The DOI matches its Crossref record; 84 of the 84 references it cites were found in a registry or an index.
Physical Activity and Incident Depression: A Meta-Analysis of Prospective Cohort Studies
Open accessAbstract
OBJECTIVE: The authors examined the prospective relationship between physical activity and incident depression and explored potential moderators. METHOD: Prospective cohort studies evaluating incident depression were searched from database inception through Oct. 18, 2017, on PubMed, PsycINFO, Embase, and SPORTDiscus. Demographic and clinical data, data on physical activity and depression assessments, and odds ratios, relative risks, and hazard ratios with 95% confidence intervals were extracted. Random-effects meta-analyses were conducted, and the potential sources of heterogeneity were explored. Methodological quality was assessed using the Newcastle-Ottawa Scale. RESULTS: =0.00). Furthermore, physical activity had a protective effect against the emergence of depression in youths (adjusted odds ratio=0.90, 95% CI=0.83, 0.98), in adults (adjusted odds ratio=0.78, 95% CI=0.70, 0.87), and in elderly persons (adjusted odds ratio=0.79, 95% CI=0.72, 0.86). Protective effects against depression were found across geographical regions, with adjusted odds ratios ranging from 0.65 to 0.84 in Asia, Europe, North America, and Oceania, and against increased incidence of positive screen for depressive symptoms (adjusted odds ratio=0.84, 95% CI=0.79, 0.89) or major depression diagnosis (adjusted odds ratio=0.86, 95% CI=0.75, 0.98). No moderators were identified. Results were consistent for unadjusted odds ratios and for adjusted and unadjusted relative risks/hazard ratios. Overall study quality was moderate to high (Newcastle-Ottawa Scale score, 6.3). Although significant publication bias was found, adjusting for this did not change the magnitude of the associations. CONCLUSIONS: Available evidence supports the notion that physical activity can confer protection against the emergence of depression regardless of age and geographical region.
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“Furthermore, physical exercise for approximately 45 minutes per day can significantly reduce the risk of MDD. 320 , 321”
From Major depressive disorder: hypothesis, mechanism, prevention and treatment (2024) · cites this paper as [321]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Finally, self-reported physical activity or exercise interventions may have potential beneficial effects to lower the incidence of depression20 and lower the severity of obstructive sleep apnea and associated comorbidities21.”
From Association of step counts over time with the risk of chronic disease in the All of Us Research Program (2022) · cites this paper as [20]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“There are recent large-scale observational [18] and Mendelian randomisation studies [124] suggesting that higher levels of PA can confer protection against mental disorders.”
From Exercise as Medicine for Mental and Substance Use Disorders: A Meta-review of the Benefits for Neuropsychiatric and Cognitive Outcomes (2020) · cites this paper as [18]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Adjusting for baseline depressive symptoms, body mass index, smoking status, age, gender and other confounds did not alter the findings.”
From A meta-review of "lifestyle psychiatry": the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders (2020) · cites this paper as [29]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“and in children/adolescents (n=3, OR=0.907, 95% CI: 0.836-0.985), adults (n=16, OR=0.787, 95% CI: 0.707-0.877) or older adults (n=16, OR=0.794, 95% CI: 0.726-0.868).”
From A meta-review of "lifestyle psychiatry": the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders (2020) · cites this paper as [29]
The cited source says what the claim attributes to it.
In the citing paper
“Although there was indication of publication bias, adjusting for this did not alter overall findings (OR=0.85, 95% CI: 0.81-0.89).”
From A meta-review of "lifestyle psychiatry": the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders (2020) · cites this paper as [29]
In the citing paper
“Longitudinal studies show that this association is bidirectional, 241,242 but with a stronger time-lagged association of marital discord predicting depressive symptoms than viceversa. 243”
From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [242]
In the citing paper
“The risk of incident depression is estimated to be 21% lower in older adults who engage in PA, especially at moderate to vigorous intensities [442,443].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [443]
In the citing paper
“The risk of incident depression is estimated to be 21% lower in older adults who engage in PA, especially at moderate to vigorous intensities [442,443].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [443]
In the citing paper
“a recent meta-analysis of 49 prospective studies across nearly 267,000 individuals demonstrated that higher levels of PA associated with reduced odds of developing depression [odds ratio (OR) = 0.83, 95% confidence interval (CI) 0.79–0.88] across age groups (2).”
