The DOI matches its Crossref record; 88 of the 88 references it cites were found in a registry or an index; 5 of the 37 sources its claims cite were checked for support.
The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials
Open accessAbstract
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
Overview
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.
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Verification
Claims the paper makes
30 Own result · 11 Own interpretation · 8 No full text of the sources · 7 Not checked yet · 6 No basis given · 2 Couldn’t confirm · 2 Sources not found · 2 Own method · 1 Supported · 1 Partly supported · accuracy not yet measured
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“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”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Abstract
What the sources say
- Could not verifycites [74] Singh, 1997, A randomized controlled trial of progressive resistance training in depressed elders., J Gerontol A Biol Sci Med Sci sourceExperimental — accuracy not yet measured
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)
- Not checked — no full text of the sourcecites [75] source
- Could not verifycites [82] Martinsen, 1985, Effects of aerobic exercise on depression: a controlled study., BMJ sourceExperimental — accuracy not yet measured
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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Quality assessment · hedged
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“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”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Abstract
What the sources say
- Not checked — no full text of the sourcecites [73] source
- Could not verifycites [74] Singh, 1997, A randomized controlled trial of progressive resistance training in depressed elders., J Gerontol A Biol Sci Med Sci sourceExperimental — accuracy not yet measured
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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Quality assessment · plain
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“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”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Introduction
What the sources say
- Not checked — no full text of the sourcecites [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
- Partly supportedcites [2] Johnson, 1973, Treatment of depression in general practice., BMJ sourceExperimental — accuracy not yet measured
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)
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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).”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Abstract
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Study populations · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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).”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Study populations · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“All of the 14 studies analysed had important methodological weaknesses”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Abstract
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The effect size was significantly greater in those trials with shorter follow up”
- Also stated in: § Study populations · plain
“Length of follow up was significantly negatively associated with the size of effect”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Study populations · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The effect of exercise was similar to that of cognitive therapy (standardised mean difference -0.3 (95% confidence interval -0.7 to 0.1))”
- Also stated in: § Exercise compared with standard treatments for depression · plain
“the difference in effect size between exercise and cognitive therapy was not significant (standardised mean difference -0.3 (95% confidence interval -0.7 to 0.1)).”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Abstract
plainn = 4- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Exercise compared with standard treatments for depression · plain
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“assessment of outcome was blinded in only one”
- Also stated in: § Quality assessment · plain
“assessment of outcome was blind in only one of the 14 studies.”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Abstract
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Quality assessment · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“weighted mean difference in Beck depression inventory -7.3 (-10.0 to -4.6)”
- Also stated in: § Study populations · plain
“Pooling the nine studies that used the Beck depression inventory as a measure of depression gave a weighted mean difference in the score of -7.3 (-10.0 to -4.6).”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Abstract
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Study populations · plain
- Probably not a substantial claim. 16
- It may state two separate claims as one. 17
- The quote only partly states this claim. 1
Every source the paper cites for this claim was checked and supports it.
