The effects of exercise on clinical depression and depression resulting from mental illness: a meta-regression analysis., J Sport Exerc Psychol source

  • May combine two claims.

    Premisecitation

    Three meta-analyses have looked at the effect of exercise on depression, and all found a benefit.

    “Three meta-analyses have looked at the effect of exercise on depression, and all found a benefit.[9][10][11]”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [9] North, 1990, Effect of exercise on depression., Exerc Sports Sci Rev source
    • cites [10] Carlson DL .The effects of exercise on depression: a review and meta-regression analysis [dissertation]. In: Milwaukee:University of Wisconsin,1991.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [11] Craft, 1998, The effects of exercise on clinical depression and depression resulting from mental illness: a meta-regression analysis., J Sport Exerc Psychol source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    'Exercise on prescription' schemes have become popular in primary care in the United Kingdom, and many include depression as a referral criterion.

    “In the past decade”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4] Biddle S Fox K Edmund L .Physical activity in primary care in England. London:Health Education Authority,1994.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    McNeil et al included a social contact control group and found no significant difference in the effect on depressive symptoms between this group and the exercise group.

    “McNeil et al included a social contact control group and found no significant difference in the effect on depressive symptoms between this group and the exercise group.77”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [77] source

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationcitation

    Other health benefits could accrue to patients who do become more active.

    “Other health benefits could accrue to patients who do become more active.92 93”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [92] source
    • cites [93] Berlin, 1990, A meta-regression analysis of physical activity in the prevention of coronary heart disease., Am J Epidemiol source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    The effect of exercise may be due to psychosocial factors, such as learning a new skill or socialising, rather than to the exercise itself.

    “However, this may be because the effect is due to psychosocial factors, such as learning a new skill or socialising, rather than to the exercise itself.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    We used a random effects model based on DerSimonian and Laird's method to calculate the pooled effect size for studies comparing exercise with no treatment.

    “for these we used a random effects model based on DerSimonian and Laird's method to calculate the pooled effect size.15”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [15] source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The two authors independently extracted data using a structured form.

    “The two authors independently extracted data (the quality criteria, participant details, intervention details, outcome measures, baseline and post-intervention results, and main conclusions), using a structured form.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    The size of the effect is increased by results from two unpublished conference abstracts and studies with a shorter follow up period, suggesting that results may be sustained only in the short term.

    “The size of the effect is increased by results from two unpublished conference abstracts and studies with a shorter follow up period, suggesting that results may be sustained only in the short term.”
    Quote in the paperSubstantial claim
28 of 28

  • The authors state this as an assumption.

    Compliance among patients with depression in exercise-on-prescription schemes would be similar to or worse than the 20-50% compliance observed among patients with any referral criteria.

    “It is reasonable to assume that compliance among patients with depression would be similar or worse.”

  • The paper relies on this without support.

    Other studies on exercise and depression have been completed since the most recent previous meta-analysis was published.

    “Other studies have been completed since the most recent of these meta-analyses was published.”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Two meta-analyses which included assessments of study quality both cautiously concluded that exercise may be effective, but recommended that further well-designed trials are required.

    “Two meta-analyses which included assessments of study quality both cautiously concluded that exercise may be effective, but recommended that further welldesigned trials are required (Sjosten 2006;Lawlor 2001).”

    From Exercise for depression (2009) · cites this paper as Lawlor 2001

  • A total of 28 trials fulfilled the criteria, of which 14 had already been identified in 2001.

    “A total of 28 trials fulfilled our criteria, of which 14 had already been identified in 2001 (Lawlor 2001).”

    From Exercise for depression (2009) · cites this paper as Lawlor 2001

  • The literature was systematically searched in 2001 and extensively in 2007, including electronic searches, hand-searching, contact with authors, reference lists, citation searches, and controlled-trials.com.

    “The literature was systematically searched in 2001 (Lawlor 2001).”

    From Exercise for depression (2009) · cites this paper as Lawlor 2001

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Reuter is classified as a conference abstract but cited as a dissertation

    Minor

    Table 1 calls the Reuter report a conference abstract, while reference 86 identifies it as a dissertation. This also conflicts with the statement that both trials in the conference-abstract subgroup were reported only as abstracts.