From The Role of Exercise in Management of Mental Health Disorders: An Integrative Review (2021) · cites this paper as [2]
In the citing paper
“Meta-analyses of prospective cohort studies showed that physical activity had a protective effect against the future onset of depression [17], while sedentary time increased the risk of depression [18].”
From Digital Biomarkers for Depression Screening With Wearable Devices: Cross-sectional Study With Machine Learning Modeling (2021) · cites this paper as [17]
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“Studies have shown that physical activity is a protective factor against depression 44 and suicide risk in youngsters 45 which adjusts to smoking but not to other behavioral risks, including unhealthy diet and alcohol.”
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“Physical activity has been suggested to have antidepressant effects [14].”
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Lemos, V. C., Barros, M. B. D. A., & Lima, M. G. (2023) · Revista Brasileira de Epidemiologia · doi:10.1590/1980-549720230009.2 · Cited by 10
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“A previous meta-analysis analyzing the prospective association between physical activity and incident depression found that the older adults with higher physical activity were 21% less likely to present incident depression than the older adults with lower physical activity (Schuch et al., 2018).”
BackgroundAssociation of Low-Normal Free T4 Levels With Future Major Depression Development
Odawara, S., Shimbo, T., Yamauchi, T., & Kobayashi, D. (2023) · Journal of the Endocrine Society · doi:10.1210/jendso/bvad096 · Cited by 7
“and diabetes had an increased risk of major depression, which was consistent with previous observations [32-41].”
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“Further, a meta-analysis of 49 prospective studies found physical activity had a protective effect against the emergence of depression in youths, adults, and elderly persons [41].”
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“PA is recommended for prevention and treatment of depressive episodes (Sutherland, 2019), regardless of age or geographic region (de Oliveira et al., 2019; Schuch et al., 2018).”
BackgroundFeter, N., Caputo, E. L., Leite, J. S., Delpino, F. M., Cassuriaga, J., Huckembeck, C. M., da Silva, C. N., Alt, R., da Silva, M. C., Reichert, F. F., et al. (2022) · Mental health and physical activity · doi:10.1016/j.mhpa.2022.100468 · Cited by 8
“Although the protective effects of physical activity on depression are well established (Schuch et al., 2018), the association between physical activity in different places (e.”
BackgroundMethodInfluentialLuttenberger, K., Najem, C., Rosenbaum, S., Sifri, C., Kind, L., & Baggenstos, B. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20054289 · Cited by 8
“In addition, physical activity can protect against the onset of mental illness [18,19].”
BackgroundSelf-citationTsujita, N., Akamatsu, Y., Nishida, M. M., Hayashi, T., & Moritani, T. (2020) · Nutrients · doi:10.3390/nu12030690 · Cited by 8
“Low PA levels are associated with depression onset [7], while higher PA levels are consistently associated with lower odds of developing depression in the future [8].”
BackgroundThe Impact of Physical Activity on Mental Health Outcomes during the COVID-19 Pandemic
Tao, C. S., Zhu, L., Strudwick, G., Hopkins, J. P., Bennington, M., Fitzpatrick, S., Sachdeva, H., Vanderlinden, L. D., Mushquash, C. J., Bobos, P., et al. (2022) · doi:10.47326/ocsat.2022.03.62.1.0 · Cited by 9
Fanelli, G., Franke, B., Fabbri, C., Werme, J., Erdogan, I., Witte, W. D., Poelmans, G., Ruisch, I. H., Reus, L. M., van Gils, V., et al. (2024) · medRxiv · doi:10.1101/2024.03.07.24303921 · Cited by 7
Mehrabi, F., Amiri, P., Naseri, P., & Azizi, F. (2022) · Archives of Iranian Medicine · doi:10.34172/aim.2022.85 · Cited by 7
“16,50 Further time-varying longitudinal investigations seem essential to clarify this controversy.”