In the paper
“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”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Study populations
What the sources say
- Supportedcites [74] Singh, 1997, A randomized controlled trial of progressive resistance training in depressed elders., J Gerontol A Biol Sci Med Sci source
The Study population section states that eligible participants could meet DSM-IV criteria for dysthymia. The measures section states that psychiatric diagnoses were assessed by structured clinician interview, supporting both parts of the cited claim. (LLM, conf=0.93)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Supported
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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.”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Abstract
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Also stated in: § Study populations · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Abstract
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Also stated in: § Study populations · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Study inclusion and characteristics
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Through contact with authors we were able to obtain adequate data for a further five.”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Missing data and contact with authors
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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.”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Study populations
plaindirectn = 8- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Of 72 potentially relevant studies, we excluded 56”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Study inclusion and characteristics
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Authors of 11 of the 14 studies responded to our request to provide missing data, 73-78 80 82-86 88”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Missing data and contact with authors
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“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.”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Exercise compared with standard treatments for depression
What the sources say
- Not checked — no full text of the sourcecites [73] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“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”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Quality of the studies
What the sources say
- Not checked — no full text of the sourcecites [84] Klein, 1985, A comparative outcome study of group psychotherapy vs. exercise treatments for depression., Int J Ment Health source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Study populations
plaincorrelationaln = 8- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“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).”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Study populations
plainn = 9- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“None of the participants in the studies we reviewed exercised alone: they were either with other participants or with a coach.”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Type of exercise
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Table 1 summarises the 11 studies that compared exercise with no treatment, 10 of which had data available for analysis.”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Study populations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“thus in total 11 studies compared exercise with no treatment and six compared it with an established treatment (fig 1).”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Study inclusion and characteristics
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Study populations
plaincorrelationaln = 4- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Table 2 summarises the six studies that compared exercise and standard interventions, four of which”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Exercise compared with standard treatments for depression
plainn = 6- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one. The quote only partly states this claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, the fact that most studies used non-clinical participants means that the results may be less generalisable.”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Implications
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“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.”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > JAMA, Archives of Internal Medicine, New England Journal of Medicine, Journal of the Royal Society of Medicine, Comprehensive Psychiatry, British Journal of Psychiatry, Acta
plainn = 3- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“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.”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Introduction
What the sources say
- Not checked — no full text of the sourcecites [9] North, 1990, Effect of exercise on depression., Exerc Sports Sci Rev source
- Not matchedcites [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.
- Not checked — no full text of the sourcecites [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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Three meta-analyses have looked at the effect of exercise on depression, and all found a benefit.[9][10][11]”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Introduction
What the sources say
- Not checked — no full text of the sourcecites [9] North, 1990, Effect of exercise on depression., Exerc Sports Sci Rev source
- Not matchedcites [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.
- Not checked — no full text of the sourcecites [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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In the past decade”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Introduction
What the sources say
- Not matchedcites [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.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Not matched
In the paper
“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”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Type of exercise
What the sources say
- Not checked — no full text of the sourcecites [77] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Other health benefits could accrue to patients who do become more active.92 93”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Implications
What the sources say
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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.”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Type of exercise
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“for these we used a random effects model based on DerSimonian and Laird's method to calculate the pooled effect size.15”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Statistical analysis
What the sources say
- Not checked — no full text of the sourcecites [15] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“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.”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Data extraction
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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 effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Quality of the studies
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
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.”
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?
The cited source says what the claim attributes to it.
In the citing paper
“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
The cited source says what the claim attributes to it.
In the citing paper
“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 cited source says what the claim attributes to it.
In the citing paper
“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.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > What this study adds
“| Reuter et al, | Conference | 18 | University students | N/A | N/A | 1. Counselling plus | 10 | Mean difference in BDI | No | No | No |”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > References
“86. Reuter M, Mutrie N, Harris DV. Running as an adjunct to counseling in the treatment of depression [dissertation]. Pennsylvania: Pennsylvania State University, 1984.”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > Implications
“Reuter et al 86 (8)”
§ The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials > What this study adds
“| Reuter et al, | Conference | 18 | University students | N/A | N/A | 1. Counselling plus | 10 | Mean difference in BDI | No | No | No |”
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Cited by
Sorted by citations
Child abuse: Adolescent records vs. adult recall
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Twohig-Bennett, C., & Jones, A. (2018) · Environmental Research · doi:10.1016/j.envres.2018.06.030 · Cited by 1,766
“Putting aside the health benefits of physical activity, which have been widely documented (Bize et al., 2007; Janssen and LeBlanc, 2010; Lawlor and Hopker, 2001; Penedo and Dahn, 2005; Warburton et al., 2006), the associations between greenspace and health found in this study suggests that “green exercise” may have ad…”
BackgroundPhysical Activity and Mental Health: Current Concepts
Paluska, S. A., & Schwenk, T. L. (2000) · Sports Medicine · doi:10.2165/00007256-200029030-00003 · Cited by 1,722
The health benefits of urban green spaces: a review of the evidence
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“8–15 It also improves mental functioning, mental health and well-being 16–22 and may have long-lasting psychological benefits.”