  • Reuter intervention duration is listed as both eight and ten weeks

    Minor

    Figure 2 labels Reuter as an eight-week intervention, whereas table 1 gives its intervention duration as ten weeks. The table separately says its outcome was measured at eight weeks, which does not resolve the conflicting intervention-duration labels.

2 of 2

Cites

Flagged first, then by citations

Research works printed but not linked: 13

  1. Scott, 1960, The contributions of physical activity to psychological development., Res Q, 31, 307
  2. Carlson DL .The effects of exercise on depression: a review and meta-regression analysis [dissertation]. In: Milwaukee:University of Wisconsin,1991.
  3. Antonelli, 1982, Sport and depression therapy., Int J Sport Psychol, 13, 187
  4. Martinsen EW .Exercise intervention studies in patients with anxiety and depressive disorders [abstract]. In: Proceedings of sport, health psychology and exercise symposium. London:Sports Council and Health Education Authority,1988:77–83.
  5. Pezzarossa, 1991, Physical activity and psychopathological variables., Analytic Psychother Psychopathology, 10, 163
  6. D'Amato G .The relative efficacy of structured reminiscence and physical exercise on clinically depressed geriatric inpatients [dissertation]. In: Hempstead, NY:Hofstra University,1990.
  7. Giardinelli, 1996, Depression and psychomotor retardation: exercise intervention combined with a pharmacological treatment of inpatients., Minerva Psichiatr, 37, 179
  8. Bosscher, 1993, Running and mixed physical exercises with depressed psychiatric patients., Int J Sport Psychol, 24, 170
  9. Martinsen EW .Comparing aerobic and non-aerobic forms of exercise in the treatment of clinical depression: a randomised trial [abstract]. In: Proceedings of sport, health psychology and exercise symposium.London:Sports Council and Health Education Authority,1988:84–95.
  10. Veale D Le Fevre K .Aerobic exercise in the adjunctive treatment of depression: a randomised controlled trial [abstract]. In: Proceedings of sport, health psychology and exercise symposium.London:Sports Council and Health Education Authority,1988:106–111.
  11. Mutrie N .Exercise as a treatment for moderate depression in the UK National Health Service[abstract]. In: Proceedings of sport, health psychology and exercise symposium.London:Sports Council and Health Education Authority,1988:96–105.
  12. Epstein D .Aerobic activity versus group cognitive therapy: an evaluative study of contrasting interventions for the alleviation of clinical depression [dissertation]. In: Reno:University of Nevada,1986.
  13. Reuter M Mutrie N Harris DV .Running as an adjunct to counseling in the treatment of depression [dissertation]. In: Pennsylvania:Pennsylvania State University,1984.

Cited by

Sorted by citations

Related

Authors
Lawlor, D. A., & Hopker, S. W.
Affiliations
University of Bristol (GB)
Corresponding author
Lawlor, Debbie A
ORCID
Lawlor, Debbie A
Venue
BMJ
Publisher
BMJ
Published
2001-03-31
Volume
322
Issue
7289
Pages
763
ISSN
  • 0007-1447 (ISSN-L)
  • 0959-8138
  • 1468-5833
DOI
10.1136/bmj.322.7289.763
PMC
PMC30551
OpenAlex
W2111373412
Cited by
995
References
88
Citations by year
2026: 6 · 2025: 8 · 2024: 19 · 2023: 20 · 2022: 16 · 2021: 28 · 2020: 31 · 2019: 34 · 2018: 35 · 2017: 40 · 2016: 45 · 2015: 46 · 2014: 44 · 2013: 68 · 2012: 61
FWCI
1.72
Type
journal article
Language
en
Open access
Licence
www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
Locations
  • BMJ (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (submittedVersion)
  • PubMed Central (submittedVersion)
  • HighWire Press Open Archive (submittedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
physical activity, depression, depression treatment, exercise therapy, cognitive therapy, treatment efficacy, methodological quality of trials, follow-up duration
MeSH terms
Data Collection, Depressive Disorder, Exercise Therapy, Humans, Randomized Controlled Trials as Topic, Treatment Outcome

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