Cho, E. (2024) · Gerontology and Geriatric Medicine · doi:10.1177/23337214241253365 · Cited by 7
“…adults (150 minutes or more of moderate-intensity PA or 75 minutes or more of vigorous-intensity PA per week) compared to those without depression (Schuch et al., 2018), suggesting that higher levels of depression are associated with less frequent PA, one of the most important health-related…”
BackgroundDepression and Its Effect on Geriatric Rehabilitation Outcomes in Switzerland’s Aging Population
Miletić, B., Plisic, A., Jelovica, L., Saner, J., Hesse, M., Šegulja, S., Courteney, U., & Starčević-Klasan, G. (2025) · Medicina · doi:10.3390/medicina61020257 · Cited by 5
“Deterioration in physical health not only significantly impairs quality of life, but also represents a significant barrier in overcoming depression, creating a complex, self-repeating cycle [11].”
Liu, Y., Tong, Y., Huang, G., & Guo, K. (2025) · Scientific Reports · doi:10.1038/s41598-025-07767-z · Cited by 6
“…to the Cognitive Appraisal Theory of Stress and Coping Theory, physical exercise enhances an individual’s self-efficacy 30 , reduces threat appraisal of stressors 31 , and decreases anxiety and ruminative thinking 32 , thereby improving sleep quality 33 and alleviating depressive symptoms 34 .”
Building and strengthening physical activity identity: a theory-informed user-guide
Strachan, S. M., Kullman, S. M., & Rhodes, R. E. (2025) · Health Psychology Review · doi:10.1080/17437199.2025.2550359 · Cited by 9
Mengist, B., Lotfaliany, M., Pasco, J. A., Agustini, B., Berk, M., Orchard, S. G., Ryan, J. L., Owen, A. J., Woods, R. L., McNeil, J. J., et al. (2026) · Journal of Cachexia Sarcopenia and Muscle · doi:10.1002/jcsm.70223 · Cited by 7
“Individuals with depressive symptoms are less likely to engage in physical activity and reduced physical activity is a risk factor for functional impairment [28, 40].”
Exercise and PTSD Symptoms in Emergency Service and Frontline Medical Workers: A Systematic Review
McKeon, G., Steel, Z., Wells, R., Fitzpatrick, A., Vancampfort, D., & Rosenbaum, S. (2021) · Translational Journal of the American College of Sports Medicine · doi:10.1249/tjx.0000000000000189 · Cited by 6
Self-citationGalán-Arroyo, C., Pereira-Payo, D., Hernández-Mocholí, M. A., Merellano-Navarro, E., Pérez‐Gómez, J., Rojo-Ramos, J., & Adsuar, J. C. (2022) · Healthcare · doi:10.3390/healthcare10010100 · Cited by 6
“It has also being observed that physical activity protects against the emergence of depression regardless of age and geographical region [32,33].”
Backgrounddo Nascimento, R. B., Santos, R., Gomes, T. H. S., França, C. N., Rossi, F. E., Natrielli, D. G., Filho, J. C. J., Gil, S. D. S., Stubbs, B., Lafer, B., et al. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192214913 · Cited by 6
Self-citationEnergy Availability, Mental Health, and Sleep Patterns of Athletic Trainers
Torres-McGehee, T. M., Emerson, D. M., Flanscha, A. N., Uriegas, N. A., Moore, E. M., & Smith, A. B. (2023) · Journal of Athletic Training · doi:10.4085/1062-6050-0547.22 · Cited by 10
Kim, S., & Joo, C.-H. (2023) · Medicine · doi:10.1097/md.0000000000033460 · Cited by 6
Sever, S., Harrison, A. S., & Doherty, P. (2023) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2023.111342 · Cited by 6
Interactive effect between sleep and exercise on depressive symptoms in Chinese adolescents
Zou, S., Deng, F., Tan, W., Fu, Y., Zhang, H., Xu, H., Tao, Y., Tang, X., Tang, X., Xiong, P., et al. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1207243 · Cited by 8
“In fact, a meta-analysis of prospective cohort studies found that physical exercise can reduce the incidence of depression among people of all ages (13).”
BackgroundMartins, J., Masoumi, H., Loureiro, V., Gomes, M., Ratinho, F., Ribeiro, T., Mehriar, M., Rakovac, M., Šentija, D., Bahr, A., et al. (2023) · Healthcare · doi:10.3390/healthcare11172395 · Cited by 6
Niven, A. G., & Strain, T. (2023) · Mental health and physical activity · doi:10.1016/j.mhpa.2023.100556 · Cited by 6
“The evidence base for mental health has typically focused on the role of physical activity and sedentary behavior in reducing mental ill-health (3), such as depression (4–8).”