BackgroundEvidence for prescribing exercise as therapy in chronic disease
Pedersen, B. K., & Saltin, B. (2006) · Scandinavian Journal of Medicine & Science in Sports · doi:10.1111/j.1600-0838.2006.00520.x · Cited by 1,384
“The effect of exercise was similar to that of cognitive therapy (Lawlor & Hopker, 2001).”
ResultRebar, A. L., Stanton, R., Geard, D., Short, C., Duncan, M. J., & Vandelanotte, C. (2015) · Health Psychology Review · doi:10.1080/17437199.2015.1022901 · Cited by 1,323
“…activity has moderate-to-strong anti-depressive effects (Cooney et al., 2013; Josefsson, Lindwall, & Archer, 2013; Krogh, Nordentoft, Sterne, & Lawlor, 2011; Lawlor & Hopker, 2001; Rethorst, Wipfli, & Landers, 2009; Rimer et al., 2012; Rosenbaum, Tiedemann, Sherrington, Curtis, & Ward, 2014).”
BackgroundResultThe significance of parks to physical activity and public health
Rung, A. L., Mowen, A. J., & Cohen, D. A. (2005) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2004.10.024 · Cited by 1,372
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Higgins, J. P. T., & Thompson, S. G. (2004) · Statistics in Medicine · doi:10.1002/sim.1752 · Cited by 1,267
Physical activity, exercise, depression and anxiety disorders
Ströhle, A. (2009) · Journal of Neural Transmission · doi:10.1007/s00702-008-0092-x · Cited by 1,269
“However, these studies suffered from a variety of methodological flaws (Lawlor and Hopker 2001) and may have dampened the enthusiasm towards implementing exercise training in the routine care and treatment.”
BackgroundThe epidemiology, pathophysiology, and management of psychosocial risk factors in cardiac practice
Rozanski, A., Blumenthal, J. A., Davidson, K. W., Saab, P. G., & Kubzansky, L. (2005) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2004.12.005 · Cited by 1,238
“The ability of xercise to reduce depression also has been demonstrated in andomized controlled trials, although many of these studies ave had methodologic limitations (90).”
BackgroundThe Psychobiology of Depression and Resilience to Stress: Implications for Prevention and Treatment
Southwick, S. M., Vythilingam, M., & Charney, D. S. (2005) · Annual Review of Clinical Psychology · doi:10.1146/annurev.clinpsy.1.102803.143948 · Cited by 1,160
Singh, B., Olds, T., Curtis, R., Dumuid, D., Virgara, R., Watson, A., Szeto, K., O'Connor, E., Ferguson, T., Eglitis, E., et al. (2023) · British Journal of Sports Medicine · doi:10.1136/bjsports-2022-106195 · Cited by 1,049
Cooney, G. M., Dwan, K., Greig, C. A., Lawlor, D. A., Rimer, J., Waugh, F. R., McMurdo, M., & Mead, G. E. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004366.pub6 · Cited by 1,834
Self-citationExercise and Pharmacotherapy in the Treatment of Major Depressive Disorder
Blumenthal, J. A., Babyak, M. A., Doraiswamy, P. M., Watkins, L., Hoffman, B. M., Barbour, K. A., Herman, S., Craighead, W. E., Brosse, A. L., Waugh, R., et al. (2007) · Psychosomatic Medicine · doi:10.1097/psy.0b013e318148c19a · Cited by 1,019
Dishman, R. K., Berthoud, H., Booth, F. W., Cotman, C. W., Edgerton, V. R., Fleshner, M. R., Gandevia, S. C., Gomez‐Pinilla, F., Greenwood, B. N., Hillman, C. H., et al. (2006) · Obesity · doi:10.1038/oby.2006.46 · Cited by 958
Exercise for the Treatment of Depression
Knapen, J., Vancampfort, D., Schoubs, B., Probst, M.-T., Sienaert, P. A., Haake, P., Peuskens, J., & Pieters, G. (2009) · The Open Complementary Medicine Journal · doi:10.2174/1876391x00901010078 · Cited by 912
Anderson, I. M., Ferrier, I. N., Baldwin, R., Cowen, P. J., Howard, L. M., Lewis, G., Matthews, K., McAllister-Williams, H., Peveler, R. C., Scott, J. L., et al. (2008) · Journal of Psychopharmacology · doi:10.1177/0269881107088441 · Cited by 909
Harbord, R. M., & Higgins, J. P. T. (2008) · The Stata Journal: Promoting communications on statistics and Stata · doi:10.1177/1536867x0800800403 · Cited by 897
“The second example is drawn from a systematic review of 10 randomized controlled trials of exercise as an intervention in the management of depression (Lawlor and Hopker 2001).”
BackgroundMethodWhooley, M. A. (2008) · JAMA · doi:10.1001/jama.2008.711 · Cited by 887
Depression as a Risk Factor for Coronary Artery Disease: Evidence, Mechanisms, and Treatment
Lett, H. S., Blumenthal, J. A., Babyak, M. A., Sherwood, A., Strauman, T. J., Robins, C., & Newman, M. F. (2004) · Psychosomatic Medicine · doi:10.1097/01.psy.0000126207.43307.c0 · Cited by 847
“In addition, there is preliminary evidence, mostly from noncontrolled trials, that exercise is an effective treatment for depression (74,151).”
BackgroundPhysical Activity Reduces the Risk of Subsequent Depression for Older Adults
Strawbridge, W. J. (2002) · American Journal of Epidemiology · doi:10.1093/aje/kwf047 · Cited by 818
“Results from intervention trials involving physical activity and depression have been equally inconsistent; a recent meta-analysis concluded that the reviewed results were contradictory and had serious methodological difficulties such as lack of concealment for treatment allocation, blinding of results, and intention-…”
ResultUpdating the evidence that physical activity is good for health: an epidemiological review 2000–2003
Bauman, A. E. (2004) · Journal of Science and Medicine in Sport · doi:10.1016/s1440-2440(04)80273-1 · Cited by 768
Tobacco use and cessation in psychiatric disorders: National Institute of Mental Health report
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The benefits of exercise for the clinically depressed
Craft, L. L., & Perna, F. M. (2004) · The Primary Care Companion For CNS Disorders · doi:10.4088/pcc.v06n0301 · Cited by 692
“Characteristics of 37 Studies Included in Exercise and Depression Meta-Analysesa Study Characteristic No. of Studies Sample size, N < 30 21 30–60 10 > 60 6 Subject assignment Stratified/block random 8 Random 19 Intact groups 1 Single group (pre/post) 9 Depression measureb Beck Depression Inventory 25 Zung Self-Rating…”
BackgroundPhysical activity and likelihood of depression in adults: a review
Teychenne, M., Ball, K., & Salmon, J. (2008) · Preventive Medicine · doi:10.1016/j.ypmed.2008.01.009 · Cited by 677
Interventions for promoting physical activity
Foster, C., Hillsdon, M., Thorogood, M., Kaur, A., & Wedatilake, T. (2005) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003180.pub2 · Cited by 692
Exercise Interventions for Mental Health: A Quantitative and Qualitative Review.