BackgroundTan, Z., Su, L., Chen, X., He, H., & Long, Y. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13030868 · Cited by 6
“Studies with NOS scores of one to three, four to six, and seven to nine are considered to be of low, medium, and high quality, respectively [12,13].”
BackgroundWang, Z., Cao, Z., Min, J., Duan, T., & Xu, C. (2024) · BMJ Evidence-Based Medicine · doi:10.1136/bmjebm-2024-112933 · Cited by 8
The effects of physical activity on adolescents’ depression: evidence from China
Chen, H., Liu, M., Zhao, W., Wei, H., Zhang, Y., & Li, S. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1430145 · Cited by 6
Yuan, W., Yang, T., Chen, L., Zhang, Y., Liu, J., Song, X., Jiang, J., Yang, Q., Wang, R., Guo, T., et al. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.08.026 · Cited by 6
Chen, C., Du, S., Shao, Q., Fu, X., Lin, J., Zhou, S. L., & Li, Y. (2024) · Journal of Bodywork and Movement Therapies · doi:10.1016/j.jbmt.2024.10.068 · Cited by 8
Zheng, J., Xu, J., Wu, Y., & Liu, D. (2025) · BMC Geriatrics · doi:10.1186/s12877-025-05797-w · Cited by 6
“Numerous studies have shown that physical activity is closely related to mental health [54, 55].”
Chekroud, A. M. (2019) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2018.3870 · Cited by 5
Pizzol, D., Smith, L., Koyanagi, A., Stubbs, B., Grabovac, I., Jackson, S. E., & Veronese, N. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16142489 · Cited by 6
“Contrariwise, structured PA is demonstrated to reduce depressive symptoms [19].”
BackgroundSelf-citationDavis, M. E., & McGrane, N. (2021) · Physiotherapy Practice and Research · doi:10.3233/ppr-210512 · Cited by 9
“…only one study [48] measured and demonstrated the significant long-term efficacy of exercise on depression, these findings align with previous research which identified exercise as a protective factor against the reoccur-rence of depressive episodes in depressed adults who remained active [49, 50].”
Lattari, E., Pascouto, A. J. C., Oliveira, B. R. R., Silva, L. S., de Oliveira, A. J., Machado, S. E. D. C., & Neto, G. D. A. M. (2021) · Clinical Practice and Epidemiology in Mental Health · doi:10.2174/1745017902117010198 · Cited by 6
Triolo, F., Saadeh, M., Sjöberg, L., Fratiglioni, L., Welmer, A., Calderón‐Larrañaga, A., & Dekhtyar, S. (2022) · Innovation in Aging · doi:10.1093/geroni/igac041 · Cited by 6
“, 2019) and depression (Schuch et al., 2018) during nonpandemic times (Belvederi Murri et al.”
BackgroundDenche-Zamorano, Á. M., Mendoza-Muñoz, D. M., Pastor-Cisneros, R., Adsuar, J. C., Carlos‐Vivas, J., Franco-García, J. M., Pérez‐Gómez, J., & Mendoza-Muñoz, M. (2022) · Healthcare · doi:10.3390/healthcare10081403 · Cited by 7
“883) [51], in their meta-analysis in 11 cohorts with a total of 69,037 participants, found that higher levels of PA significantly reduced incident anxiety (OR = 0.”
BackgroundStaff perspectives on obesity within a Welsh secure psychiatric inpatient setting
Davies, J. L., Bagshaw, R., Watt, A. A., Hewlett, P., & Seage, C. H. (2022) · The Journal of Mental Health Training Education and Practice · doi:10.1108/jmhtep-06-2022-0050 · Cited by 6
da Costa, B. G. G., van Rooij, A. J., Tuijnman, A., Saunders, T. J., & Chaput, J. (2023) · Journal of Physical Activity and Health · doi:10.1123/jpah.2022-0485 · Cited by 6
da Silva, B. G. C., Menezes, A. M. B., Gonçalves, H., Alves, C. P. D. L., Delpino, F. M., Martins, R. C., & Wehrmeister, F. C. (2023) · Journal of Physical Activity and Health · doi:10.1123/jpah.2022-0658 · Cited by 8
Feng, R., Wang, S., Yu, J., Zheng, X., Chen, W., Wang, X., & Chang, G. (2023) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2023.1226136 · Cited by 6
Correlation Between Obesity and Mental Health Status in Riyadh, Saudi Arabia
Nasser, K. A. A., Alsaffar, Y. K., & Alhazmi, A. (2024) · Cureus · doi:10.7759/cureus.53976 · Cited by 7
“A statistically significant association was found between physical activity and depression; moderate/severe depression was associated with no or once-a-week physical activity and this was found to be in agreement with the findings of the studies [25, 26, 27].”