Stathopoulou, G., Powers, M. B., Berry, A. C., Smits, J. A. J., & Otto, M. W. (2006) · Clinical Psychology: Science and Practice · doi:10.1111/j.1468-2850.2006.00021.x · Cited by 663
A solution to minimum sample size for regressions
Jenkins, D. G., & Quintana-Ascencio, P. F. (2020) · PLOS ONE · doi:10.1371/journal.pone.0229345 · Cited by 665
“This fundamental problem contributes to uncertainty in subjects as disparate as benefits of exercise [53], linkage between binge drinking and heart disease [54], ecological disturbances [8,55,56,57] and the relationship between natural diversity and habitat area [9,58].”
BackgroundNeurogenesis and Exercise: Past and Future Directions
van Praag, H. (2008) · NeuroMolecular Medicine · doi:10.1007/s12017-008-8028-z · Cited by 645
“1999; Gobbo and O’Mara 2005) and depression (Babyak et al. 2000; Lawlor and Hopker 2001).”
BackgroundContemporary behavioral activation treatments for depression: Procedures, principles, and progress
Hopko, D. R., Lejuez, C. W., Ruggiero, K. J., & Eifert, G. H. (2003) · Clinical Psychology Review · doi:10.1016/s0272-7358(03)00070-9 · Cited by 634
“There also are data to suggest that exercise (e.g., jogging) may serve an antidepressant function, though further research is necessary to support this hypothesis (Bodin & Hartig, 2003; Lawlor & Hopker, 2001; Lox, Martin, & Petruzzello, 2003).”
BackgroundExercise and the brain: something to chew on
van Praag, H. (2009) · Trends in Neurosciences · doi:10.1016/j.tins.2008.12.007 · Cited by 599
“Physical activity also activates the monoamine system [89] and promotes recovery from depression [9].”
BackgroundPsychological Balance in High Level Athletes: Gender-Based Differences and Sport-Specific Patterns
Schaal, K., Tafflet, M., Nassif, H., Thibault, V., Pichard, C., Alcotte, M., Guillet, T., Helou, N. E., Berthelot, G., Simon, S., et al. (2011) · PLoS ONE · doi:10.1371/journal.pone.0019007 · Cited by 551
“The literature already strongly supports the anti-depressive benefits of physical exercise [1], and our results show that lower depression rates are also found within high level sport.”
ResultThe Antidepressive Effects of Exercise: A Meta-Analysis of Randomized Trials
Rethorst, C. D., Wipfli, B. M., & Landers, D. M. (2009) · Sports Medicine · doi:10.2165/00007256-200939060-00004 · Cited by 541
Bauer, M., Pfennig, A., Severus, E., Whybrow, P. C., Angst, J., Möller, H.-J., & Šon behalf of the Task Force on Unipolar Depressive Disorders (2013) · The World Journal of Biological Psychiatry · doi:10.3109/15622975.2013.804195 · Cited by 632
“The effectiveness of this treatment strategy could not be analysed in an early meta-analysis because of a lack of good quality studies (Lawlor and Hopker 2001).”
BackgroundKennedy, S. H., Lam, R. W. M., Parikh, S. V., Patten, S. B., & Ravindran, A. V. (2009) · Journal of Affective Disorders · doi:10.1016/j.jad.2009.06.043 · Cited by 529
“, 2001) noted that a meta-analysis did not find clear evidence of benefit for exercise versus no treatment (Lawlor and Hopker, 2001).”
BackgroundStreeter, C. C., Whitfield, T. H., Owen, L., Rein, T., Karri, S. K., Yakhkind, A., Perlmutter, R., Prescot, A. P., Renshaw, P. F., Ciraulo, D. A., et al. (2010) · The Journal of Alternative and Complementary Medicine · doi:10.1089/acm.2010.0007 · Cited by 532
“The results of exercise as a treatment for mild to moderate depression compare favorably to psychotherapy and pharmacologic treatment, supporting the contention that a behavioral intervention can have an effect similar to a pharmacologic intervention on mood.(11) This study extends the findings of self-reported mood c…”
The longitudinal effects of depression on physical activity
Roshanaei-Moghaddam, B., Katon, W. J., & Russo, J. E. (2009) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2009.04.002 · Cited by 540
“aerobic exercise has also been found to improve depressive symptoms in most, but not all, treatment studies [27–29].”
ResultExercise and the Treatment of Clinical Depression in Adults: Recent Findings and Future Directions
Brosse, A. L., Sheets, E. S., Lett, H. S., & Blumenthal, J. A. (2002) · Sports Medicine · doi:10.2165/00007256-200232120-00001 · Cited by 505
“[134-136] In the most recent meta-analysis, Lawlor and Hopker[135] found that exercise was associated with a greater reduction in depressive symptoms when compared with no treatment, and was as effective as cognitive therapy.”
BackgroundMethodResultInfluentialHigginson, I. J., Finlay, I. G., Goodwin, D. M., Hood, K., Edwards, A., Cook, A., Douglas, H.-R., & Normand, C. E. M. (2003) · Journal of Pain and Symptom Management · doi:10.1016/s0885-3924(02)00599-7 · Cited by 504
Sedentary Behavior and Depression Among Adults: A Review
Teychenne, M. J., Ball, K., & Salmon, J. (2010) · International Journal of Behavioral Medicine · doi:10.1007/s12529-010-9075-z · Cited by 529
Yoga for depression: the research evidence
Pilkington, K., Kirkwood, G., Rampes, H., & Richardson, J. (2005) · Journal of Affective Disorders · doi:10.1016/j.jad.2005.08.013 · Cited by 495
“Systematic reviews on the effect of exercise in general on depression have reported differing conclusions: Craft and Perna, 2004 and North et al., 1990 concluding that exercise results in overall benefit while Lawlor and Hopker (2001) concluded that the evidence was insufficient.”
ResultIntegrating Physical Activity Into Mental Health Services for Persons With Serious Mental Illness
Richardson, C. R., Faulkner, G., McDevitt, J. H., Skrinar, G. S., Hutchinson, D. S., & Piette, J. D. (2005) · Psychiatric Services · doi:10.1176/appi.ps.56.3.324 · Cited by 517
“1 (39) for exercise compared with no treatment for depression, and both meta-analyses showed effects for exercise that were similar to those found from other psychotherapeutic interventions.”
ResultPhysical exercise intervention in depressive disorders: Meta‐analysis and systematic review
Josefsson, T., Lindwall, M., & Archer, T. (2014) · Scandinavian Journal of Medicine & Science in Sports · doi:10.1111/sms.12050 · Cited by 483
“Lawlor (2001) replied to some of this criticism by stating that poor methodological quality (inadequate allocation concealment, no intention-to-treat analyses, and lack of blinding) is estimated to exaggerate the treatment effect by 20–40%.”
BackgroundSex differences in stroke recovery.
Lai, S., Duncan, P. W., Dew, P., & Keighley, J. D. (2005) · Europe PMC (PubMed Central) · Cited by 460
The Effect of Exercise Training on Anxiety Symptoms Among Patients: A Systematic Review
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Longitudinal gains in self‐regulation from regular physical exercise
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“Regular physical activity has all kinds of positive benefits and has been linked to improvedmood,resistancetophysicalfatigueandothers( LawlorH Pollock VWhite& Sherman,1999).Anyor allofthesemight generate theobserved positiveresults.Somerecentresearch,however,foundthatpositivemoodproducedacost in terms of increased dis…”
BackgroundPhysical activity in the prevention and treatment of anxiety and depression.
Martinsen, E. W. (2008) · Nordic Journal of Psychiatry · doi:10.1080/08039480802315640 · Cited by 424
“72, while Lawlor and Hopker (26) reported an effect size of 1.”
BackgroundInfluentialExercise and the treatment of depression: A review of the exercise program variables
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“Given the difficulty in translating outcomes from studies using continuous variables such as BDI scores in clinical practice, Lawlor & Hopker (2001) exhort researchers to use more dichotomous (i.”