ResultMcCartan, C. J., Yap, J., Firth, J., Stubbs, B., Tully, M. A., Best, P., Webb, P., White, C., Gilbody, S. M., Churchill, R. C., et al. (2020) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013557 · Cited by 6
“[DOI: 10.1016/j.jad.2016.01.014; PUBMED: 26854964] Schuch 2018 Schuch FB, Vancampfort D, Firth J, Rosenbaum S, Ward PB, Silva ES, et al. Physical activity and incident depression: a meta-analysis of prospective cohort studies.”
BackgroundInfluentialSelf-citationPersonality Traits in Marathon Runners and Sedentary Controls With MMPI-2-RF
Roeh, A., Engel, R. R., Lembeck, M., Pross, B., Papazova, I., Schoenfeld, J., Halle, M., Falkai, P., Scherr, J., & Hasan, A. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.00886 · Cited by 8
Chatzisarantis, N. L. D., Kamarova, S., Twomey, C., Hansen, G., Harris, M. N., Windus, J., Bateson, A., & Hagger, M. S. (2020) · European Journal of Health Psychology · doi:10.1027/2512-8442/a000058 · Cited by 6
Ortaokul öğrencilerinin fiziksel aktiviteye tutum düzeylerinin incelenmesi
Birgün, A., Özen, E., UĞRAŞ, B. S., & PEHLİVAN, B. S. (2020) · International Journal of Mountaineering and Climbing · doi:10.36415/dagcilik.832865 · Cited by 8
Metadata
- Authors
- Schuch, F. B., Vancampfort, D., Firth, J., Rosenbaum, S., Ward, P. B., Silva, E. S., Hallgren, M., Ponce De Leon, A., Dunn, A. L., Deslandes, A. C., Fleck, M. P., Carvalho, A. F., & Stubbs, B.
- Affiliations
- Universidade Federal do Rio Grande do Sul (BR)
- From La Salle University, Canoas, Brazil; the School of Physical Education, Physiotherapy, and Dance and the Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; KU Leuven–University of Leuven, Department of Rehabilitation Sciences, and University Psychiatric Center, Leuven-Kortenberg, Belgium; the NICM Health Research Institute, School of Science and Health, University of Western Sydney, Sydney, Australia; the School of Psychiatry, University of New South...
- ORCID
- Venue
- American Journal of Psychiatry
- Published
- 2018-07-01
- Volume
- 175
- Issue
- 7
- Pages
- 631-648
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W2803008851
- Semantic Scholar
- 4574bb06e26a873ebb0a8607fd5719c390dbe21e
- Cited by
- 1,763
- References
- 84
- Citations by year
- 2026: 270 · 2025: 282 · 2024: 218 · 2023: 254 · 2022: 240 · 2021: 204 · 2020: 158 · 2019: 104 · 2018: 30
- FWCI
- 16.24
- Type
- journal article
- Language
- en
- Open access
- green
- lirias.kuleuven.be
- Licence
- other-oa
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Lirias (KU Leuven) (submittedVersion, other-oa)
- Figshare (submittedVersion)
- Research Portal (King's College London) (submittedVersion, other-oa)
- Research Explorer (The University of Manchester) (submittedVersion)
- Funders
- King's College Hospital NHS Foundation Trust
- National Institute for Health and Care Research (ICA-CL-2017-03-001, APP1123336, NIHR-INF-0685)
- Department of Health and Social Care
- King's College London
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Keywords
- physical activity, depression, incident depression, protective effect, youth, adults, older adults, depressive symptoms, major depressive disorder, age differences, geographic region
- MeSH terms
- Adult, Depression, Female, Humans, Male, Prospective Studies, Risk, Exercise, Incidence, Odds Ratio
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