BackgroundMethodResultInfluentialObesity Among Those with Mental Disorders
Allison, D. B., Newcomer, J. W., Dunn, A. L., Blumenthal, J. A., Fabricatore, A. N., Daumit, G. L., Cope, M. B., Riley, W. T., Vreeland, B., Hibbeln, J. R., et al. (2009) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2008.11.020 · Cited by 403
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All about running: synaptic plasticity, growth factors and adult hippocampal neurogenesis
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“Indeed, the changes in monoamines with exercise are of particular interest as physical activity has been shown to lead to recovery from depression (Lawlor and Hopker 2001).”
BackgroundMather, A. S., Rodriguez, C., Guthrie, M., McHarg, A. M., Reid, I., & McMurdo, M. E. T. (2002) · The British Journal of Psychiatry · doi:10.1192/bjp.180.5.411 · Cited by 370
Exercise as Treatment for Anxiety: Systematic Review and Analysis
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Effects of Socioeconomic Status on Physical and Psychological Health: Lifestyle as a Mediator
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“For instance, risk behaviors, such as smoking, have been reported to be associated with poor mental health [16]; by contrast, health-promoting behavior, such as taking physical exercise, have been recommended as an effective intervention to relieve depression [17].”
BackgroundBauer, M., Whybrow, P. C., Angst, J., Versiani, M., Möller, H., & WFSBP Task Force on Treatment Guide (2002) · The World Journal of Biological Psychiatry · doi:10.3109/15622970209150599 · Cited by 342
“However, a recent meta-analysis concluded that the effectiveness of exercise in reducing symptoms of depression cannot be determined to date because of a lack of good quality research on clinical populations (Lawlor and Hopker 2001).”
BackgroundMarkowitz, S. M., Friedman, M. A., & Arent, S. M. (2008) · Clinical Psychology Science and Practice · doi:10.1111/j.1468-2850.2008.00106.x · Cited by 365
“…on depression has generated particular interest, with at least six meta-analytic reviews conducted on the topic since the 1990s (Calfas & Taylor, 1994; Craft & Landers, 1998; Kugler, Seelback, & Kruskemper, 1994; Lawlor & Hopker, 2001; McDonald & Hodgdon, 1991; North, McCullagh, & Tran, 1990).”
BackgroundRimer, J., Dwan, K., Lawlor, D. A., Greig, C. A., McMurdo, M., Morley, W., & Mead, G. E. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004366.pub5 · Cited by 330
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“Of the three remaining meta-analyses that did calculate pooled effect sizes controlling for the degree of change in no-exercise control groups, one reported no effect (Lawlor & Hopker, 2001), and two a positive effect (Netz, Wu, Becker, & Tenenbaum, 2005; Schechtman & Ory, 2001).”
BackgroundInfluentialExercise and depression: A review of reviews
Daley, A. (2008) · Journal of Clinical Psychology in Medical Settings · doi:10.1007/s10880-008-9105-z · Cited by 324
“Other reviews and meta-analyses have included only RCTs. Specifically Lawlor and Hopker (2001) included only RCTs where participants had been diagnosed with depression.”
BackgroundMethodBlumenthal, J. A., Babyak, M. A., O’Connor, C., Keteyian, S., Landzberg, J., Howlett, J., Kraus, W., Gottlieb, S., Blackburn, G., Swank, A., et al. (2012) · JAMA · doi:10.1001/jama.2012.8720 · Cited by 305
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The Protective Role of Exercise on Stress System Dysregulation and Comorbidities
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Testing Causality in the Association Between Regular Exercise and Symptoms of Anxiety and Depression
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Depressive Symptom Outcomes of Physical Activity Interventions: Meta-analysis Findings
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“Several studies suggest the benefits of being physically active, including reduced likelihood of chronic diseases (Berlin & Colditz, 1990), cognitive decline (Lautenschlager et al., 2008; Rovio et al., 2005), and mental health issues (Lawlor & Hopker, 2001; Netz, Wu, Becker, & Tenenhaum, 2005).”
BackgroundTrejo, J. L., Llorens-Martı́n, M., & Torres‐Alemán, I. (2007) · Molecular and Cellular Neuroscience · doi:10.1016/j.mcn.2007.10.016 · Cited by 297
“Exercise has antidepressant (Farmer et al., 1988; Greenwood et al., 2003; Lawlor and Hopker, 2001) and anxiolytic effects (Dunn et al.”
BackgroundPhysical exercise and clinically depressed patients: a systematic review and meta-analysis
Silveira, H., Moraes, H., Oliveira, N., Coutinho, E. S. F., Laks, J., & Deslandes, A. (2013) · Neuropsychobiology · doi:10.1159/000345160 · Cited by 279
A multicomponent model of the theory of planned behaviour
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Prospective Study of Physical Activity and Depressive Symptoms in Middle-Aged Women
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Physical Activity and the Regulation of Neurogenesis in the Adult and Aging Brain
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“Physical exercise also acts as an antidepressant ( Lawlor and Hopker 2001 ).”
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“Regular physical activity has been linked to improved mood (Lawlor & Hopker, 2001).”
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Exercise and clinical depression: examining two psychological mechanisms
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Effectiveness of complementary and self‐help treatments for depression
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The effects of physical exercise on depressive symptoms among the aged: a systematic review
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Physical activity and mental health: evidence is growing
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Mental health benefits of physical activity
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“…however, have been criticized for involving non-clinical volunteers, brief follow-ups, inadequate experimenter blinding, and lack of proper intention-to-treat statistical analyses, all of which may all have led to an overestimation of the effectiveness of physical activity (Lawlor & Hopker, 2001).”
BackgroundPedersen, B. K., & Febbraio, M. (2005) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2005.04.008 · Cited by 233
“The effectiveness of exercise as an intervention in the management of depression seems promising, although it is premature to conduct firm conclusions (Lawlor and Hopker, 2001).”
BackgroundPoor-Quality Medical Research: What Can Journals Do?
Altman, D. G. (2002) · JAMA · doi:10.1001/jama.287.21.2765 · Cited by 34
Mead, G. E., Morley, W., Campbell, P., Greig, C. A., McMurdo, M., & Lawlor, D. A. (2009) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004366.pub4 · Cited by 364
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Differential effects of acute and regular physical exercise on cognition and affect
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“Moreover, the literature is primarily comprised of retrospective rather than prospective studies (Lawlor and Hopker, 2001; Smith et al., 2010).”
BackgroundCharacterizing Geographic Variation in Well-Being Using Tweets
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“People report feeling better after exercising, and some evidence suggests that it reduces risk of depression and can act as an alternative to drug treatments in treating depression and other disorders (Lawlor and Hopker 2001; Mutrie 2004; Stathopoulou et al. 2006)”
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A pilot study of aerobic exercise as an adjunctive treatment for drug dependence
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“Engaging in exercise has been consistently associated with reductions in depressive symptoms (Craft & Landers, 1998; Dunn, Trivedi, & O’Neal, 2001; Lawlor & Hopker, 2001; Mead et al., 2009) and thus exercise may reduce risk for relapse by reducing depressive symptoms.”
BackgroundDepression and Anxiety in Women With Breast Cancer and Their Partners
Badger, T. A., Segrin, C. G., Dorros, S. M., Meek, P., & López, A. M. (2006) · Nursing Research · doi:10.1097/00006199-200701000-00006 · Cited by 211
“Unauthorized reproduction of this article is prohibited. nonaerobic) and the effect on symptoms; each works equally well (Byrne & Byrne; Lawlor & Hopker, 2001).”
BackgroundQuality of life after spinal cord injury: a meta-synthesis of qualitative findings
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Metadata
- 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
- 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
- bronze
- doi.org
- 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 › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Health Sciences › Medicine › Pharmacology (medical) › 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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